Surgery and Chest Discomfort: Length and Remedies Exploration
A mastectomy, the removal of the entire breast, can be a challenging experience for those undergoing the procedure. One common symptom that many patients may encounter is chest tightness. However, it's essential to understand that this sensation is not solely due to the shortening of the pectoralis major muscle.
Chest tightness after a mastectomy arises from a combination of muscular, connective tissue, nerve, lymphatic, and postural factors.
Muscle changes and tension, particularly if implant-based reconstruction is involved, can contribute to chest tightness. Surgical incisions lead to scar tissue, which can restrict movement and cause a feeling of tightness around the chest. Post-surgical swelling of the chest wall and surrounding tissues can create pressure and tightness sensations.
After axillary lymph node removal, tight, rope-like bands of tissue called cording (Axillary Web Syndrome) can form under the arm and extend into the chest area, causing discomfort and tightness. The physical trauma and altered chest contour can also affect posture, leading to muscle strain and tightness.
Nerve damage during surgery can cause sensations of tightness, soreness, or phantom breast pain.
Swelling and bruising that can cause chest tightness can last up to 8 weeks following breast reconstruction. To alleviate chest tightness, a person can be given exercises by their healthcare team. These exercises, which should be done with a physical or occupational therapist and at home as directed, can include raising the affected arm, deep breathing exercises, and opening and closing the hand.
If a person experiences capsular contracture after reconstructive surgery, the chest tightness may not resolve unless a person undergoes surgery to remove the scar tissue. It's important to note that exercises can typically begin 3-7 days after surgery, but it is crucial to wait for a doctor's approval before starting.
Recovery from a mastectomy can take several months, particularly if breast reconstruction is involved. A temporary drain may need to be cared for after a mastectomy, and a doctor will provide instructions for its care, the surgery site, and the wound dressing.
Side effects of a mastectomy can include bleeding, pain and tenderness, numbness, swelling, clear fluid buildup in the wound, shooting pain, and lymphedema. Further treatment after a mastectomy may involve hormone therapy, chemotherapy, targeted therapy, or radiation therapy.
If chest tightness does not decrease with exercise, a person should contact their doctor. It's crucial to remember that understanding the causes of chest tightness after a mastectomy can help in managing and alleviating the symptom, ensuring a smoother recovery process.
[1] American Society of Plastic Surgeons. (2021). Breast reconstruction. Retrieved from https://www.plasticsurgery.org/cosmetic-procedures/breast-reconstruction
[2] Breastcancer.org. (2021). Breast reconstruction: Recovery and side effects. Retrieved from https://www.breastcancer.org/treatment/surgery/reconstruction/recovery
[3] Breastcancer.org. (2021). Axillary web syndrome. Retrieved from https://www.breastcancer.org/treatment/surgery/axillary_web_syndrome
[4] American Cancer Society. (2021). Understanding breast cancer surgery. Retrieved from https://www.cancer.org/cancer/breast-cancer/treatment/surgery/understanding-breast-cancer-surgery.html
[5] Breastcancer.org. (2021). Chest wall pain and tightness after breast cancer surgery. Retrieved from https://www.breastcancer.org/treatment/surgery/chest_wall_pain_and_tightness
- Chest tightness is not solely due to muscle shortening after a mastectomy; it results from a blend of muscular, connective tissue, nerve, lymphatic, and postural factors.
- Scar tissue from surgical incisions can restrict movement and cause chest tightness, particularly if implant-based reconstruction is involved.
- Post-surgical swelling and surrounding tissue pressure can create sensations of chest tightness that can last up to eight weeks.
- Axillary Web Syndrome, tight, rope-like bands of tissue under the arm, can form after axillary lymph node removal and extend into the chest area, causing discomfort and tightness.
- Nerve damage during surgery can lead to sensations of tightness, soreness, or phantom breast pain.
- Exercises prescribed by a healthcare team, such as raising the affected arm, deep breathing exercises, and hand opening and closing, can help alleviate chest tightness.
- In cases of capsular contracture after reconstructive surgery, chest tightness may not resolve without surgery to remove scar tissue, but exercises can typically begin 3-7 days after surgery with a doctor's approval.
