Legend states that female Amazon warriors cut their breasts off for improved dexterity when firing a bow. These days, women are having them removed in order to live longer.
In 2013, Hollywood actress and humanitarian Angelina Jolie shocked the world by announcing she would undergo preventive double mastectomy. Her decision to do this came after she discovered she was carrying a genetic mutation, BRCA1, that put her at risk of developing breast and ovarian cancer.
Advances in medicine allow for women like Jolie to get tested for cancer risks, and the number of mastectomy procedures performed worldwide is steadily increasing. Breast cancer is the second most deadly type of cancer for women, the first one being lung cancer.
As many women would know, the decision to get a mastectomy is not an easy one. Leaning on family and friends in times like that is the most invaluable method of support one can have.
In this article, we hope to offer some additional help by describing simple home remedies to alleviate any pain or discomfort one may be experiencing after a mastectomy. We hope to assist in making the journey to healing less arduous!
Mastectomy types and procedure
We owe this cancer-arresting procedure to William S. Halsted, a surgeon at Johns Hopkins who did the first radical mastectomy in the late 1800s.
Unlike lumpectomy, which only removes the abnormal tissue on your breast, mastectomy is a surgery to remove all breast tissue to treat or prevent breast cancer.
There are few types of mastectomy, based on how the surgery is done and how much tissue is removed:
- Simple (or total) mastectomy – The entire breast and, in some cases, some underarm lymph nodes may be removed.
- Skin-sparing mastectomy – The breast tissue, nipple and areola are removed while most of the skin over the breast is left intact. Implants or tissue from other body parts can be used during the surgery for breast reconstruction. This type, though, is not an option for those with larger tumors or for those whose tumors are located near the skin’s surface.
- Nipple-sparing mastectomy – This procedure involves the removal of breast tissue but it retains the breast skin and nipples. Women with early stage cancer, or those with tumors located close to the outer part of the breast, may find this a good option.
- Radical mastectomy – This was the first type of mastectomy performed, where the surgeon removes the entire breast, axillary (underarm) lymph nodes, and the pectoral (chest wall) muscles under the breast. This type of surgical procedure is rarely done these days, with the discovery of equally effective yet less extensive modified radical mastectomy.
- Modified radical mastectomy – A simple mastectomy and the removal of the lymph nodes under the arm, called axillary lymph node dissection, are performed in this procedure.
- Double or bilateral mastectomy – This involves the removal of both breasts to prevent or reduce the risk of cancer. Those with a BRCA gene mutation, like Jolie, are presented with this option to avoid cancer. Breast reconstruction, a surgical procedure which aims to restore shape to your breasts, may be done simultaneously or at a later date.
Home care after mastectomy
- Empty your drain as directed – Mastectomy patients will have a Jackson-Pratt (JP) drain attached to a surgical bra. The JP drain is a soft, thin and flexible tube inserted near a mastectomy patient’s incision to drain extra fluid and prevent swelling. The drain(s) will usually be removed after one or two weeks or longer following surgery. Jolie had six JP drains, as shared by her doctor. No matter how strictly you follow the instructions, there is a possibility that you’ll develop seroma — a collection of fluids that build up under the skin. This requires a simple intervention from your doctor.
- Elevate your arm above the level of your heart to help decrease swelling and pain. Prop your arm on pillows or blankets to keep comfortable.
- Rest as directed, but move lightly – While you may go on with doing light activities, do not lift anything heavy or push or pull with your arms. Take short walks around the house and gradually extend your walks as you feel better. Walking and moving around decreases your chances of developing pneumonia or blood clots. Be careful not to do too much, too soon.
- Do not sleep on your stomach – Sleep on your side opposite to your incision to avoid putting too much pressure on it and damaging your sutures.
- Pain medications – It’s highly recommended that you fill up all your prescription drugs so you don’t run out. Follow your physician’s directions on how or when to take them.
- Wear a supportive bra – You will be wearing a surgical bra for the first few days following the procedure. When you are allowed to change, choosing a supportive bra may help hold your bandages in place. Avoid lace and underwire bras that may itch or rub against your incision.
- Wound care – Your incision should not get wet within 24 to 48 hours after hospital discharge. Within this period, you may only take a sponge bath and wash the incision with soap and water. Gently pat the area and do not rub. Replace your bandages if they get wet and check your incision regularly for unusual swelling, redness or pus.
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- Use cold and warm breast packs if your surgeon approves – In the initial stage of the healing process following mastectomy, using cold breast packs can help in managing pain and discomfort. There’s one important caveat, though: only use cold breast packs upon the advice of your surgeon.
A few physicians do not recommend using ice, citing that mastectomy patients have decreased sensitivity to temperatures, increasing the risks of frostbite and tissue damage. Applying cold therapy also constricts blood supply to an already sensitive and endangered area, according to the same physicians. Further blood flow restriction delays healing.
If you get the green light to use ice therapy, breast packs will come in handy after your mastectomy.
Two to three days following ice application on your mastectomy, soothe sore tissues and disintegrate bruising discolorations by using warm breast packs. Choose breast packs that may be used hot or cold. Have at least two packs ready to use alternately, as you need to use each pack for only 10 to 15 minutes.
- Mastectomy recovery clothing – As you will have difficulty putting your arms up or on your sides, wear clothes that are loose-fitting, comfortable and easy to put on and take off.
Precautions in using temperature therapy
Mastectomy patients’ nerves, especially in the underarm area, are affected by the surgery, making it hard for the area to signal the brain when the ice pack is too cold. This impairment could likely lead to ice burns. Heat therapy post-mastectomy is discouraged by some physicians for the same reason.
Science explains that inappropriate use of cold therapy may cause the forming of ice crystals in the cell, affecting its natural structure and leading to tissue loss and necrosis because of frostbite.
Temperature therapy is not suitable for persons with nerve and blood circulation issues such as diabetes, dermatitis and deep vein thrombosis.
When to call your surgeon
Before hospital discharge, the nurse will instruct you on the proper use of the drain, wound care, signs of wound infection and pain management. However, not everything will work out perfectly, and you may develop mild issues following your mastectomy.
Watch out for the following signs and contact your doctor or healthcare provider immediately:
- If you develop a high fever (38.6 degrees Celsius and higher)
- Breathing difficulties
- Extreme swelling of the arm
- Bleeding wounds with pus-like drainage
- Pain that’s not addressed by medicines and other means
- If you cannot eat or drink
Recovery after your mastectomy
You will feel extremely tired for a few weeks following the surgery, and this is normal. It takes time to heal, but you must have enough rest, take your pain medications, avoid strenuous activities and perform light arm exercises to avoid stiffness.
Physically, you will get better from four to eight weeks, although a general feeling of weakness may occur from time to time even months later.
Perhaps the most critical phase is overcoming the emotional and psychological fatigue that goes with the entire procedure. It is difficult not to worry about your close encounter with a deadly disease, not to mention the physical fatigue following a mastectomy.
Instead of toughing it out, lean on your family, friends and other mastectomy survivors to help you take charge of your life.
What is the best tip or advice you can give to women who have undergone mastectomy? Do you want to know more about breast pack use? Share your stories with us here.