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Side Effects Of Surgery For Breast Cancer

Available Or Current Treatment Guidelines:

Side effect of breast cancer surgery becomes concern for some patients

A core panel of cancer rehabilitation experts supported by the American Cancer Society published clinical practice guidelines for breast cancer rehabilitation, including postoperative issues and CIPN.6 While specific to breast cancer, these guidelines can be used as framework for many cancer-related issues that span tumor type. The National Comprehensive Cancer Network has guidelines for clinical practice based on tumor type and common symptoms, such as pain and cancer-related fatigue.7

How Does Lymphedema Start

Lymphedema can occur when the lymph system is damaged, which can prevent the lymph fluid from returning to the blood. For people with cancer, the build-up of lymph fluid can be caused by:

  • Cancer surgery, especially when lymph nodes are removed
  • Radiation therapy that can damage nearby lymph nodes or lymph vessels
  • Infections that damage surrounding tissue or cause scarring
  • Other health conditions, such as heart or vascular disease, arthritis, and eczema
  • Gene changes or mutations that involve the lymph system
  • Injury or trauma to a certain area of the body
  • Increased white blood cells from leukemia

Limited Arm And Shoulder Movement

You might also have limited movement in your arm and shoulder after surgery. This is more common after ALND than SLNB. Your doctor may advise exercises to help keep you from having long-lasting problems .

Some women notice a rope-like structure that begins under the arm and can extend down toward the elbow. This is sometimes called axillary web syndrome or lymphatic cording. It is more common after ALND than SLNB. Symptoms may not appear for weeks or even months after surgery. It can cause pain and limit movement of the arm and shoulder. This often goes away without treatment, although some women may find physical therapy helpful.

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What Is The Right Choice

Sometimes your doctor will recommend a particular treatment for you. Often the decision between mastectomy and breast conservation comes down to your personal choice. Everybody is different and what is right for one person may not be right for another.

You have time to make up your mind. A week or two will not make any difference to how the treatment works. You should take the time to understand your choices and feel comfortable with them.

How Is Chemotherapy Given

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Many different drugs and combinations of drugs can be used to treat breast cancer. Chemotherapy can be taken as tablets or capsules, or injected through an intravenous drip. Chemotherapy for breast cancer is usually given through a drip. The way that treatment is given depends on the specific drugs that are being used.

Chemotherapy is co-ordinated by a medical oncologist and is given by specialist cancer nurses in the chemotherapy unit at a hospital. Chemotherapy is usually given over a few hours as a day-only treatment, so you can go home on the same day. Some women find it helpful to have someone available to drive them home after treatment in case they feel unwell. Chemotherapy is not normally painful although some people find the drip uncomfortable.

Chemotherapy for breast cancer is usually given in treatment cycles. Typically, you would go to the hospital for the day every three weeks and this would be repeated until you have had four or six treatments. Sometimes chemotherapy is given more often than every three weeks, for example it can be given as a weekly cycle for eight to twelve cycles. Your doctor will explain the schedule that has been recommended for you.

The common chemotherapy drugs for breast cancer include:

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Low Blood Cell Counts

Low blood cell counts can lead to anemia, increased infections, and easy bleeding.

For anemia, try to:

To address easy bleeding or bruising:

  • Take extra care going about your daily activities, especially when they come with a risk of nicks, scrapes, and cuts.
  • Remove trip hazards around your home and add padding to sharp furniture edges.
  • Avoid contact sports or strenuous exercise that could lead to injury.

Seeing A Palliative Care Or Anesthesia Pain Specialist

Sometimes a palliative care specialist or an anesthesia pain specialist is part of your treatment team. If not, be sure to ask your oncologist for a referral to a specialist if:

  • Your pain is not controlled
  • You have side effects from the pain medications
  • You would like to discuss more options to manage your pain

Your oncologist can usually follow the specialists recommendations. If the treatment is effective, you wont need to see the specialist again.

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What Are Signs And Symptoms Of Lymphedema

Its important to know the signs and symptoms of lymphedema, so it can be recognized and treated right away.

Common signs and symptoms of lymphedema can include:

  • Swelling in part of the body
  • Skin feeling tight or hard, changing in texture, looking red, or feeling hot
  • New aching, tingling, numbness, or other discomfort in the area. The area might also feel full or heavy.
  • Less movement or flexibility in nearby joints
  • Trouble fitting your arm into a jacket or sleeve, or trouble fitting into or buttoning your pants
  • Collars, rings, watches, and/or bracelets feeling tight even though you havent gained weight

Lymphedema often develops in the arms or legs when surgery or other treatment affects those areas, but it can develop in other parts of the body, too.

  • If lymphedema develops after breast cancer treatment, it can affect the breast, chest, and underarm, as well as the arm closest to the surgery.
  • After cancer in the abdomen or pelvis has been treated, lymphedema may appear as swelling of the abdomen, genitals, or one or both legs.
  • Treatment of tumors in the head and neck area might lead to lymphedema in the face and neck.

Does Your Surgeon Participate In The Breastsurganz Quality Audit

Lymphedema as a Side Effect from Breast Cancer Treatment – SLUCare Breast Surgery

If you are in the process of choosing a surgeon, you may wish to see if there is a surgeon in your area who participates in the BreastSurgANZ Quality Audit.

The Audit collects data and information from breast surgeons across Australia and New Zealand about the treatment and care of women with breast cancer. The Audit was established in 1998 with the purpose of improving the quality of care for women with breast cancer. It now has more than 300 surgeons from Australia and New Zealand participating in the reporting process.

The find a surgeon section of the BreastSurgANZ website has a list of participating surgeons.

Information about some of the research that has resulted from the data collected through the Audit can be found on our BreastSurgANZ Quality Audit page.

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What Is Cancer Coach

Our Cancer Coach support groups are available to anyone who has completed their physical cancer treatment and is experiencing low mood, anxiety and worry, and doesnt know how to move forward in their recovery.

The groups are suitable for people who have previously had a stage 1-3 diagnosis.

The course takes participants through a series of weekly facilitated group sessions, run for a six-week period over the telephone or online video. The sessions take participants through a series of strategies, techniques and exercises that aim to furnish them with the tools, support and coping strategies that can help them on their recovery journey.

Our trained group facilitators talk participants through the negative thought patterns that can linger after treatment ends, how to challenge them, as well as how to manage worries. There is also a chance to talk to others in the group, all of whom are recovering following the end of treatment. This ensures everyone can receive and give valuable peer support and encouragement.

The course is free and completely confidential, accessible via the telephone or online video, from the comfort and privacy of home.

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Keeping Personal Health Records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed. At the conclusion of active treatment, ask your doctor to provide you with a treatment summary and a survivorship care plan.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor, another health care professional, or a specialized survivorship clinic. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences. If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

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Early Predictions Of Outcomes

Regarding surgery, early full ROM and excellent wound healing are predictors of good outcomes. For CIPN, an earlier resolution of symptoms can be predictive of a better overall recovery of sensation and pain, because severe symptoms may persist for longer.4 For radiation effects, early full ROM and minimal skin burning may have a better outcome.

Tips For Managing Chemotherapy Side Effects For Breast Cancer

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  • There are many practical ways to prepare for chemotherapy and its side effects.
  • People who have been through chemotherapy, including MyBCTeam members, are a great resource when preparing to undergo this cancer treatment.
  • Pay attention to how your body feels before, during, and after chemotherapy, and discuss your side effects with your oncology provider.

Chemotherapy is a common treatment for breast cancer, but it unfortunately comes with a range of side effects. If youre nervous about the side effects of chemotherapy, youre not alone. People whove been there, like members of MyBCTeam, have helpful tips and suggestions for dealing with the side effects of chemotherapy.

The side effects of chemotherapy can vary, depending on the type and dose of chemotherapy drug, the length of treatment, and the individual. You may not experience all of the possible side effects of treatment.

Common side effects of chemotherapy include:

  • Trouble concentrating, also known as chemo brain
  • Increased risk of infection

Consider the tips in this article, as well as recommendations from your cancer care team, to help you mentally, emotionally, and physically prepare for chemotherapy treatment.

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Biopsy Of An Enlarged Lymph Node

If any of the lymph nodes under the arm or around the collarbone are swollen, they may be checked for cancer with a needle biopsy, either a fine needle aspiration or a core needle biopsy. Less often, the enlarged node is removed with surgery. If cancer is found in the lymph node, more nodes will need to be removed .

Was All The Cancer Removed

During BCS, the surgeon will try to remove all the cancer, plus some surrounding normal tissue. This can sometimes be difficult depending on where the cancer is located in your breast.

After surgery, a doctor, called a pathologist, will look closely at the tissue that was removed in the lab. If the pathologist finds no invasive cancer cells at any of the edges of the removed tissue, it is said to have negative or clear margins. For women with DCIS, at least 2mm of normal tissue between the cancer and the edge of the removed tissue is preferred. If DCIS cancer cells are found near the edges of the tissue , it is said to have a close margin. If cancer cells are found at the edge of the tissue, it is said to have a positive margin.

Having a positive margin means that some cancer cells may still be in the breast after surgery, so the surgeon often needs to go back and remove more tissue. This operation is called a re-excision. If cancer cells are still found at the edges of the removed tissue after the second surgery, a mastectomy might be needed.

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Returning To Normal Activities

You should be able to return to most of your normal activities within a few weeks of your operation. However, this will vary from person to person and will depend on the type of surgery youve had.

It can help to take things gently at first. You may have more discomfort and stiffness as you begin to move your arm more and become more active. This usually improves naturally over time.

Once you get home from hospital, you can try to do a little more physical activity each day.

Dont set yourself enormous tasks and remember to rest between them. Your body needs time and energy to recover.

Eating well will also help your body recover and your wound to heal.

Hair Loss And Regrowth

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Hair loss can be a distressing side effect of chemotherapy. Your hair may be an important part of how you feel about yourself and losing it can affect your confidence and self-esteem.

Hair loss is almost always temporary and hair usually starts to grow back once chemotherapy has finished, sometimes sooner.

Find out more about breast cancer and hair loss.

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Breast Cancer: Types Of Treatment

Have questions about breast cancer? Ask here.

ON THIS PAGE: You will learn about the different types of treatments doctors use for people with breast cancer. Use the menu to see other pages.

This section explains the types of treatments, also known as therapies, that are the standard of care for early-stage and locally advanced breast cancer. Standard of care means the best treatments known. When making treatment plan decisions, you are encouraged to discuss with your doctor whether clinical trials are an option. A clinical trial is a research study that tests a new approach to treatment. Doctors learn through clinical trials whether a new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug and how often it should be given, a new combination of standard treatments, or new doses of standard drugs or other treatments. Some clinical trials also test giving less drug or radiation treatment or doing less extensive surgery than what is usually done as the standard of care. Clinical trials are an option for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

Cancer Treatment Premature Menopause And Infertility

About a quarter of the nearly 285,000 women diagnosed with breast cancer in the U.S. each year have not gone through menopause.

Some chemotherapy and hormone therapy drugs that treat breast cancer can cause permanent or temporary infertility or early menopause. Women who havenât yet gone through menopause should use birth control while having these treatments, because some chemotherapy drugs are linked with birth defects.

Chemotherapy-induced menopause happens in 10% to 50% of women younger than 40 and in 50% to 94% of women over 40. After chemotherapy, you may have months or even years of uneven ovarian function.

Radiation therapy wonât cause infertility unless it is directed at both ovaries. Depending on the type and extent of the breast cancer, your ovaries may be surgically removed or radiated to lower the amount of estrogen that your body makes. This will cause permanent infertility.

Women with breast cancer who want to start or expand a family later on should consider options to keep fertility before beginning treatment. These include:

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Tips For Easing The Side Effects Of Chemotherapy:

Short-term side effects may be reduced by taking a little extra care of yourself in the days before and after treatment. Your white blood count is lower after breast cancer treatment, which is why many of these short-term side effects happen.

  • Get plenty of rest
  • Eat a balanced diet
  • Try to minimize stress as much as possible.
  • Wash your hands regularly and reduce your exposure to germs while your white blood count is lower.
  • Ask your doctor about flu vaccinations or other precautions you should take during the sick seasons.
  • If hair loss occurs, you may look into options such as a headscarf or wig or speak with your doctor about ways to prevent hair loss.

Make plans to take off work or school in the days following your treatments so you may rest. You may also want to ask a family member or friend to help you for a few days while recovering from the treatments.

For long-term side effects, you may consider some additional planning. For instance, if youre concerned about infertility, then you may want to make arrangements to freeze your eggs before you begin treatment. Your doctor will provide other information regarding managing heart damage or bone thinning.

Nerve Pain After Mastectomy Or Lumpectomy

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In about 25-45 percent of women, the nerves in the surrounding tissues are injured during breast surgery . The more extensive the surgery , the higher the chance of injury tends to be.

This nerve damage can lead to a persistent burning or shooting pain in the area of the surgical scar and/or the underarm area on the affected side. This may be called post-mastectomy pain syndrome. However, women who have lumpectomy can also get this syndrome.

Women who have a port-a-cath or a Hickman catheter inserted for chemotherapy may develop a similar pain around the insertion site.

Treating surgery-related nerve pain

Blocking the nerves with a local anesthetic injection can ease nerve pain after breast surgery.

A lidocaine patch placed over the area can also ease nerve pain. The patch can stay in place for 12-24 hours each day. This is usually enough time to control the pain. Place the patch in the daytime if putting clothes on over the area is difficult. Place it in the evening if the pain keeps you up at night.

Some non-opioid pain medications, such as gabapentin and pregabalin , are specific for nerve pain. If the lidocaine patch doesnt relieve your pain, ask your health care provider whether either of these drugs might help. They are more likely than opioids to relieve this type of pain.

Let your health care provider know if you have burning or stabbing pain or skin sensitivity that lasts for more than a month after surgery.

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