Are the scars painful after healing?

Nope....not painful. A little sensitive because the area where the surgeon removes the mass and enough tissue for clear margins will fill up with fluid until it ends up being replaced by fatty tissue. I had my lumpectomy in July 08, and my surgeon wasn't happy with his margins, so he went back in a week later through the same incision site. I healed up fabulously. I started rads this week, and during my set ups last week, the techs (and rads doctor) were mightily impressed by my scar, being that you can barely see it at all. I'm getting good sensations back as well. 

If she's a candidate for a lumpectomy, do it. Not everyone will experience the same pains or have the same "dramatic" side effects as someone else.

Good luck! 

Robin 

No pain here.  I'm 60, had a radical mastectomy, no reconstruction, etc.  My scar looks like a railroad track from sternum to underarm.  No pain at all.  A little underarm pain, but that's because I had to have a nerve cut during surgery.  Tumor was wrapped around the nerve.  But as far as the scar from surgery goes, there never was any pain, even the day after.   Cora

No pain here either. I'm 61, had a modified radical mastectomy, never had to take so much as an advil. I DID have an anesthetist who suggested he give me a "12 hour pain block" which was an injection in my back just before surgery, said I wouldn't reget it. So I said yes. That was end of July  2008 and I've never had a moment of pain - oh, except when my surgeon pulled out my drainage tube after a month. I could have clobbered him, but just for a minute.

Mayer, as I understand your question, your mom is refusing to have a mastectomy because she thinks it will leave her in life-long pain.  Instead, she is requesting a lumpectomy, but she is planning to refuse the radiation therapy that would ordinarily be done after a lumpectomy.

Before I say anything about the mastectomy question, I want you to be sure that your mom's surgeon discusses the risks associated with declining radiation treatment after a lumpectomy.  You said your mom's tumor was 4 cm, and her lymph nodes were positive.  Even if her tumor was much smaller (say, 1 cm) and none of her lymph nodes were positive, her surgeon and radiation oncologist would probably be recommending radiation as a follow-up to the lumpectomy.  Without radiation, the risk of the cancer recurring is much greater. That is especially true considering the large size of your mom's tumor and the fact that it has already spread to her lymph nodes. 

The most common type of mastectomy done today is the "modified radical mastectomy."  It involves removal of all the breast tissue on the cancerous side, and some of the lymph nodes near the breast, but none of the chest muscle underneath the breast.  That's the main difference between the "modified radical" mastectomy and the now-obsolete "Halstead radical" mastectomy.  A Halstead radical involves removal of pectoral muscles.  Because your mom has positive nodes, she would probably also have an axillary lymph node dissection in which all of the lymph nodes under her arm were removed.

Her surgical incision would most likely be a line across her chest that curved up underneath her arm.  Yes, the surgical site can be painful--but, ironically, the incision itself is usually numb because of the nerves that are cut during the surgery.  Some of those nerves will heal eventually, and the healing process can cause some pain, but it is usually temporary.

I had a mastectomy and removal of 3 lymph nodes (sentinel node biopsy) a year ago.  There is no pain whatsoever on my surgery side anymore.  I've regained some of the sensation in the skin over the incision, but mostly it is still numb.  I had some help from a physical therapist, who made sure I was doing the right kinds of exercises to regain full motion in my arm and to keep the skin and muscles in my chest wall pliable.  My mastectomy scar is a thin, pink line that runs from my breastbone (sternum) to the side of my chest underneath my armpit.

Any surgery can be painful.  I hope your mom doesn't compromise on her care because of her fear of post-op pain.

[Edited:  I just read your other post on another BCO forum. Most of what I said in this post is irrelevant, if your mom has already decided that she does not want radiation or chemotherapy to treat her Stage IIIb cancer.  I hope your family can reach peace with this decision.] 

otter 

I've had both breasts removed and also went through delayed bilateral DIEP and have never had any pain.

Mary Jo

No one says it better than otter when it comes to the facts! That being said...as you can see everyone can be different with what they experience. I had blm with immediate DIEP and while I did experience "shooting pains" much like bolts of electricity...they did become more and more infrequent as I healed...it wasn't really so much painful as it was unexpected and shocking...lasting no more than a split second each. Some days very active, some not at all. I am just about a year out from my surgery and I can't tell you when the last time I had one was. I also had nerve damage from the surgery that was severe at first but over the past year has recovered nicely.

Please make sure your mom is well versed on the options and knows the risks of not doing radiation with a lumpectomy or not doing the mastectomy. She can only do what she is comfortable with in the end and I wish you both much love and peace in making the decisions...

Hi Mayer

I would be more concerned with your mom's refusal of radiation with a lumpectomy especially with a 4cm tumor.  I hope she gets a couple of opinions so she is well informed before making that decision.

I chose a mastectomy because I did not want to have radiation.  I decided to do a bilateral.  Except for the first few days of post-op I have never had any pain from my mastectomies.  I have returned fully to work.  I am able to lift as I did before (I work with a severely disabled population).  During the entire reconstruction process the only time I had pain was initially after my tissue expanders were filled.  The exchange surgeries were not painful as I have very little sensation in that area.  I don't really have any sensation over the scars.

Best of luck to your family with these difficult decisions.

Gee, sorry about not know the status from another post. Yikes!

i had a double mastectomy this past november and i have never had any pain at all. i had a very easy surgery and recovery. it's been four months since surgery, and my scars have healed. i have no pain at all.  i just had chemo treatment #6 out of 8, and will have 36 radiation treatments. my oncologist told me that with the combination of double mastectomy, chemo, and radiation, i am bringing my chance of cancer recurrence down to 2%.  that's why i chose to go ahead with chemo and radiation.  good luck to you and your mom.  she's young! i understand the need to want to be in control. i also know the fear of chemo and radiation. i was terrified. but it hasn't been as bad as i imagined. one day at a time!

Maybe your mom just needs to confront one step at a time. When she rebounds from the surgery in a day or two, she may be ready to take on chemo and/or rads. Breast-cancer treatment has such a reputation for pain and suffering, but it has come a long way in recent years, and the fact is that for most people it's manageable—not pleasant—but manageable. I had lumpectomy, radiation, bilateral mastectomy, chemo and herceptin and worked through all of it. There were days when I didn't feel well, but I got through it. There are very good antinausea medications now that were not available even a few years ago. Radiation is now much more targeted then it used to be—I never even experienced fatigue. To tell you the truth, the worst thing for me was losing my hair. Now THAT hurt! My suggestion would be to let your mom have a few days to pull herself together, and once her drains are out ask her to talk to the oncologist and/or radiation oncologist again. When she sees how manageable the surgery was, she may reconsider about the other treatments. 

Mayer

Although it was a little different because it was my good friend and not my mom, I also had the same experience with uninformed choices and denial.  My friend was diagnosed in 2000 with bc.  She went through all of the treatments and had 7 years of NED.  The summer of 2007 she told me she had a "kidney stone".  She has an insurance that I won't mention here, but she went to her PCP and they started treating her for the "kidney stone".  Except the pain in her back never got better.  Then she started complaining of joint symptoms and some neurological symptoms.  She went to her PCP and she told them that she thought she had gotten a tic bite (she had terrible eyesight, I doubt if she could have even seen a deer tic) but she begged her PCP put her on antibiotics for Lymes disease even though her Lymes titres came back negative.  So I said to her very very gently...."have you ever thought that maybe you should go talk to your oncologist?" and she told me No - why would she because he can't help her with Lymes.  She had firmly decided in her head despite all of the indications to the contrary that she had Lymes disease.  She convinced herself and her entire family that she had Lymes disease.  When none of her symptoms were getting any better I said: "lets just say for the sake of argument, you don't have lymes disease, would you just humor me and go to your oncologist?"  Finally 6 months after her initial "kidney stone" symptom she got an appointment with her oncologist.  Lets just say it wasn't Lymes disease.  My point is, sometimes you just have to be gently persistent and they will come around.  But the bottom line is that we can't make choices for people who are able to make their own.  We can only attempt to guide them into getting the information they need so they can make a more informed choice.  Best of luck to you...you sound like a wonderful daughter.