How Physical Therapy Can Help the Challenges After Breast Cancer Surgery

October is Breast Cancer Awareness Month! Breast cancer is a disease where the cells located in the breast grow uncontrollably and is the most common cancer among women in the United States.¹ 240,000 cases of breast cancer are diagnosed in women and 2,100 cases are diagnosed in men each year in the United States.¹ Surgery is a common component for women diagnosed with breast cancer.² Two common types of surgery for breast cancer is breast-conserving surgery and mastectomy.² Breast-conserving surgery is to remove all of the breast tissue that contains cancerous tissue.² Mastectomy is surgery to remove the entire breast including all of the breast tissue and some nearby tissue.² Most patients who undergo breast cancer surgery will not need physical therapy.³ However, some patients may experience decreased range of motion due to pain or tightness, weakness, and lymphedema.³ Physical therapists can help you or loved one after breast cancer surgery in the following ways.

1. Improve Range of Motion: Difficulty moving the arm after surgery can be due to several reasons including pain, tightness, or even mild weakness.³ Physical therapists have a large toolbox to evaluate and treat this problem. Upon examination they may offer you stretching, soft tissue and joint mobilizations, strengthening, and education to return to your prior level of function.

• Reduce Pain: 25 to 60 percent of women who underwent breast cancer surgery experienced some pain or sensations.⁴ Pain or altered sensation can be due to the need to cut nerves in order to perform the surgery.⁴ Patients may experience phantom breast pain, increased sensitivity to pain (hyperalgesia), pain caused by objects that normally do not cause pain (allodynia), and altered sensation including numbness and loss of sensation.⁴ Medications, skin creams, injections, surgery, acupuncture, or physical therapy may be deemed as an appropriate treatment depending on your symptoms.⁴ Physical therapists can prescribe shoulder strengthen and mobility exercises which can help reduce pain.⁴

• Decrease Swelling: The increase in swelling seen from months to years after treatment is called lymphedema. Lymphedema occurs due to some, or all of the lymph nodes being removed during the surgery.⁴ Removal of lymph nodes causes limitations in the flow of fluid called lymph.⁴ The reduce flow of lymph causes fluid to build-up and swelling to occur.⁴ Physical therapists can help drain fluid from the area with manual techniques, provide compression bandaging, create a exercises program to reduce swelling, and educate on how to manage swelling long-term.³ Make sure your physical therapist is trained in lymphedema management if you are experiencing any of these symptoms.

The impairments seen after breast cancer surgery can negatively impact your ability to function in everyday life and participate fully in all the activities you love. Physical therapists are the perfect healthcare providers to help improve range of motion, reduce pain, and decrease swelling after surgery. Contact us today for a free consultation!

References

¹CDC Breast Cancer. Basic information about breast cancer. Centers for Disease Control and Prevention. Published September 14, 2020. https://www.cdc.gov/cancer/breast/basic_info/index.htm#:~:text=Each%20year%20in%20the%20United

²Surgery for Breast Cancer | Breast Cancer Treatment. www.cancer.org. https://www.cancer.org/cancer/types/breast-cancer/treatment/surgery-for-breast-cancer.html

³Articles. Cedars-Sinai. https://www.cedars-sinai.org/health-library/diseases-and-conditions/p/physical-therapy—breast-cancer.html

⁴Coping with pain after breast surgery. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/mastectomy/expert-answers/pain-after-breast-surgery/faq-20058049

⁵Breast Cancer: Lymphedema After Treatment. www.hopkinsmedicine.org. Published June 23, 2022. https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-cancer/breast-cancer-lymphedema-after-treatment#:~:text=Lymphedema%20is%20a%20problem%20that