What to do if your breasts hurt after mammoplasty?

Breast cancer is a malignant neoplasm in the breast area. Among all cancer diseases, it occupies a leading position. According to statistics, more than 1,500,000 women around the world suffer from this pathology. Every year, approximately 1,250,000 new cases of breast cancer are registered worldwide, of which 54,000 are in Russia. Rehabilitation physician Emmy Want from Illinois, USA, wrote in the Physical Therapy Journal: “Today, rehabilitation after cancer removal is a rapidly growing area in medicine. And this is not surprising - the number of cancer survivors is increasing every year. According to WHO, the five-year survival rate after breast cancer in the world is 89%, ten-year - 82%, fifteen-year - 77%. In the United States alone, the estimated number of cancer patients is 13 million, and the number of patients with this disease is growing. Given early diagnosis and timely treatment, the number of cancer survivors is growing. This means that the need for rehabilitation measures will also increase”

What does rehabilitation after surgical treatment of breast cancer (BC) include, specialists from the Federal State Budgetary Institution “National Medical Research Center of Oncology named after. N.N. Blokhin" of the Ministry of Health of the Russian Federation and the non-profit service "Clear Morning".

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Rehabilitation doctor, candidate of medical sciences, head of the rehabilitation department Olga Obukhova and rehabilitation doctor Marina Khulamkhanova State Budgetary Institution "National Medical Research Center of Oncology named after. N.N. Blokhin" of the Ministry of Health of the Russian Federation: - The treatment plan for each patient is determined at a consultation with the participation of a surgeon, chemotherapist and radiologist. Treatment of breast cancer includes local treatment (surgery, radiation therapy) and systemic treatment (chemotherapy, hormone therapy, targeted therapy).

Surgery to remove the breast is called a mastectomy. This is usually only part of the comprehensive treatment prescribed to women diagnosed with breast cancer. Its goal is to prevent the spread of the cancer process. Breast removal in women is achieved by completely removing the tissue of the gland itself, the surrounding subcutaneous fat and lymph nodes.

The operation is traumatic for the body, but overall health is restored quite quickly. By the evening after the operation (by agreement with the attending physician), you can sit up in bed and get up on the second day. If your health allows, you can carefully move around the room and go to the toilet on your own. On the 3-4th day after the operation, the state of health becomes normal. The length of hospitalization after surgery averages 10-21 days.

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The questions are answered by the winner of the nomination “BEST ONCOLOGIST” Vitaly Aleksandrovich Skvortsov , doctor of the highest category of the State Clinical Clinical Oncology Department, kmn, oncologist surgeon, mammologist, plastic surgeon

Hemoglobin dropped sharply

QUESTION: Doctor, my mother’s hemoglobin dropped sharply after a mastectomy. What do you recommend? How to raise it? And what caused this? Thank you. ANSWER: Hello! How long ago was the operation? Your mother, most likely, if she recently had surgery, has a hematoma after lymph puncture! Contact the surgeon who performed the operation! Has hemoglobin dropped significantly? He shouldn't fall like that!

Hemoglobin

QUESTION: Vitaly Alexandrovich, I asked you a question about my mother, whose hemoglobin dropped after a mastectomy. 12 days have passed since the operation, hemoglobin is 80. Thank you. ANSWER: Hello! Most likely, your mother was bleeding! But 80 is not enough, we must definitely raise it!

Breast removal

QUESTION: Vitaly Alexandrovich, are the emotional needs of the patient taken into account when deciding to remove the mammary gland? ANSWER: Hello! Many factors are taken into account: from the type of tumor, from the person and his adequate response to the situation, from the future lifestyle! Everything is taken into account! How could we do without this?

Mammary cancer

QUESTION: Vitaly Alexandrovich, does preventive mastectomy—breast removal—increase survival? If it increases, then for what molecular subtypes of cancer? ANSWER: Hello! Of course, you can argue that no gland and no cancer, increasing survival rates! Typically, prophylactic mastectomy is done for Brca1,2,3,4 mutations! But in our country, prophylactic mastectomy is not yet widely used!

How many lymph nodes are removed during a mastectomy?

QUESTION: Vitaly Alexandrovich, how many lymph nodes are removed during a mastectomy? ANSWER: Hello! During a standard operation according to Madden and Patty, 3 levels of lymph nodes in the axillary region are removed - for some it may be 10 lymph nodes, and for others 20 or more.

First shower after mastectomy

QUESTION: Vitaly Alexandrovich, when can you take your first shower after a mastectomy? ANSWER: Hello! The answer is when the doctor allows it, usually after the drainage is removed!

Exercise after breast cancer

QUESTION: Vitaly Alexandrovich, what physical activity is acceptable after a mastectomy? Thank you. ANSWER: Hello! There are loads, but they are dosed. You can read more details in my article on the website. Rehabilitation after breast removal

Dressings after mastectomy

QUESTION: Vitaly Alexandrovich, how long should dressings be done after a mastectomy? ANSWER: Hello! This period is different for everyone, while lymphorrhea lasts, this is normal during a mastectomy. On average 1.5-2 months.

seam seal

QUESTION: Hello, Vitaly Alexandrovich! My question is, 2 months after the mastectomy, my suture became thicker and reddened. Very dense in some areas. Previously there was a thin seam. What could this be and what should I do? ANSWER: Hello! Most often this is a healing process! Up to 6 months it becomes denser, and then vice versa. Red because now it is sprouting vessels and it’s like a reaction! Sometimes inflammation occurs after 2 months, but usually it goes away after local dressings!

Reconstruction of the arm after mastectomy.

QUESTION: Vitaly Alexandrovich, almost 6 months have passed since the mastectomy and my arm is still limited in mobility. What will you advice me? ANSWER: There can be many reasons for this. Do you do exercises and a set of exercises for recovery? We need to look at you, come for a consultation and we will solve this issue! I think it will be useful for you to read my article about how to live after a mastectomy. https://www.skvorsov.ru/blog-breast-cancer/reabilitatsiya-posle-udaleniya-grudi

Pain after mastectomy

QUESTION: Doctor, my mother has had 4 months since her mastectomy, but she still feels pain in the operated area. How normal is this? And how long does the recovery process take? Thank you. ANSWER: Hello! This is normal and natural, you can read in detail on my website information about recovery and pain! We are all different and everyone’s pain lasts differently! I hope everything gets better for your mom soon. On average, pain can last 6 months! https://www.skvorsov.ru/blog-breast-cancer/reabilitatsiya-posle-udaleniya-grudi

Ring after mastectomy

QUESTION: Vitaly Alexandrovich, is it possible to wear jewelry on the operated side after a mastectomy. I mean bracelets on the hand or rings on the fingers. Or it's better not to do this. Thank you. ANSWER: Hello! Of course you can wear jewelry. If you have symptoms of lymphadenitis, then you will not be able to put on the ring, but if you do not have signs of hand swelling, then wear it without problems!

Lymphorrhea after mastectomy

QUESTION: Vitaly Alexandrovich, is there always lymphorrhea after a mastectomy? Is this considered normal? And how long can it last? Thank you. ANSWER: Hello, this is the norm and natural! It lasts differently for everyone - from a month to 3-4 months!

Suture hurts after mastectomy

QUESTION: Vitaly Alexandrovich, 3 months have passed since the mastectomy and the stitch still hurts. Is this a normal option? And this place is still numb. ANSWER: Hello! This is the norm in your case! This is all related to the operation and soon all symptoms should disappear!

Swelling after mastectomy

QUESTION: Vitaly Alexandrovich, I am worried about swelling after a mastectomy. The operation took place 2 months ago. Do I have cause for concern? Thanks a lot. ANSWER: Hello, you have no reason to worry, this is a natural normal process after a mastectomy.

Lymphorrhea after mastectomy

QUESTION: Vitaly Alexandrovich, are there any ways to reduce lymphorrhea after a mastectomy? Thank you. ANSWER: Hello! Surgeons have been trying to combat this problem for many years and, unfortunately, nothing has been invented, only punctures! This process usually goes away later!

Lymphorrhea

QUESTION: Vitaly Alexandrovich, what will happen if the fluid that forms during lymphorrhea is not pumped out? Thank you. ANSWER: Hello, liquid will accumulate under the skin and this will cause discomfort, and the worst thing is that the wound may become inflamed and suppurate!

Arm pain after mastectomy

QUESTION: Vitaly Alexandrovich, more than two months have passed since the mastectomy, but I am still bothered by pain in my arm. How to relieve this arm pain after mastectomy? Thank you. ANSWER: Hello! Pain is a natural state in this case, it can be reduced by taking painkillers! This pain will soon be less!

Sick leave after mastectomy

QUESTION: Vitaly Alexandrovich, for how long is sick leave given after a mastectomy? Thank you. ANSWER: Hello! Usually, a sick leave certificate is given by the attending physician in a hospital and in a clinic at the place of residence, and it is given for the period that is necessary, this period is unlimited!

Mastectomy

QUESTION: Vitaly Alexandrovich, what is a Madden mastectomy? ANSWER: Hello, this is removal of the breast with lymph nodes of all levels in the axillary region for breast cancer!

Compression sleeve after mastectomy

QUESTION: Vitaly Alexandrovich, how long after a mastectomy should I start wearing a compression sleeve? Thank you. ANSWER: Hello! It is not necessary to wear a sleeve after a mastectomy; it is necessary to wear it only if any complications arise, for example, lymphedema!

Chemotherapy

QUESTION: Is it necessary to prepare the body for chemotherapy, when to start and how? ANSWER: Hello, there is no such need, since our body is ready for anything!

Mastectomy

QUESTION: Vitaly Alexandrovich, are there any ways to somehow reduce the secretion of serous and lymphatic fluid after a mastectomy? And what is this process called? The drainage has been in place for the seventh day and a lot of fluid is still accumulating - sometimes less, sometimes more! ANSWER: Hello! I’ll honestly tell you that this problem is hanging in the air and no one knows how to solve it!!! There are many methods for stopping lymphorrhea, as this process is called, but they are all ineffective and lymph still continues to accumulate in the armpit area, but only time stops this process, which on average lasts about 1-2 months! Some surgeons sew flaps of skin to the chest in the axillary region, some inject solutions into this area, but I repeat that this is all pointless! Don't trust anyone who promises otherwise! Everything will pass for you soon, be patient!

Blood in fluid after surgery

QUESTION: Good afternoon! For the second week after a mastectomy, my mother’s drainage has accumulated fluid and blood, the blood is dark, is this normal? Is it possible to remove the drainage if there is little fluid, but there is blood in it. If so, where will this blood go after the drainage is removed? ANSWER: Hello, the question of removing the drainage is decided by her surgeon, it can be from 5 days to 15 days! This is not blood, but ichor, and if it is old blood, then it was a small hematoma under the skin, this happens often and is, in principle, normal! When the drainage is removed, the blood is lysed (the clot will dissolve) and punctures through a needle will remove it all over time!

Histology and immunohistochemistry after mastectomy

QUESTION: Vitaly Alexandrovich, how does histology differ from immunohistochemistry after mastectomy? ANSWER: Hello! Fundamentally different!! Histology is the structure of the tumor, what type of cancer and the damage to the lymph nodes is assessed. Immunohistochemistry is an analysis of the same tumor, which tells how to treat this tumor! Is this studying tumor cell receptors? This is in short words for the average non-medical person!

Suture after mastectomy

QUESTION: Vitaly Alexandrovich, what can you recommend to make the suture after a mastectomy less noticeable. Or is there any special care for the suture immediately after a mastectomy? Thank you. ANSWER: Hello! No special care! The healing process of wounds and sutures depends on you, everyone has different regenerative capabilities, you cannot improve this situation with any ointments! The healing process takes up to 6 months! There are special silicone-based bandages, this is the only way to somehow make the seam less noticeable!

Suture after mastectomy

QUESTION: Vitaly Alexandrovich, good evening! Thank you for your answers to the questions. I have a question for you about the suture after a mastectomy. Maybe you can advise how to make it invisible? Thank you. ANSWER: Hello! You need to watch! Everything is individual! It won’t be possible to make a seam at all! And you can make it minimally visible, observing all plastic principles, remove it and recreate it in a new way! get rid of the so-called “fishbone”!

breast bruise after mastectomy

QUESTION: Good day! My mother had breast cancer in her left breast and had a mastectomy. On the first day, or rather the evening after the anesthesia, she lost consciousness, fell on her chest, there was a bruise all over her chest, she complained that it felt like her chest was pinching; now they clean/wash the wound twice a day. what could be the consequences? ANSWER: Hello! None. Most likely, there was a collapsed state after the operation, this often happens, so we usually tell patients to lie down for the first 24 hours. Blood has accumulated in the area of the postoperative wound and is now a bruise. It's okay and will pass soon.

Mastectomy and fibroadenoma

QUESTION: Vitaly Aleksandrovich, in what cases with fibroadenoma do you recommend mastectomy. Thank you. ANSWER: Hello! Fibroadenoma is a benign disease and a mastectomy is never performed for fibroadenoma, so I do not recommend doing a mastectomy for fibroadenoma, only removing the tumor itself through a minimal incision and an invisible area, so that there is no visible scar in the future.

Mastectomy

QUESTION; Vitaly Alexandrovich, what kind of mastectomy should be performed for breast cancer? Thank you. You can read the ANSWER to your question at the link mastectomy

Mastectomy

QUESTION: Vitaly Alexandrovich, good evening! What is a Madden mastectomy? Thank you. ANSWER: Madden mastectomy is a gentle radical method that involves removing the mammary gland, but preserving the pectoralis minor and major muscles, which allows you to shorten the rehabilitation period and obtain the maximum possible cosmetic effect.

Reconstruction quota

QUESTION: Hello! In July 2020, I had a mastectomy of the right breast (stage 2A cancer). I live in a rural area and there is no oncologist. The attending physician is a surgeon. I wanted to sign up with my attending physician for a quota for breast reconstruction, but the doctor had not heard anything about it. He told me to find out everything about the quota myself and tell him what was needed for this. And he, in turn, will give all the directions that will be needed for the quota. Please explain what is needed to obtain a quota. Where to sign up, who to call? Thank you. ANSWER: Hello! You need to take a referral from an oncologist at your place of residence and go to your regional oncology clinic and get a quota there. Free assistance is provided as part of the compulsory medical insurance at the oncology center at the place of residence.

treatment after mastectomy according to Madenne

QUESTION: Hello Vitaly Alexandrovich! After a mastectomy according to Madenna for TNBC, what kind of chemotherapy is usually given, how much, h/w what is the time from course to course? They also prescribe rays after x/t. ANSWER: Hello! After a mastectomy for triple-negative cancer, any chemotherapy can be used, but in the regimen, taxanes are preferable, the chemotherapist knows this for sure! Taxanes can be prescribed once every 21 days or weekly! For this type of cancer, radiation therapy is also prescribed!

Collecting fluid after a mastectomy

QUESTION: Good afternoon! Today is 10 days after my mastectomy. I was discharged. I'm home. But it seems to me that fluid is collecting in me, a sort of sac appears. Go to the appointment only on the 9th. Is there any reason to panic? We live 250 km from the hospital. ANSWER: Hello! Normally, it should accumulate, if there are no signs of inflammation, and you feel good, then everything is fine and calm on the 9th, go for a dressing!

Mammography

QUESTION: Hello Vitaly Alexandrovich! Please tell me, is it necessary to do mammography (ultrasound) after a mastectomy on the axillary lymph nodes and is it possible to do mammography with an implant? ANSWER: Hello! Mammography for axillary nodes is not performed; only ultrasound of this area is performed. For implants, it is necessary to perform an MRI of the mammary glands, since this method is informative in this case, but mammography is not.

Airplane and mastectomy

QUESTION: Good evening! Is it possible to take a long flight on an airplane? ANSWER: Hello! Of course, you can take long flights after a mastectomy. This will not affect your illness in any way.

Mastectomy and sports

QUESTION: Doctor, hello! Can you please tell me when can I do TRX after a mastectomy? There was slight swelling of the arm on the side of the operation. Thank you. ANSWER: Hello! TRX training is not contraindicated for you in principle. It all depends on when the mastectomy was! How long ago and how much did your hand swell? If more than 3 months have passed, then you can gradually dosage it; if it starts to swell again, then you need to stop and take measures to prevent lymphedema!

RMJ

QUESTION: Good afternoon! On January 16, 2019, a sectoral resection was performed for a suspected fibroadenoma. A routine histological examination revealed infiltrative lobular breast cancer, grade 2 malignancy. In an immunohistochemical study, the reaction with antibodies to estrogen receptors is positive in 65% of tumor cell nuclei (intense staining) (7 points (TS) Allred score), the reaction with antibodies to progesterone receptors is positive in 80% of tumor cell nuclei (intense staining) (8 points (TS) Allred score), reaction with antibodies to the oncoprotein cerb - B2 0. Reaction with antibodies to Ki-67 is positive in 23% of tumor cell nuclei. On February 20, 2019, a Madden radical mastectomy was performed with plastic surgery of the axillary-subclavian region using a composite graft. Histological examination: At the site of the removed sector of the mammary gland there is lipogranuloma. Fmbrocystic disease of the breast: periductal fibrosis, ductal ectasia. No tumor cells were found. The nipple is of normal structure. No tumor cells were found in 17 axillary lymph nodes. No tumor cells were detected in 1 subclavian lymph node. The chemotherapy doctor prescribed treatment with Tamoxifen 20 mg per day for 7 years. Please decipher the histology after a mastectomy in simple language. Is it always the case that during a Madden mastectomy, so many lymph nodes are removed, because no cancer cells were found in them? And another question: Tamoxifen was prescribed, but I am allergic. The allergy manifests itself in the form of a skin rash. At the moment, it is most severe at the site of the postoperative suture. Everything is red and very itchy. Is it possible to replace the drug with something? 51 years old, menopause (about half a year ago I had spotting menstruation, the Chemotherapist claims that menopause is not yet stable). ANSWER: Hello! During mastectomy, all axillary lymph nodes are removed: they can be from 4-6 to 23 nodes, their number is different for everyone, red manifestations and itching in the area of the postoperative scar are not associated with allergic manifestations of tamoxifen, but with early changes in wound healing. You have early stage cancer and only Tamoxifen is indicated for you. Take this drug, and if after long-term use of 3-4 months this continues, then it must be changed to another drug.

Silicone patches

QUESTION: Good afternoon Vitaly Aleksandrovich, can you recommend which company is better to buy silicone plasters? Thank you in advance. ANSWER: Hello! Today there are already many manufacturers on the market, previously there were several, I recommend not getting hung up on any manufacturer, the main thing is that the bandage has a silicone base, and it doesn’t matter the brand! Find headbands that suit your price on the Internet!

Lump after mastectomy

QUESTION: Hello! A year ago I had breast removal surgery. I get examined once every three months. Now I found a very hard, uneven lump on my chest next to the seam. I often experience spasmodic pain in this area. The pressure has decreased, the pulse is 90-130 at rest. Could it just be a chest spasm? ANSWER: Hello! It could be anything, it is better to contact an oncologist at your place of residence and carry out a series of diagnostic procedures to exclude relapse of the disease. You are examined very often - once every three months!

One and a half years after mastectomy, pain on the operated side

QUESTION: Vitaly Alexandrovich, almost a year and a half has passed since the mastectomy (stage 2). Recovery was normal, without swelling. Exercises, massage, gentle regimen - everything is still being done. And recently, without any clear reasons, without increased stress or a cold, pain appeared again in the entire affected area. For two weeks now my arm and shoulder have been aching, even a small load is unpleasant, but there is no swelling. Can this phenomenon occur periodically? And is it worth increasing exercises and massage? ANSWER: Hello! This may happen, perhaps you have somehow stressed this area, but in this case I would contact an oncologist at your place of residence in order to carry out a set of minimal procedures to prevent tumor progression, since pain may be a manifestation of bone metastasis.

Breast prosthesis

QUESTION: Vitaly Alexandrovich, what is a breast prosthesis? ANSWER: Hello! A breast prosthesis is an artificial device that is inserted into underwear to replace a missing body part, in this case the breast.

Is mastectomy necessary and what is the prognosis?

QUESTION: Good afternoon. I am 43 years old and have been diagnosed with G3 invasive nonspecific carcinoma. IHC - expression of estrogen receptors is weak in 90% of nuclei, expression of progesterone receptors is pronounced and moderate in 80% of nuclei, ki 67 -30%. FISH - Her 2 negative 1+. CT scan showed no metastases. What will be the treatment and prognosis? Is a mastectomy necessary? ANSWER: Hello! The scope of the operation depends on the stage of the disease and the location of the tumor, usually your surgeon looks at it and determines the volume of the operation, this is very individual and breast preservation depends on many factors, it is often possible to perform organ-preserving surgery!

Lymphostasis

QUESTION: Good afternoon, doctor. In March 2020 I had a mastectomy with the removal of 7 lymph nodes. Recently, swelling of the arm and axillary area and severe pain, with anemia, appeared. What could it be? How to relieve unbearable pain. I wanted to make an appointment with you for a consultation in the near future, but I only have an appointment for May 15th. ANSWER: Hello! You need to be looked at to find out the possible cause. It is possible to consult with me by prior arrangement, by calling the phone number indicated on the website, or in any way convenient for you, and also sign up on the oncology center website.

complete breast removal, please tell me this is correct

QUESTION: Hello, Vitaly Alexandrovich! I am 49 years old, I was diagnosed with cancer of the right breast, here are the results of an immunohistochemical study: Strong estrogen expression>10% of tumor cells, strong progesterone expression, 10% of tumor cells, C-erb2 negative, ki67 - 10%. The doctor said complete breast removal, please tell me this is correct. ANSWER: Hello! Breast removal or preservation depends on many factors; in your case, you need to know the size of the tumor, its location and distance from the areola, breast size, one or more tumor nodes, and the type of cancer - lobular or ductal. Knowing these indicators, you can determine the indications for breast removal or conservation. If your surgeon says that only removal, then everything is not so simple for you. Simply being diagnosed with breast cancer is not an indication for breast removal.

Drainage after mastectomy

QUESTION: Hello! After a Madden mastectomy, my mother has a drainage installed, there is already 30 ml, it needs to be removed, and the doctors are on the weekend, since it’s the holidays, what do you recommend to do? Thank you. ANSWER: Hello! This is an important decision that your surgeon makes and it is better to discuss this with your attending physician; it is correct to leave the drain on the weekend, regardless of the volume in ml of the contents.

Severe redness after breast removal

QUESTION: A month has passed since the removal of the left breast, the first chemotherapy, there is severe redness throughout the entire area, it feels hot to the touch, but there is no temperature, what should I do? ANSWER: Hello! It is possible that lymph has accumulated there and needs to be evacuated from under the suture! Contact your treating surgeon!

drainage and blood with odor

QUESTION: Hello. I wanted to ask you, my mother was diagnosed with breast cancer, had surgery, there was a drainage, everything was fine and the fluid came out well, but a week later there was blood with a smell, what could it be. Thank you. ANSWER: Hello! Most likely, ichor with lymph accumulated there and became slightly inflamed and is now beginning to go away. In this case, it is better to contact the attending surgeon.

drainage after mastectomy is leaking

QUESTION: Hello! An operation was performed: radical resection of the mammary gland with regional lymphadenectomy. 6 days have passed, the stitch does not bother me, I am worried that I am leaking lymph from the hole where the drainage tube is sewn. Until yesterday everything was fine, 50 ml in the morning and 50 ml in the evening. Now little flows into the accordion storage tank, 20 ml in the morning, 30 ml in the evening. And it oozes out of the hole, I put a napkin under it, it’s damp. What to do in this situation? ANSWER: Hello! If the drainage does not work and leaks past, then you just need to remove it and that’s it! Contact your surgeon and he will remove your drainage!

the hand is limited in movement

QUESTION: Hello, a month has passed since my mastectomy. I'm doing exercises. But the arm is still limited in movement and hurts from the inside to the elbow. ANSWER: Hello! In general, this is normal, such phenomena can occur for up to 6 months. You need to go to a rehabilitation center and they will prescribe you adequate recovery.

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Beginning rehabilitation after mastectomy

Before discharge from the hospital, patients are given recommendations for further treatment and follow-up. Rehabilitation begins immediately after the operation and includes physical therapy, massage, physiotherapy of various volumes, psychotherapy, and, later, after removal of the stitches, wearing a properly selected prosthesis and underwear. Surgical treatment of a particular volume (organ-preserving or complete removal of the mammary gland) often leads to postoperative complications and functional disorders - a decrease in the range of movements in the upper limb on the side of the operation, swelling (lymphostasis) of the upper limb and chest, pain, poor posture, weakness , soft tissue dysfunction, pain, fatigue.

Complications

If detected early, seroma can be successfully treated, but in the absence of adequate correction, this condition can lead to:

The development of infectious processes - inflammation and suppuration of the wound. A cavity filled with serous fluid is an ideal incubator for the activity of pathogenic bacteria. Moreover, they can get into the wound even with complete sterility during and after surgery. The infection easily spreads throughout the body along with lymph and blood, for example, from chronic lesions in the nasopharynx.
Intensive growth of connective tissue at the site of intervention. As a result, a rough scar may remain on the skin, and if a seroma appears after implantation, the implant subsequently becomes deformed.
The occurrence of a serous fistula. This condition, as we have already found out, increases the likelihood of secondary infection several times.
Sepsis (blood poisoning).

Compression sleeve after mastectomy

Compression therapy is the basis for the treatment and prevention of lymphedema (“lymph stagnation”). Only a rehabilitation specialist can help you choose the right model of compression hosiery. Compression underwear will bring relief to a woman in a short time: it will relieve swelling, reduce pain, thereby increasing the quality of life. When swimming in the pool and doing therapeutic exercises, wearing a compression sleeve is mandatory. But there are some contraindications to compression therapy: erysipelas, severe pain.

Prevention of complications

Most complications after a mastectomy are considered inevitable.

But it is important to detect them in a timely manner:

To prevent bleeding, a special power tool is used that stops bleeding from small vessels.
To prevent infections, skin treatment with a special disinfectant is used.
To prevent the occurrence of lymphostasis, it is necessary to follow the prescribed preventive measures. It is necessary to prevent the possibility of infection.
If you suspect the occurrence of erysipelas, you must visit a doctor in order to begin the necessary therapy.
If lumps, swelling of the breast or arm occur, you should immediately visit a doctor.
Diet, special nutrition.
Exercise therapy and proper breast care.
Under no circumstances should you use your injured arm to draw blood, measure blood pressure, or give injections.

Mastectomy is an effective treatment option. In order to save her life, a woman needs to decide to take such a step. In general, the prognosis after a mastectomy is quite favorable. It is considered favorable when it is detected at an early stage. And also with proper treatment.

In due time, removal of the tumor and a course of therapy can preserve the patient’s normal life for a long time. This disease progresses without treatment, leading to disability and death. A woman who has learned about her illness should set herself up for a good outcome, because this helps in confronting the disease. According to statistics, a favorable outcome in the first stage is about 99.9%, and in the second stage – 80% of recovery.

Exoprostheses and special underwear after mastectomy

Exoprostheses are artificial overlays made of soft materials. They imitate the shape and size of the patient's real breasts. Exoprostheses are selected individually for each woman and are worn continuously after the permission of the attending physician. A correctly selected exoprosthesis will give a woman confidence, and will also become a therapeutic and prophylactic means of rapid post-operative adaptation.

The exoprosthesis compensates for weight imbalance, preventing secondary body deformations such as curvature of the spine, drooping shoulders, and poor posture. It is also worth noting the importance of special underwear that will secure the exoprosthesis. Special bras are worn together with exoprostheses. They provide safety and comfort when wearing exoprostheses.

The straps of special bras are padded, widened in the shoulder area, do not cut into the skin, and reduce pressure on the shoulders, preventing lymphedema. The underwear should fit tightly so that the prosthesis does not change position when moving and bending.

Is it possible to have a massage and when?

If breast augmentation was performed using smooth or saline implants, light breast massage after mammoplasty can begin as early as the sixth day.

Why is it necessary:

space for the implant is preserved. It is placed in a special chest pocket. If the implant is smooth, then the pocket is made larger than its size. As a result of healing, scar tissue forms around it. But sometimes this capsule thickens and begins to compress the implant. This can be prevented with a special light massage;
the implant is perceived by the body as a foreign body, so the immune system reacts in a special way and tries to independently limit the material and give as little space as possible, tightening the skin around it. Thanks to the massage, the implant moves and becomes soft to the touch.

Breast massage must be continued for 6 months. At first, it needs to be done at least 5 times a day, then gradually the number of massages decreases.

In this case, the fingers are placed on top of the implant, and it is gently pushed in a circle.

Find out why swelling occurs after mammoplasty.

Who should undergo mammoplasty? The answer is here.

Time for a silicone prosthesis

Of course, patients are concerned about the question of when they will be able to purchase silicone prostheses. Wearing them is not recommended in the first days after surgery. Silicone prostheses are contraindicated for women undergoing radiation and chemotherapy. During this period, the sensitivity of scars and skin around the stitches increases, and sweating increases. Silicone pads do not absorb moisture well, so they can rub and cause inflammation. We recommend fabric prostheses, which do not irritate the skin and speed up recovery. Today, it is possible to perform reconstructive operations (simultaneous or delayed) using silicone endoprostheses. The tactics of such treatment should be discussed with your doctor.

When to see a doctor

Swelling is not always an expected and normal reaction, so its character must be carefully monitored, the operated area must be inspected daily, and the general condition must be monitored. There are several factors to be wary of:

Changes on the skin. This may be cyanosis or redness, the appearance of a small rash, or local compaction.
Continued increase in swelling a week after mammoplasty.
Purulent discharge from under surgical sutures.
Fever and chills.
Constant burning sensation in the chest after mammoplasty, which did not go away within a week.

It is not necessary to show all the signs. One is enough to go for an unscheduled inspection.

What is prohibited after a mastectomy

There are many recommendations for preventing complications after surgery. It is better to consult with a specialist on this matter in each specific case. To name just a few: DO NOT : measure the pressure on the arm on the side of the operation, wear rings, thick bracelets, watches, sleeves with elastic bands, bags on the elbow or shoulder, lift more than 2 kg with the hand on the side of the operation. DO NOT: sleep on the arm on the side of the operation. DO NOT: take blood or perform infusions on the arm on the side of the operation.

Diet and nutrition after mastectomy

There are no reliably studied diets that would be recommended for women after breast cancer treatment. However, it is better to exclude some foods from the diet: fatty foods, preservatives, alcohol. It is believed that the introduction of omega-3 fatty acids (fish oil), selenium and vitamin D into the diet in daily dosages makes it easier to tolerate antitumor therapy.

Rehabilitation advice from Western specialists. WebMd magazine in rehabilitation focuses on proper nutrition and movement. At the end of 2020, the magazine published the basic rules for selecting a diet for patients after a mastectomy: Eating in small portions will help cope with loss of appetite, nausea, and weakness after surgery. Avoid solid foods at first; it is better to include yogurt and kefir in your diet. Women after a mastectomy need protein, a building material, an “assistant” in restoring strength and fighting infection. Lean meat is rich in protein. Despite the usefulness of cheese and nuts, excessive indulgence in them is fraught with the development of pancreatitis. Antioxidants protect cells from damage. They are found in broccoli, blueberries, carrots, liver, mangoes, tomatoes, and apricots. Western and Russian doctors say that everything is useful, but in moderation. Abuse is unacceptable, because the opposite of the desired effect may occur!
It is also known that there is no panacea for cancer. Treating oncology means being observed by a doctor and strictly following his recommendations.

Sports, cottage, sea after mammary gland removal

Exercising is beneficial for the physical and mental health of women after completion of treatment. Swimming and water aerobics, Nordic walking are especially suitable. Avoid sports that involve repeated energetic, counteracting movements of the hand on the side of the operation (tennis, etc.), strong temperature fluctuations (skis, skates). It is also better to exclude traumatic sports, basketball, volleyball, wrestling.

After removal of the mammary gland, with the permission of the doctor, it is necessary to engage in physical exercise. Weight gain is a chance for breast cancer to return. It's worth starting with walks. The main exercise therapy complex: 1. Before gymnastics, be sure to warm up your muscles: 1) Sitting with your hands on your knees, clench your fingers into a fist as tightly as possible, then unclench, relax and repeat 5-7 times. 2) Sitting, arms bent at the elbows, fingers relaxed: turn the palms with the back side up, then smoothly raise and lower the palms 7-10 times. 3) Hands on shoulders, smoothly raise and lower elbows, 7-10 times. 4) We press our hands to the body, smoothly raise and lower them, 7-10 times. 2. After the warm-up is completed, the main complex. 1) Alternately strain and relax the muscles of the arm. We try to stay in the tension phase for at least 3-4 seconds. 2) Straighten your arm in front of you, then move it to the side and lower it. When stretching, inhale; when lowering, exhale. 3) Hands on the shoulders, smoothly make circular movements clockwise, then counterclockwise. 4) Place your wrists behind your back and slowly stretch your shoulder blades back. 5) Hands are lowered, we alternately make circular movements with the shoulder joint, first clockwise, then counterclockwise. 6) While sitting, we try to raise the arm from the operated side. During the first lessons, you can help her with your other hand. 7) We bend the body to the side of the operated side, linger for a couple of seconds in this position and return to the starting position. When bending, exhale; when straightening, inhale. We lean our backs on the wall, raise our arms and try to spread them to the sides. 9) With your back against the wall, raise your arm from the operated side up and linger in this position for a little while. Each time we try to reach with this hand a little higher than in the previous lesson.

Wear gloves when doing housework, gardening, or other work that may cause even minimal damage. Try to avoid any injury to the arm on the side of surgery (bumps, cuts, sun or other burns, sports injuries, insect bites, scrapes). Traumatization of the skin of the operated hand is dangerous due to infection and the development of erysipelas. Regarding a holiday at sea, climate change (a trip to the south) - discuss with your doctor, because this is decided individually and only after completion of treatment.

Technique for sectoral resection

During the operation, the woman lies on her back. Preparations for general anesthesia are administered intravenously; if local anesthesia is planned, then the tissues in the area of intervention are injected with an anesthetic before the incisions begin until sensitivity is completely lost. The operation lasts approximately half an hour.

The course of the intervention includes several stages:

Marking the surgical field;
Anesthesia;
Treating the skin with antiseptics;
The incisions are made along the marked lines, they are directed from the peripheral parts of the organ towards the nipple, retreating at least three centimeters from the boundaries of the neoplasm; in the case of an abscess, it is permissible to retreat to a smaller distance;
Separation of the pectoralis major muscle and excision of pathologically changed areas;
Hemostasis by ligation of vessels or coagulation;
Installation of drainage, suturing incisions and applying a sterile dressing.

If during the operation there is a need to clarify the malignant potential of a tumor if cancer is suspected, then a fragment of tissue is taken from it and sent for urgent histological examination. It takes no more than 20 minutes, during which the operating team waits for an answer, the woman is under anesthesia, and the wound is covered with a sterile napkin.

sectoral resection technique for breast fibroadenoma

In case of an unfavorable result, the volume of resection is increased, lymphatic collectors are additionally removed, and if cancer is excluded, the surgeon completes the operation and sutures the incisions.

When removing papilloma of the milk duct, additional contrasting with a dye solution under ultrasound control is necessary. The dye indicates how long the duct should be ligated and removed.

Radical resection is more extensive and includes:

Anesthetic instructions, markings on the skin;
The incisions are made at least 3 cm from the outer boundaries of the neoplasia;
Excision of the formation, pectoralis minor and fascia of the pectoralis major muscles;
Continuation of the incision in the direction of the armpit, retraction of the muscle bundles, removal of the axillary, subclavian subscapular lymphatic collectors along with the tissue;
Coagulation of blood vessels, suturing and installation of drainage in the wound.

During the operation, a histological analysis is required; according to indications, the entire gland is removed. After 2-3 weeks, radiation or special hormone therapy is prescribed for sex steroid-sensitive tumors.

For formations of the central part of the mammary gland, multiple papillomas of the milk ducts, central resection can be performed. It is permissible when a woman excludes the possibility of breastfeeding, since it will become impossible. The incision is made along the edge of the areola, then the ducts are crossed and the affected part of the organ is removed.

An option for resection can also be isolated removal of the nipple. It is indicated for adenoma of this area or for diagnostic purposes when cancer is suspected. The nipple is excised in the form of a wedge, the ducts are ligated. Lactation will be difficult or impossible at all.

Wide resections for cancer, even if only part of the organ is removed, inevitably lead to deformation and changes in the appearance of the breast, so they are gradually becoming a thing of the past, giving way to modern options for oncoplastic resections.

Oncoplastic resection involves excision of the diseased tissue followed by plastic surgery to achieve a good cosmetic result. Simultaneous intervention on the second gland is allowed in order to restore symmetry.

Plastic surgery may consist of moving healthy areas of the gland and tissue into the “void” formed at the resection site, excision of the tissue of the opposite gland, etc. In each case, the option of restoring aesthetics is individual, but an indispensable condition for the adequacy of treatment is that the edges of the incisions are clear of tumor cells, and also providing postoperative radiation, which makes resection in oncology a radical operation.

To make the scar after the incisions less noticeable, cosmetic sutures are used, in which the edges are very carefully aligned, the suture thread goes inside the skin without puncturing it. Surgeons with certain skills and qualifications can apply such sutures.

Rehabilitation time after mastectomy

The duration of rehabilitation depends on the functional disorders that arise after surgery. During rehabilitation, good psychological support from family and friends is important. This helps a woman quickly adapt to a new life situation. In oncology, it is very important after treatment to undergo regular follow-up examinations as prescribed by the doctor. After primary treatment, it is recommended to conduct examinations 1 to 4 times a year (depending on the specific clinical situation) during the first 5 years, then annually thereafter.

How long does it take for a stitch to heal?

After breast surgery, special attention should be paid to the stitches . They are treated with iodine, and after ten days, if there are no complications, they are removed. They heal differently, some do not cause any trouble, while others are forced to see the doctor again. Repeated sutures are applied after a mastectomy if the suturing site swells, pulls, diverges and does not heal.

The rapid healing of wounds depends on the progress of the operation, the location of the tumor and the degree of its development, the qualifications of the surgeon and the adherence to his recommendations.

If the stitch does not heal, you need to wear special underwear, apply dressings, avoid hypothermia and overheating, and treat the wound with antiseptics, anti-inflammatory and healing ointments.