A mastectomy is one of the three most common treatments for breast cancer, the other two being radiotherapy and chemotherapy. With mastectomy, the whole or part of the breast, muscles, and lymph nodes may be removed during surgery, depending on the spread of cancer.

Post Mastectomy

Cancer is a rather unusual disease since a patient usually enters the process feeling reasonably well, and can come back from medical treatments feeling terrible. However, successful cancer treatment should not be thought of as merely being cancer free, but being cancer free and returning to an active, healthy, and pain-free lifestyle.

After mastectomy, the affected side usually becomes more susceptible to infection. The removal of axillary lymph nodes (under arm) and radiation to the axilla (causing scarring) tends to obstruct the ability to transport lymph fluid, putting a post-mastectomy patient at risk of developing lymphedema (occurring within 6 weeks to 3 years after treatment) and loss of shoulder movement.

The accumulation of fluids in the affected arm may result in sensory impairment, increased size of arm, stiffness, and loss of motion and function. To reduce the risk, avoid injury, and decrease circulation to the affected arm, post-mastectomy rehabilitation is recommended.

Post mastectomy rehabilitation programs

There are a number of different standard procedures of rehabilitation for patients following surgery.

  1. Breast prosthesis and specialty bra
    Following mastectomy, the patient may require custom breast prosthesis, specialty bra, or breast form designed to resemble the breast or breast tissue removed, in order to restore body balance, provide comfort, and offer security and confidence in your wearing experience.

    A few things go into consideration when selecting the best style of specialty bra and/or breast prosthesis, including breast shape, body type, lifestyle, and daily activities. Breast prosthesis also help to prevent neck, shoulder, and back pain.

  2. Pressure garment
    Depending on the extent and area of swelling, your therapist may prescribe a pressure garment to control lymphoedema. Pressure garments work by reducing excessive body fluid entering the tissues and maintaining any previous reduction. In cases where lymphoedema is already present, the pressure garment may be worn for 24 hours, except when bathing or swimming.
  3. Functional activity VIA physical therapy
    To sleep comfortably and perform daily activities, it is important that you restore your active range of motion and active endurance, as well as strengthen the muscles. To achieve this, therapeutic and postural exercise is necessary. In fact, there is robust evidence that physical therapy and exercise can:
    • Reduce swelling and maximize range of motion
    • Speed functional recovery post surgery
    • Reduce and eliminate pain
    • Correct postural imbalance due to surgery
    • Address fatigue, scarring, and fibrosis
    • Help moderate weight gain
    • Improve perceived quality of life

    Everyone has different needs for physical therapy, so you should never start exercising until your doctor allows it, and instructs you on the exact way to do it safely. Wear loose-fitting garments when exercising, and stop as soon as your arm or chest area begins to hurt or swell.

    Some exercises that help to increase your strength and flexibility include: elbow circles, shoulder roll, shoulder shrug, shoulder blade stretch, shoulder pinch, and overhead reach.

  4. Health Qigong program
    Qigong is a form of mind-body intervention that simultaneously exercises the body and mind while addressing a number of ailments and enabling a healthy life. The program is helping to maintain joint flexibility and lymph flow, which can help prevent or control lymphoedema.

Start rehab early
It is important to prevent or control lymphedema as early as possible following surgery to avoid the risk of bacteria and infections. For more information, speak to the Dymanic Physiotherapy team today!


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