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This post was edited by Glenys at November 20, 2012 9:54:54 AM WATime"
Hi Vicky
I'm so sorry to hear you have this ongoing discomfort after your surgery - and having two operations close together was pretty rough for you too!
It is very common for the lymph node surgery to cause more discomfort than surgery to the breast, - for two reasons: 1. movement of the arm aggravates the healing wound in the armpit, which can mean more pain and longer time to heal (but as I'm sure the physio would have explained, arm exercises are very important!); and 2. the intercostal-brachial nerve runs through the armpit area - this nerve is always damaged with lymph node surgery, causing some degree of numbness, 'altered' sensation and discomfort. The degree of damage can vary, particularly with the type of surgery to lymph nodes. Sentinel lymph node biopsy may cause a little damage - possibly a little mild numbness and stiffness after. The axillary clearance surgery (your second op) does cause more damage - often resulting in an area of numbness/altered sensation to armpit area extending toward the back, and back of upper arm. As the damaged nerve starts to recover it's very common for the nerve to 'over-sensitise' - which can be very uncomfortable and often causes shooting pains and pins & needles to the area (a bit like when you sit on your feet - they go numb then get pins & needles as the sensation returns). Exercises and massaging the area can help with this. ... Is it like that at all???
Then three other aspects can cause ongoing discomfort - a) fluid collection in the armpit (called a seroma). The fluid can continue to build up after the drain is removed, causing a swelling and pain. Is there any swelling? Usually managed by draining the fluid with a needle and syringe. b) a condition called 'cording' - where the lymph vessels can tighten and harden. This is very uncomfortable and you can often feel a 'cord' around armpit extending down arm. A physiotherapist treats this with massage & exercises. c) any infection in the area will cause pain - is there redness around the area? Is the wound looking completely closed and healing?
A good article posted by a breast surgeon in Victoria explaining some of these things can be found at: http://www.melbournebreastcancersurgery.com.au/after-your-breast-surgery.html
The most important aspect is the discomfort should be settling down by now. Painkillers such as Paracetamol and Ibuprofen often help, but even these should no longer be needed by 3 weeks post-op. Has this been reviewed recently by the surgical team? Certainly worth a call to your breast nurse (do you have one at hospital where you had surgery?). This is not likely to delay chemo (nor chemo affect it) unless there is an infection or healing problem.
Hope all settles down for you soon Vicki. Please let me know how it goes ..
Love Glenys xx
The Click Breast Care Nurse 
The Click Breast Care Nurse
61 year youngmother of 3 grown up boys, 3 grandchildren. Mastectomy LB with implant reconstruction, removal of sentinel and lymph nodes, no radio or chemotherapy needed.
61 year youngmother of 3 grown up boys, 3 grandchildren. Mastectomy LB with implant reconstruction, removal of sentinel and lymph nodes, no radio or chemotherapy needed.
The Click Breast Care Nurse
