October is most importantly, Breast Cancer Awareness and Prevention Month. It also happens to be National Physical Therapy Month. Therefore, we felt it was appropriate to integrate the two and make a blog series based on how the two can integrate. It may seem a bit personal and private, yet it has extreme relevance on females dealing with shoulder pain, upper and lower back pain. This series will focus on surgical interventions of breast tissue and how physical therapy can help alleviate some of the associated pain symptoms.
Cancer is a scary topic and it brings with it a lot of uncertainty. Breast cancer occurs as a result of gene mutations and uncontrolled cell growth that can invade surrounding tissue in the chest wall including lymph nodes, areolar ducts, muscles that lay beneath the breast, as well as the ribs. If the cancer metastasizes (travels) too much or growth is out of control, then invasive surgery (Mastectomy) may be required to remove the cancerous cells as well as the surrounding tissue: lymph nodes and ducts and possibly musculature in some extreme cases.
Mastectomy presents challenges for any patient undergoing recovery because the tissue structure of the shoulder and breast region has been surgically altered, not only requiring healing of the surgical site, but also limitations of ROM dependent on the type of mastectomy and phase of healing. The most common and well researched mastectomy procedures are quite invasive.
Least to most invasive:
- Total (Simple) – removal of all breast tissue, including: nipple, areola, & most skin
- Modified Radical – all tissue removed in a Total (simple), along with lining of some chest muscles, lymph nodes in the upper arms, neck, and armpit.
- Radical – all tissue removed in a Modified Radical mastectomy along with all lymph nodes and all chest muscles. (This type was most common for many years but is not rarely used unless the metastasis of cancer has spread through chest muscles).
There are some newer procedures that are less invasive and more sparing than even the Total mastectomy.
- Skin-sparing & Nipple-sparing: these procedures allow for keeping as much superficial skin while removing the underlying pathologic tissue.
Although these methods may be riskier and not as researched, it allows for the patient to keep more of their body intact and keep their human dignity, which is important for any medical procedure.
Post-Mastectomy surgery, patients can suffer from lymphedema, swelling, phantom pain, range of motion, and strength deficits that physical therapy is very effective at improving.
What about Physical Therapy?? Can it help?? My doctor said I didn’t need to go, so should I??
These are questions we are asked frequently after a mastectomy. It is not well understood what a PT can do, if anything at all. However, from experience, as the testimonials will show in a few weeks, it absolutely can help.
PT can help post-mastectomy surgery by helping to minimize scar tissue build up. The surgical procedure is intimately related to the muscles of the chest and shoulder, which will get very tight, especially when someone is sitting with their shoulders forward. PT will help to lengthen those tissues and minimize the pulling feeling. It will help with shoulder pain, or minimizing the looming shoulder pain that almost always occurs. PT will also help to minimize back pain that starts since the individual is usually rounded forward, in a slouched posture, much worse than normal.
Furthermore, post-mastectomy, many women suffer from lymphedema issues in their hands and arms. There are specialists who are trained to help minimize this swelling and pain associated with swelling. There are many people and services here for your needs, please allow us to help you find who you are in need of!
In the upcoming weeks, we will discuss the anatomy of reconstructive surgery or enhancement surgery, and the general PT effects with that. Then, we will follow up with a much more intensive PT treatment blog. Followed by testimonials and personal experiences.
If you have any input or questions, please let us know. We are always here to help!
Cancer Sucks. Recovery Doesn’t Have To…Let Us Help!