Breast Health and Post Mastectomy Pain
"In the US, 1 in 8 women (12%) will develop breast cancer. In 2020, an estimated 276,480 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 48,530 new cases of non-invasive (in situ) breast cancer. About 2,620 new cases of invasive breast cancer are expected to be diagnosed in men in 2020. A man’s lifetime risk of breast cancer is about 1 in 883." (Breastcancer.org) The majority of breast cancer patients will undergo breast conserving surgery (lumpectomies) or mastectomies. Some elect to have bilateral mastectomies also known as contralateral prophylactic mastectomy.
What kind of problems can I have after a lumpectomy or mastectomy?
Depending on the type of surgery performed, some breast cancer patients can have complications after surgery ranging from scar tissue tightness, decreased shoulder range of motion, neck, upper back and shoulder pain and lymphedema. After you have been cleared by your surgeon, a physical therapist can assess your range of motion, fascial tightness, weakness, spinal alignment and scar tissue to see how they can help you to return to your normal function.
What can I expect from my physical therapy visits?
Your physical therapist will work with you to find an exercise program to improve the range of motion of the shoulder, neck, upper back and ribs. You will learn how to strengthen muscles that may have been affected by surgery or have been deconditioned after your surgery. Your therapist will use manual techniques like Muscle Energy, Strain/Counterstrain, Bowenwork, Craniosacral, and other soft tissue and joint treatments to ease pain and improve flexibility. They will work on your scar tissue to help it to remodel with more flexibility.
What if I have lymphedema?
Please see a certified lymphedema specialist if your primary problem is lymphedema. If you have seen a lymphedema specialist and continue to have lymphedema issues, please contact our office to see one of our therapists for Visceral mobilization, Total Body Lymphatic Balancing ™ technique, Bowenwork or Craniosacral therapy to assist your lymphatic system.
What is cording?
Cording, also known as Axillary Web Syndrome (AWS) can occur after removal of lymph nodes in your armpit. It can show up within days to weeks after surgery and even several months later. It is thought that connective tissue can get inflamed and scar down around blood vessels or nerves causing cordlike structures in your armpit and sometimes down your arm and into the chest wall. If you can feel a tightness in your armpit or see cordlike structures in your armpit, arm or chest wall, contact your physician for a physical therapy referral and we will assess you for cording. The sooner you can get treatment, the easier it will be to treat. Contact us if you have questions.
How soon can I see a physical therapist during my breast cancer treatment?
If you are having general neck, shoulder or upper back pain, with a doctor’s clearance, we can help you with pain in those areas at any phase of your treatment. This will help you to be able to move easier, sleep with less discomfort and continue with your treatments with the least amount of pain. After surgery, you will need your surgeon to clear you to come to physical therapy. Depending on your surgery or your surgeon, this time may vary.
What if I’m having problems with my shoulder, neck or back a year or two after surgery?
Some women seem to notice that their shoulders are getting tighter or they are having difficulties changing clothes or reaching overhead. As soon as you feel that tightness, please check with your physician and get a prescription to see your physical therapist.
What if I have breast pain that is not cancer related?
Always consult your physician if you have breast pain.
Many women have breast implants, reductions or lifts without any complications. If you continue to have tightness or pain after a cosmetic procedure, please consult your surgeon. Once you are medically cleared and have a prescription, your physical therapist can assess you for neck, thoracic and rib dysfunction, scar tissue tightness or soft tissue dysfunction. If you have difficulty sleeping, pain with movement or noticeable tightness, please contact us.
Many women also have breast pain or mastitis related to breastfeeding. Once you have seen your physician, ask for a physical therapy referral. There are manual techniques including Total Body Lymphatic Balancing (™), myofascial release, visceral mobilization and Bowenwork as well as ultrasound to help decrease pain and swelling and improve your breastfeeding time with your baby. Contact us at Healing Hands Physical Therapy, Parkland Plaza, Suite 100, Ann Arbor, MI 48103.