Radiation is used routinely after lumpectomy but may be used after mastectomy as well, depending on the disease pathology. Radiation therapy causes fatigue, which affects sexual interest and activity. It also may burn the skin on and around the breast, causing pain and discomfort that would preclude caressing these areas. Moreover, the tattoo marks made on the patient’s chest wall to guide treatment may serve as a reminder of the cancer long after treatment is over.