chest tightness after mast/ bad scar

Hi!  I'm three months away from bilateral mastectomy, no plans for reconstruction.  Some refer to the tightness as "iron bra" syndrome, especially for those who went through reconstruction during surgey.   Even now, I experience this feeling--- less and less painful, but still very tight, uncomfortable sensation  Scar on left nice straight line (but with a puffed area at its end); my right one sounds very similar to what you are describing.  My surgeon's favorite line was it takes time.... Near my arm-pits I have slight "dog-ear" skin effect.  From what I have read on this site and heard from some ladies who have come before, these are not unusual.  On weekly basis, I see slight visible changes.  I'm half-way through chemo.  When finished, I plan to go to surgeon and have her evaluate the situation to see what additional changes to expect.  (The puffed area is my concern--- she says it is not a seroma; my concern: did she leave something that should not have been left.  My oncologist says no.  Again.... the "in-time-thing".  If you are truly concerned, go see your surgeon now!!!!! 

Hi --

My short answer to tightness is: physical therapy. Specifically, myofascial release. If at all possible -- go for it! 

I had a left-sided mastectomy 8/08, decided against reconstruction for a lot of reasons, including that i'm so tired of surgery (lumpectomy, pelvic floor repair, hernia surgery, plus the mastectomy, all in 15 months). Also, even DIEP doesn't give back sensation... I didn't have chemo, but had rads after the lumpectomy in '07 (the mastectomy was because ADH that showed up when my clinic switched to digital mammograms). So my skin is definitely damaged.

As soon as i knew i was headed for a mastectomy, i asked for a prescrption for physical therapy (it had been really, really helpful after pelvic floor surgery). It's been a godsend! My therapist specializes in pelvic floor and breast problems - does a lot of work with women who've had breast cancer. She says both rads and surgery leave the skin ready to 'stick' to underlying tissue (in the abdomen, tissues sticking together gives adhesions; apparently this is similar). She's been working on me weekly since early November and i feel great, physically. (Adjusting psychologically will take longer...)

The process of freeing skin from the underlying tissues is called myofascial release (and it hurts! I'm usually sore all day.) But my skin moves now, the cordinng in the axilla is almost gone, and i have full range of motion with my left arm. I had dry skin on the ex-breast at one point, in late fall or early winter -- my therapist said it was due to poor ciculation because of the adhesions, and it seems she was right, because as my skin loosened, it stopped being so dry - even tho it's been a cold winter.

The "bad" news is that my PT is actually pleased to see wrinkles around the scar -- says it is means the skin is loose and moveable. And she says i'm lucky to have enough skin over the ex-breast for wrinkles -- some surgeons take too much off, and it can make motion painful. That "extra" skin is not really extra, it just looks wrinkly when my arm is down (like my knee when my leg is straight). So i guess i won't be seeing a plastic surgeon about scar revision ... the volcano where the SNB was is probably also worth keeping, since it does disappear when i stretch my arm above my head. (Why does all this bother me when i'm not interested in reconstruction? But it does.)

Anyway -- even if it's been years -- PT can probably help. My therapist says she's worked with women 3 years out from rads, and it's slower, but it still helps. The adhesions can really mess up your shoulder, too, she says.  

Finally: be sure you go to a therapist who does myofascial release -- this is not something that resolves with exercises. 

hugs!! 

I agree with mouser that PT can be a godsend to help with this tightness. I got a prescription from my rad onc's office and a recommendation for a very good PT department at a hospital near my office. I've been going once a week for a little over a month now and the tightness has slowly been dissolving as we work on stretching the muscles and breaking the adhesions.



I've had two different therapists (first one left after a month to join her fiancé in England). They were both good, but I think I like the technique of the second one better. She seems more involved in working on me physically, massaging the areas that are tight. Plus, she's given me some great exercises to do, adding one a week building on the strengh that has been created.



The scars sound like your surgeon did a skin-sparring mx. The extra skin can be removed and the area left smoother if you decide definitely not to reconstruct. I would give it at least 6 mos - a year from surgery to see how it settles.

margeb,

I hope the silicone prosthesis (breast form) you have becomes easier to wear comfortably as you heal. If not, there are many lightweight silicone forms available these days. Some are even ultra-light. I can't take much weight, so have made it my mission to find forms that look good but are also comfortable. You should be able to find something that both feels good and matches your healthy breast. The Breast Forms section of my non-profit website, BreastFree.org, offers some recommendations for breast forms with comfort features that many women seem to like.

Barbara

Hi Marge,

I'm 60 and am a 2 time breast cancer within 5 yrs.  In June of '05 I had a lumpectomy, left breast, chemo and radiation. I was put on Arimidex. 5% recurrence rate.  I was in the 5%.  In June of '09 my cancer returned, same breast.  So much for Arimidex.  I had a mastectomy and although the pain was well controlled, I've had tightness ever since.  It's as though there isn't enough skin there.  I thought it would go away, I have full motion of my left arm, but am still suffering from the tight feeling.  I have to put a pillow against it every night.  I'm wondering if there is a way the incision could be reopened and sewed again so it's looser.  I also do not have a straight incision and a puffy spot left over.  I didn't have reconstruction, not sure whether I'm sorry or not.  I just wanted you to know that others have the same.  I wish everyone good health and happiness.

Jackie