SYMPTOMS & SIGNS post Breast Cancer Surgery

 

1. Post op swelling:

You may experience some swelling or puffiness over your hand or arm on the operated side.  It is normal and will improve with elevation and exercises.

2. Shoulder tightness:

You may feel your skin and tissue stretch and pull with movement. Be careful not to make sudden and jerky movements until the incision has healed.

3. Axillary/ Arm symptoms :

• Tingling and pulling sensation.
• Numbness on the inner arm
• Stiffness and weakness on the operated arm

4. Axillary web syndrome  (cording) *

• Axillary web syndrome is development of visible or palpable cord like tissue under the axilla, but can extend into medial arm. The exact cause in still unknown but it could likely be due to surgical trauma of the connective tissue that encases the vessels, lymph vessels and nerves.
• It can be painful and limits the range of motion of the affected shoulder. Axillary web syndrome can appear days or weeks after surgery.

5. Lymphedema *

• Lymphedema is swelling of arm, hand, breast or torso as a result of accumulation of protein rich fluid in extracellular spaces.
• It is caused by obstruction or disruption of lymphatic system associated with cancer treatment or extensive cancer metastasis to the axillary nodes.
• It can develop soon after surgery, months or even years later after surgery.
• Symptoms of lymphedema: swelling, tightness, discomfort.
• Ways of reducing risk of lymphedema:
• Maintain healthy body weight
• Skin care
• Use of ‘at risk’ arm normally and regular exercise
• Avoid infection on at risk arm i.e. keep any cut clean and use of antiseptic cream
• Avoid injection/procedure on ‘at risk’ arm

Treatment of lymphedema

• Exercise and prevention
• Manual Lymphatic drainage
• Proper use of compression sleeves and stockings
• Complete Decongestive therapy / Specialised wrapping techniques
• Mechanical pumping devices if necessary

Note : Management of lymphedema is different entity and will need proper assessment and individualized treatment by a trained and certified lymphatic specialist

 

General Guideline for Physiotherapy exercise

• Start exercising slowly and increase, as you feel comfortable.  
• Do the exercise twice a day or as recommended.
• Breathing exercise: Deep diaphragmatic breathing can be practice daily at least 4-6 times a day as it helps to calm and relax your mind. It also helps to reduce pain and discomfort after surgery
• There might be tightness in your chest and armpit commonly develops 2 weeks to 2 months after surgery. This can be normal and gentle movement is recommended to release the muscle tightness. If unsure, please consult your therapist or doctor
• If you develop the following symptoms, do consult your doctor or therapist
• Pain that gets worse
• New heaviness, aching, tightness or unusual sensations
• New swelling around axilla or chest wall (seroma collection is common)
• Develop headache, dizziness, blur vision, numbness or tingling around arms and chest

Physiotherapy - Stretching Exercise