Mastectomy: What Lies Ahead

If you are having a mastectomy as part of your breast cancer treatment or as a preventative measure, your doctors will give you lots of information on what the procedure involves and what to expect. At Live Better With we have put together a list of the most common problems that can arise after a mastectomy to help you be prepared better should you experience any of these.

We have also created a mastectomy guide with more information, tips and useful products that can help you feel more comfortable and confident after a mastectomy.

Pain and altered sensation/sensitivity
It is normal to experience some pain after a mastectomy, but your doctors will prescribe you medications to help reduce this. You may also notice changes to the way your skin feels in the affected area, for example, some people report numbness or tingling. This is usually caused by damage or irritation caused to nerve endings during a mastectomy. Some people also notice that the skin becomes more sensitive to touch after their surgery. All these changes in sensation should settle down with time as the nerves heal. 
 
Scar formation 
As your skin starts to heal it will form a scar. Scar formation is the natural process of healing. Initially, you may notice that the area of skin surrounding the wound becomes raised and red or darker than the surrounding skin, but over time the scar will become flatter and paler in the majority of cases. It usually takes two years for this process to complete, but for some people, this can take longer. In a small number of individuals, excess scar tissue can form, resulting in a thick, raised scar known as a keloid scar. This is usually more common in people with darker skin.

How to reduce scarring:
●    As the area of skin on your chest starts to heal you might notice that it becomes itchy. Avoid scratching it or picking at any scabs that form as this will hinder the healing process and can make the scar worse. 
●    Try covering the wound site with a barrier cream to keep out excessive moisture which can interfere with scar formation
●    Apply silicone gels or sheets to the area to reduce redness and encourage healing
●    Use oils or creams shown to reduce scar tissue formation and improve skin healing
  
Lymphedema 
If you have lymph nodes removed from under your arm as part of your mastectomy, then you are at risk of developing lymphedema in that arm. This is because your lymph nodes drain lymph fluid, and so removing them means there are fewer nodes to drain it away. The lymph fluid can then build up and cause swelling in the affected arm.

The first signs of lymphedema can include:
•    A heavy sensation or an aching discomfort
•    Swelling
•    Fatigue with use
•    Numbness or tingling
In some cases, these symptoms develop before swelling is noticeable so let your doctor or nurse know if you are noticing any of the above.

However, there are lots of things you can do to help control any lymphedema:
●    Use compression sleeves if advised by your doctor
●    Do gentle exercises and weight training to help improve fluid clearance in the affected arm
●    Be careful with skin care to avoid infection of the lymph fluid and keep your skin in good condition
●    Apply specialised massage techniques known as manual lymphatic drainage to help clear excessive fluid

Fluid collection or seromas
Some people may notice a swelling in the area where their breast tissue was removed at around day 7-10 after any drainage tubes have been removed. A collection of fluid called a seroma which is made up of clear bodily fluids is a part of a natural healing process for the body. The body will usually reabsorb this fluid but sometimes if there are excessive amounts the area can become uncomfortable or infected, and your doctor may need to drain it for you.
 
Wound infections
Like any wound, your mastectomy site may become infected. Signs of an infection include redness surrounding the wound site, the skin feeling hot to touch and sometimes you may even notice discharge from the wound itself. If you notice any of these, you'll need to let your doctor or nurse know as you may need treatment with antibiotics.

Live Better With take home message
The complications above might sound daunting but they don’t happen to everyone and the benefit of the procedure far outweighs any potential risks you may experience. If you do notice any of the signs above you'll know what to expect, get help from your doctor or nurse early and find ways to control them better. For further ideas and useful products read Live Better With latest mastectomy guide and look at the new mastectomy products range.

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