How Does Physical Therapy Help After a Mastectomy?

What Is a Mastectomy?

A mastectomy is the primary surgery used to treat breast cancer. The procedure involves removing the whole breast, including the skin, fatty tissue, glandular tissue, and often the underlying muscle. Nearby lymph nodes may also be removed depending on the likelihood that cancer has spread.

Who Should Have a Mastectomy?

Mastectomy may be recommended for several reasons. It is the most effective treatment for breast cancer that is still localized to the breast, especially if the tumor is too large or diffuse to be removed with a lumpectomy or a breast-conserving surgery. It may also be used if the cancer is likely to recur. It may even be performed for people who have not yet been diagnosed with breast cancer. By removing the breast tissue, a prophylactic (preventive) mastectomy can dramatically reduce the risk of cancer developing in high-risk patients.

Common Post-Mastectomy Challenges

Though proven effective in treating breast cancer, a mastectomy has side effects like any other surgery. While these effects are a minor cost to be cancer-free, they can make it difficult for patients to return to normal life as quickly as they would like. Common challenges faced by post-mastectomy patients include:

• Soreness around the surgery site
• Tiredness or fatigue
• Weakness
• Nerve pain, tingling, or numbness
• Swelling in the arm or hand
• Cording, or scar tissue, in the armpit

In addition, mastectomies come with a small risk of complications. A mastectomy is generally considered a safe procedure, but the risk is never zero. Two potential major complications from a mastectomy are:

• Blood clots: After a mastectomy, there is a small chance of blood clots forming in the legs or lungs. Large clots may cause an embolism.
• Lymphedema: If lymph nodes were removed, the flow of lymphatic fluid may be impeded. This leads to a buildup of lymph fluid, known as lymphedema.

Patients should make sure they understand the risks before agreeing to a major medical procedure. They should also be careful to follow the surgeon’s recovery instructions, which are provided to reduce the likelihood of complications.

The Role of Physical Therapy Post-Mastectomy

Physical therapy is part of an integrated care model for breast cancer. It uses targeted, specialist-guided exercises and stretches to help the body heal more effectively after surgery. This provides several benefits. Physical therapy can reduce side effects and help prevent complications, ensuring a smooth and successful recovery. These are some of the most important benefits of physical therapy post-mastectomy:

• Improve healing: Exercising encourages blood flow. When oxygen and vital nutrients are delivered more efficiently, the surgical site heals faster and hurts less.
• Reduce swelling: Improved blood flow also helps reduce swelling around the surgical site, leading to reduced pain and improved range of motion.
• Enhance scar mobility: Scar tissue is often tighter than healthy skin, limiting a person’s range of motion. Physical therapy can reduce scar tightness for better mobility.
• Restore flexibility: With targeted stretches, physical therapy helps to maintain and restore flexibility, ensuring that the patient loses no mobility after surgery.
• Rebuild strength: Exercising also combats the weakness and fatigue that follow surgery, helping patients feel stronger for a faster return to normal function.
• Address posture: Pain after surgery can lead to postural changes. Physical therapy prevents this change, helping the patient maintain a healthy upright posture.
• Prevent lymphedema: Physical therapy encourages lymph fluid to flow normally, reducing the likelihood of lymphedema or slowing its progression.
• Reduce blood clots: Improved circulation keeps blood moving throughout the body, reducing the risk of clotting or hematomas.

Finally, physical therapy can also support emotional recovery. Cancer treatment is often emotionally challenging, and a mastectomy may leave patients feeling insecure about how their bodies have changed. Physical therapy helps people feel energized while restoring a healthy body image.

Common Physical Therapy Interventions and Exercises

Physical therapy is not a single treatment technique. Instead, it combines multiple methods and interventions for a comprehensive approach to surgery rehabilitation. Patients receive personalized treatment plans to address their unique needs and concerns. Techniques employed include:

• Manual therapy: Physical therapists perform massages and manual joint manipulation to ease stiffness and enhance circulation.
• Stretching: Strategic stretches help to break down scar tissue and restore muscle flexibility, helping the patient regain mobility.
• Strengthening exercises: Strengthening exercises work to rebuild muscle mass and strength after surgery, counteracting weakness.
• Breathing exercises: Deep breathing exercises maintain chest mobility, reducing stiffness while helping lungs work normally.
• Lymphedema management: Massages, compression, and exercises together encourage lymph flow to prevent or manage lymphedema.

Gentle stretches and exercises should begin immediately after surgery. After the incision sites heal, patients meet with a physical therapist to develop a more rigorous recovery plan. The strategies used in physical therapy change over the course of a person’s rehabilitation, evolving to match their changing condition and needs.

What to Expect During Physical Therapy Sessions

A physical therapy session begins with an assessment. The certified physical therapist evaluates the patient’s health, strength, and range of motion. They also interview the patient about their symptoms. Once the physical therapist understands the patient’s starting point and goals for treatment, they will develop a personalized treatment plan. Therapists collaborate with the patient and their healthcare team to ensure the most appropriate and effective treatment.

After the treatment plan has been developed, the physical therapist may perform certain treatments themselves. They will also demonstrate stretches, exercises, and massage techniques to be repeated at home, empowering the patient to work independently toward their recovery.

Getting the Most out of Physical Therapy

Physical therapy is most effective when the patient is as committed as their provider. By planning and following instructions as given, patients can maximize the benefits from their rehabilitation. The following tips can help a patient get the most out of a physical therapy regimen:

• Choose a qualified physical therapist.
• Set realistic but aspirational goals for recovery.
• Wear comfortable clothing to physical therapy appointments.
• Communicate openly about goals, limitations, and concerns.
• Consult with the surgical team and other healthcare providers.
• Follow instructions for at-home exercises and care.
• Schedule regular follow-up appointments.

Finally, patients should not hesitate to ask questions about their treatment. The more they understand which techniques are being used and why, the better equipped they are to get involved in their care.

Find Expert Breast Cancer Care Near You in NJ, CT, MA, and the Washington, D.C., Area

Physical therapy post-mastectomy helps to ensure a smooth and complication-free recovery. To learn more about breast cancer treatment and rehabilitation, patients can reach out to Regional Cancer Care Associates. RCCA specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.