After Breast Cancer Surgery Side Effects

Breast Cancer Treatment Complications

Overview

Breast cancer occurs when breast cells grow out of control and form a tumor in the breast. Cancerous or malignant tumors can spread to other parts of the body. Breast cancer mainly affects women, but men can get it too.

Treatment for breast cancer can result in adverse side effects or complications for anyone who is going through it. For example the use of chemotherapy drugs come with a number of side effects. How your body reacts to a treatment plan however, can be different from someone else. It all depends on the type of breast cancer treatment being administered to you. Talk to your doctor if you experience any side effects or complications while being treated for breast cancer.

Side Effects From Breast Cancer Treatment

Breast cancer side effects are symptoms or ailments that develop due to the treatments used or as a result of the disease itself.

Long-term side effects begin during treatment and continue after all treatment is stopped.

Late side effects are symptoms that may appear weeks, months or years after treatment ends.

Side Effects Of Breast Cancer Surgery

Some of the side effects that happen in the first few months after surgery include:

• pins and needles across the chest
• numbness of the armpit and arm surgery may damage nerves causing numbness. This can improve but may not go away completely. Shoulder exercises can help
• seroma fluid may collect in or around the scar and can last up to six weeks after surgery. Your doctor or breast nurse can drain the fluid
• shoulder stiffness exercises can help prevent or manage this. Your physiotherapist or occupational therapist can help
• lymphoedema swelling of the arm, if the lymph nodes in the armpit have been removed
• breast pain
• changes in balance because the weight of one breast is missing
• fatigue, depression and anxiety talk to your medical team about how you can manage these symptoms if they happen.

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Nerve Pain Or Numbness

Following axillary node dissection you may have an area of numbness, particularly down the back of the arm and in the axilla . This may improve over time, although it may be permanent as some of the nerves which supply sensation to the skin are divided during surgery in order to remove the lymph nodes. It’s important to protect the numb area from sunburn, sharp objects or anything that may cause injury.

Looking After Your Drains And Wound

When you leave hospital follow any instructions you are given about caring for your wound. This will vary from hospital to hospital and depends on the kind of surgery you have.

If youre discharged with your drains still in place, they may be regularly checked at home by a nurse or you may be asked to telephone or return to the hospital each day so that the drainage can be checked. This may sound frightening, but if your treatment team suggests it, they will give you all the information and support you need.

You can usually bathe and shower normally following surgery , but its advisable not to use any soaps or deodorant products on or around the area of your wound. The nursing staff on the ward will give you specific advice on caring for your wound and any dressings. They will also make any arrangements for the removal of your stitches if they are not dissolvable.

If you have questions about caring for your wound, or what kind of follow-up care youll receive, contact your breast care nurse or another member of your specialist team.

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Who Can Have Breast

Breast-conserving surgery is a good option for many women with early-stage cancers. The main advantage is that a woman keeps most of her breast. However, most women will also need radiation therapy, given by a radiation oncologist . Women who have their entire breast removed for early-stage cancers are less likely to need radiation, but they may be referred to a radiation oncologistfor evaluation because each patients cancer is unique.

• Are concerned about losing a breast
• Are willing to have radiation therapy and are able to get to the appointments .
• Have not already had that breast treated with radiation therapy or BCS
• Have only one area of cancer in the breast, or multiple areas in one quadrant that are close enough to be removed together without changing the look of the breast too much
• Have a tumor smaller than 5 cm , that is also small relative to the size of the breast
• Are not pregnant or, if pregnant, will not need radiation therapy immediately
• Do not have a gene mutation such as a BRCA or ATM mutation, which might increase your chance of a second breast cancer
• Do not have certain serious connective tissue diseases such as scleroderma or Sjögren’s syndrome, which may make you very sensitive to the side effects of radiation therapy
• Do not have inflammatory breast cancer
• Do not have positive margins

Additional Risks For Women Who Smoke

Using tobacco narrows blood vessels and reduces the supply of blood, nutrients, and oxygen to tissues. Smoking can delay healing in any surgery and is linked to a higher chance of wound complications. This can cause more noticeable scars and a longer recovery time. Sometimes these problems are bad enough that a second operation is needed to fix them. You may be asked to quit smoking a few weeks or months before surgery to reduce these risks. This can be hard to do, so ask your doctor for help. Sometimes your plastic surgeon might choose to delay your surgery until you stop smoking.

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Wire Localization To Guide Surgery

Sometimes, if the cancer in your breast cant be felt, is hard to find, and/or is difficult to get to, the surgeon might use a mammogram or ultrasound to guide a wire to the right spot. This is called wire localization or needle localization. If a mammogram is used you may hear the term stereotactic wire localization. Rarely, an MRI might be used if using the mammogram or ultrasound is not successful.

After medicine is injected into your breast to numb the area, a mammogram or ultrasound is used to guide a thin hollow needle to the abnormal area. Once the tip of the needle is in the right spot, a thin wire is put in through the center of the needle. A small hook at the end of the wire keeps it in place. The needle is then taken out. Once in the operating room, the surgeon uses the wire as a guide to find the part of the breast to be removed.

The surgery done as part of the wire localization may be enough to count as breast-conserving surgery if all of the cancer is taken out and the margins are negative. If cancer cells are found at or near the edge of the removed tissue , more surgery may be needed.

It should be noted that a wire-localization procedure is sometimes used to perform a surgical biopsy of a suspicious area in the breast to find out if it is cancer or not.

There are other ways a surgeon can be guided to the tumor, but these techniques are newer and not used in every facility.

Scar Tissue In The Armpit

Some women develop scar tissue in the armpit after lymph node removal. The connective tissues in the armpit get inflamed, which forms one or more tight bands. This usually happens within the first few weeks or months after the operation.

The scar tissue is called cording or banding or axillary web syndrome. It can feel something like a guitar string. It can extend down the arm past the elbow, possibly as far as the wrist or thumb.

Cording is harmless but can be painful and can limit your arm movement. Massaging the area regularly can help. Tell your breast care nurse if you develop cording. They can refer you to a physiotherapist. They can show you how to massage the area and teach you stretching exercises. It usually gets better within a few months. Taking anti inflammatory painkillers may also help. Speak to your nurse or doctor about taking these.

• National Institute for Health and Care Excellence July 2018

• Early Breast Cancer: ESMO Clinical Practice GuidelinesF Cardoso and others

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Breast Reconstruction Surgery After Breast

Before your surgery, talk to your breast surgeon about how breast-conserving surgery might change the look of your breast. The larger the portion of breast removed, the more likely it is that you will see a change in the shape of the breast afterward. If your breasts look very different after surgery, it may be possible to have some type of reconstructive surgery or to have the size of the unaffected breast reduced to make the breasts more symmetrical . It may even be possible to have this done during the initial surgery. It’s very important to talk with your doctor before the cancer surgery to get an idea of how your breasts are likely to look afterward, and to learn about your options.

What Are Late Effects

Most women have side effects during treatment for breast cancer and for a few weeks after treatment ends. Usually, these side effects get better slowly and then stop. But sometimes side effects do not go away. Or they can develop months or years after treatment.

There are two commonly used terms for these side effects:

• Long-term effects Long-term effects begin during, or shortly after, treatment. They last for more than 6 months after treatment has finished. They may go away on their own, with symptoms getting better over 1 or 2 years after treatment. Or they may be permanent.
• Late effects Late effects are a delayed reaction to treatment. They do not appear during treatment, but can happen months or even years later.

In this information, we use the term late effects to describe both long-term and late effects.

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Chemotherapy For Breast Cancer

This page was reviewed under our medical and editorial policy by Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on May 5, 2022.

Chemotherapy uses drugs that attack and kill cancer cells or slow their division and growth. Chemotherapy drugs for breast cancer may be given in pill form or by injection or infusion and are often used in combination with other cancer treatments, such as breast cancer surgery, radiation therapy or targeted therapy for breast cancer.

When given via injection, chemotherapy treatment is delivered into a vein with a needle quickly, taking only a few minutes. If you receive an infusion, it may take up to several hours. In some instances, you may need to have a central venous catheter such as a PICC line or port installed to provide a more stable infusion site. Whether you receive an injection or infusion, chemotherapy may be administered at your doctors office, in a hospital or at an infusion center.

What You Should Know Before Having Breast

• How much of the breast is removed depends on the size and location of the tumor, your breast size, and other factors.
• Breast-conserving surgery allows a woman to keep most of her breast, but makes it likely she will also need radiation.
• After BCS, most women will have radiation therapy. Some women might also get other treatments, such as hormone therapy or chemotherapy.
• Choosing BCS plus radiation over mastectomy does not affect a womans chances of long-term survival.
• If you think you want breast reconstruction, talk to your doctor before your breast cancer surgery.
• Not all women with breast cancer can have BCS. Talk to your doctor to find out whether BCS is an option for you.
• Side effects of BCS may include pain, a scar and/or dimple where the tumor was removed, a firm or hard surgical scar, and sometimes lymphedema, a type of swelling, in the arm.

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The Side Effects Of Breast Reconstruction

As with any surgery, there are some side effects that patients may experience after breast reconstruction. Some side effects are common, such as pain, swelling, and bruising, while risks, like infection, are less common and may not occur in all patients. The following are some side effects patients should be aware of before undergoing breast reconstruction surgery.

Seeking The Right Diagnosis

If you have complaints of pain or discomfort after breast cancer surgery, you may find that it can be hard to get a diagnosis. The surgeon has removed the cancer and the oncologist has done his or her job, but how does the leftover pain get diagnosed and treated?

If you think you may have PMRS, make an appointment with a physiatrist in your area, Dr. Ibanez advises. He or she will need to take a detailed medical and functional history. A comprehensive physical exam, which includes seeing how well you can move, may help your doctor determine if there are underlying problems with your nerves, muscles, or other tissues.

Sometimes, blood tests or an imaging test such as an MRI may be needed. A test called an electromyography can help to see if there is abnormal muscle or nerve function in the area.

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Making Decisions About Breast Reconstruction

After having a complete mastectomy, there are various choices available. Reactions to the loss of a breast or breasts vary from woman to woman, and only you can choose what feels best for you.It is important that you know the advantages and disadvantages of having a reconstruction. Breast reconstruction is a specialised form of surgery and you should talk it over with your breast surgeon first.

Incision And Dressing Care

Your incision, or scar, has both stitches and steri-strips, which are small white strips of tape, and is covered by a gauze dressing and tape or a plastic dressing.

• Do not remove the dressing, steri-strips or stitches. We will remove the dressing in seven to 10 days. We also will remove the sutures in one to two weeks unless they absorb on their own. If the dressing or steri-strips fall off, do not attempt to replace them.
• You may shower one day after the drain is out and if you have a plastic dressing.
• If you have gauze and paper tape, you may remove it two days after surgery and shower after that. Use a towel to dry your incision thoroughly after showering. Be careful not to touch or remove the steri-strips or sutures.
• Bruising and some swelling are common in women after surgery.
• A low-grade fever that is under 100 degrees Fahrenheit is normal the day after surgery.
• You will have a Jackson-Pratt drain after your surgery. This drain is a plastic tube from under the skin to outside your body with a bulb attached to it. Empty the drain two to three times per day or when the bulb is full. Write down the amount drained on a sheet of paper. Your nurse will teach you how to empty your drain. An information sheet on JP drains is included in your binder.
• A home care nurse may be assigned to check your progress at home.

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Accelerated Partial Breast Irradiation

After whole breast radiation or even after surgery alone, most breast cancers tend to come back very close to the area where the tumor was removed . For this reason, some doctors are using accelerated partial breast irradiation in selected women to give larger doses over a shorter time to only one part of the breast compared to the entire breast . Since more research is needed to know if these newer methods will have the same long-term results as standard radiation, not all doctors use them. There are several different types of accelerated partial breast irradiation:

• Intraoperative radiation therapy : In this approach, a single large dose of radiation is given to the area where the tumor was removed in the operating room right after BCS . IORT requires special equipment and is not widely available.

• 3D-conformal radiotherapy : In this technique, the radiation is given with special machines so that it is better aimed at the tumor bed. This spares more of the surrounding normal breast tissue. Treatments are given twice a day for 5 days or daily for 2 weeks.
• Intensity-modulated radiotherapy : IMRT is like 3D-CRT, but it also changes the strength of some of the beams in certain areas. This gets stronger doses to certain parts of the tumor bed and helps lessen damage to nearby normal body tissues.
• Brachytherapy: See brachytherapy below.

When To Contact Us

Contact us for the following problems, any unanswered questions and emotional support needs. Call 353-7070 and ask to speak with a nurse during the day, or the answering service in the evening to reach your doctor or the doctor on call.

• Pain that is not relieved by medication
• Fever more than 100 degrees Fahrenheit or chills
• Excessive bleeding, such as a bloody dressing
• Excessive swelling
• Discharge or bad odor from the wound
• Allergic or other reactions to medication
• Constipation
• Anxiety, depression, trouble sleeping, need more support

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Does A Lumpectomy Tell My Doctor If Cancer Has Spread

During the procedure, your surgeon may also check or remove lymph nodes to see if cancer has spread beyond the breast.

You may have an injection of blue dye or a small amount of radioactive material around the nipple area. This helps your surgeon know which lymph nodes to remove . During surgery the surgeon will make a separate, small incision in the armpit area to remove a few lymph nodes for the pathologist to check.

The tissue then goes to a laboratory. Specialized tests identify whether or not cancer has spread into the lymph nodes. . These details help your provider know which treatments are most likely to be effective for you. You may get test results several days after your surgery.