Since October is Breast Cancer Awareness Month and Pursuit Physical Therapy is sponsoring 2 breast cancer awareness events this weekend, today's post will be about....breast cancer.
Breast cancer and surgery
Breast cancer is now the most frequently diagnosed cancer and the leading global cause of cancer death in women, accounting for 23% of cancer diagnoses and 14% of cancer deaths. Metastatic disease, or the spread of tumor cells throughout the body, is responsible for the vast majority of cancer patient deaths. The decrease in breast cancer-related deaths is mainly attributed in part to improved screening, and the early detection of breast cancer. Unfortunately, many women diagnosed with breast cancer will opt to have some type of surgery. There are different types of breast surgery that are performed and this is fully discussed with the individual and their surgeon.
Following breast surgery, either a mastectomy or involving the armpit, patients will be encouraged to start moving your arm in a controlled range of motion to help prevent the arm from becoming stiff and sometimes painful. There can also be swelling and pain as a result of the procedure. There are many barriers to post-op rehabilitation but a successful outcome is expected and many patients can return to activities 2-4 weeks after surgery. Many of these complaints and post symptoms are common after any surgery but the sometimes arm is affected due to the removal of tissue that involves the chest and the arm.
After your surgery
In general, women having a mastectomy and/or axillary (arm pit) lymph node dissection stay in the hospital for 1 or 2 nights and then go home. However, some women may be placed in a 23-hour, short-stay observation unit before going home.
Less involved operations such as breast-conserving surgery and sentinel lymph node biopsy are usually done in an outpatient surgery center, and an overnight stay in the hospital is usually not needed.
You may have a dressing (bandage) over the surgery site that may wrap snugly around your chest. You may have one or more drains (plastic or rubber tubes) coming out from the breast or underarm area to remove blood and lymph fluid that collects during the healing process. You will be taught how to care for the drains, which may include emptying and measuring the fluid and identifying problems the doctor or nurse needs to know about. Most drains stay in place for 1 or 2 weeks. When drainage has decreased to about 30 cc (1 fluid ounce) each day, the drain will usually be removed.
Most doctors will want you to start moving your arm soon after surgery so that it won't get stiff. Understandably there is some pain after the surgery.
Recovery and Rehabilitation
How long it takes to recover from breast cancer surgery depends on what procedures were done. Most women can return to their regular activities within 2 -4 weeks. It can take up to 4 weeks after a mastectomy. Recovery time is longer if reconstruction was done as well, and it can take months to return to full activity after some procedures. Still, these times can vary from person to person, so you should talk to your doctor about what you can expect.
Even after the doctor clears you to return to your regular level of activity, though, you could still feel some effects of surgery. You might feel stiff or sore for some time. The skin of your chest or underarm area may feel tight. These feelings tend to improve over time. Some women have problems with pain, numbness, or tingling in the chest and arm that continues for a long time after surgery. Many women who have breast-conserving surgery or mastectomy are often surprised by how little pain they have in the breast area. But they are less happy with the strange sensations (numbness, pinching/pulling feeling) they may feel in the underarm area.
Some women have problems with nerve (neuropathic) pain in the chest wall, armpit, and/or arm after surgery that doesn’t go away over time. This is called post-mastectomy pain syndrome (PMPS) because it was first described in women who had mastectomies, but it occurs after breast-conserving therapy, as well. Studies have shown that between 20% and 30% of women develop symptoms of PMPS after surgery. The classic symptoms of PMPS are pain and tingling in the chest wall, armpit, and/or arm. Pain may also be felt in the shoulder or surgical scar. Other common complaints include numbness, shooting or pricking pain, or unbearable itching. Most women with PMPS say their symptoms are not severe.
PMPS is thought to be linked to damage done to the nerves in the armpit and chest during surgery. But the causes are not known. Women who are younger, had a full ALND (not just SLNB), or who were treated with radiation after surgery are more likely to have problems with PMPS. Because ALNDs are done less often now, PMPS is less common than it once was.
It is important to talk to your doctor about any pain you are having. PMPS can cause you to not use your arm the way you should and over time you could lose the ability to use it normally. Post operative physical therapy and rehabilitation can help with any chronic pain, decreased range of motion, fear-avoidance, and strength impairments that may persist after surgery.
Early detection is essential to getting a great outcome, so spread breast cancer awareness. If you happen to receive surgery for your breast cancer, we can help get you. If you have any persistent complaints of pain difficulty using your arm after breast cancer surgery, call Pursuit Physical Therapy at 407-494-8835 or visit us at at PursuitTherapy.com for more information. We can help regain your motion and decrease your pain, and get back to the activities you love!
Come see us on October 20th at the JCC in Maitland from 9am - 1 pm to help support breast cancer awareness with this great fundraiser.
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