Phantom Breast And Nipple Pain

Phantom breast and nipple pain is pain that feels as if its coming from the breast and nipple that have been removed. The pain and discomfort can feel like pressure, itching, throbbing or pins and needles.

Phantom breast pain can happen straight after surgery or sometimes up to a year later. Because the pain is caused by damage to the nerves at the time of surgery, the most effective types of pain relief are those used to treat nerve pain, such as antidepressants or anti-epileptic drugs.

If you have phantom breast and nipple pain and simple pain relief doesnt help, talk to your GP or treatment team.

What Is My Prognosis

This is a very common question that isnt always easy to answer. There are many factors involved in working out prognosis. Remember that a prognosis is just a figure at the point at which you receive it. For most people, the prognosis gets better with time.

Sometimes we use a five-year figure because we know that if cancer comes back, most of the time it comes back within five years. If the cancer has not come back within five years, then the chance of it coming back within ten years is quite low, and if it does not come back within ten years, then you have an almost normal life expectancy.

Its a bit like buying a second hand car. You dont really know how long its going to last, but if it lasts year after year without breaking down, then the car starts to look more and more reliable to make that long trip.

Working out prognosis can be difficult.

New Breast Pain 20 Years Post Lumpectomy

I had a right breast lumpectomy with radiation treatments almost 20 years ago. There was no lymph node involvement. I was on Tamoxifen for 5 years. About a week ago, my right breast starting hurting like a deep bruise with a slight burning sensation. It is only on one side of the breast and is most noticeable in one very tender spot. Is this normal? Should I go to my Primary Care doctor? I no longer see an oncologist.

A huge resounding yes! Because even if it turns out to be a rogue nerve, it will bring peace of mind. I believe any new and persistent breast pain requires investigation. If you have a primary care doctor you trust to really look into it, that is great. If not you might see an OBGYN, they are also trained in breast care. If it turns out to be something you have to deal with, I think you will be glad you did. I had a doctor tell me breast cancer wasnt painful, so that was actually a good sign.20 years is a long time to think it gone and then have pain. How are you doing mentally?

Mentally I am fine. Im just concerned over this new issue. I will call my doctor tomorrow for an appointment. I am a very active 73 year old and I hope to stay healthy for years to come.

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Changes To The Breast Or Chest Area

After breast-conserving surgery or a mastectomy, with or without reconstruction, be aware of any changes to either side, such as:

• swelling on your chest, in your armpit or around your collarbone
• a change in shape or size
• a change in skin texture, such as puckering or dimpling
• redness or a rash on or around the nipple or on the skin
• liquid that comes from the nipple without squeezing it
• the nipple has become inverted or looks different, for example changed its position or shape
• swelling in the arm or hand
• a lump or thickening that feels different

What Causes Breast Cancer Recurrence

The goal of cancer treatments is to kill cancer cells. But, cancer cells are tricky. Treatments can reduce tumors so much that tests dont detect their presence. These weakened cells can remain in the body after treatment. Over time, the cells get stronger. They start to grow and multiply again.

Even surgery to remove a cancerous tumor isnt always 100% effective. Cancer cells can move into nearby tissue, lymph nodes or the bloodstream before surgery takes place.

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Symptoms Elsewhere In The Body

Sometimes breast cancer cells can spread from the breast to other parts of the body. This is known as secondary breast cancer.

Some symptoms to be aware of include:

• unexpected weight loss and a loss of appetite
• severe or ongoing headaches

Find out more about the symptoms of secondary breast cancer.

What Are The Chances Of Breast Cancer Returning

Each persons risk of breast cancer recurrence is different and depends on many factors, such as the size, type, grade and features of the cancer and whether the lymph nodes were affected.

Your treatment team can tell you more about your individual risk of recurrence if you want to know this.

The risk of breast cancer recurring is higher in the first few years and reduces as time goes on.

However, recurrence can happen even many years after treatment, which is why its important to be breast and body aware, and report any changes to your treatment team or GP.

In the UK, the number of people surviving breast cancer has risen greatly over the past decade and most people diagnosed with primary breast cancer will not have a recurrence.

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What Is A Late Effect

A late effect is a side effect that is caused by treatment but happens months to years after the cancer treatment has finished. Some side effects that you develop during treatment can last for months to years after treatment is completed . These are often called long-term side effects.

Late effects can be health issues or psychological, emotional, and practical challenges.

How Long Do Symptoms Last

For many people, pain or numbness goes away after chemotherapy ends. However, it may take weeks or months.

Six years after chemotherapy, as many as half of those who developed pain related to the chemotherapy still have symptoms . If you have lingering pain, let your health care provider know. This pain can be treated.

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Persistent Pain After Breast Cancer Treatment

Howard S. Smith1, Sheng-Xi Wu2

1Department of Anesthesiology, Albany Medical College, New York, USA 2Department of Anatomy, Histology and Embryology, K.K. Leung Brain Research Centre, the Fourth Military Medical University, Xian, China

Corresponding to:

Submitted Oct 06, 2012. Accepted for publication Oct 28, 2012.

Ann Palliat Med 2012 1. DOI:10.3978/j.issn.2224-5820.2012.10.13

Take Hormone Therapies As Prescribed:

If you have been prescribed endocrine therapy its very important to take it exactly as prescribed. Research has shown that many women dont take their medication every day, either because they forget or because of the side effects. Endocrine therapy reduces the chance of breast cancer recurrence and when not taken as prescribed, the drugs are less effective.

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What Is A Breast Cancer Recurrence

Breast cancer recurrence means that the cancer was diagnosed when limited to the breast and/or armpit lymph nodes, then treated, and at some time later has come back.

This can occur in several ways:

• Local and/or regional recurrence: the breast cancer that was previously treated returns within the breast, chest wall or regional lymph nodes.
• New primary breast cancer: an unrelated new breast cancer occurs in one or the other breast. This actually isnt a local recurrence at allits a new cancer in the breast . This typically occurs many years after the original cancer and in an entirely different area of the breast. Its pathology is often different lobular instead of ductal, for example. Though they are often counted as recurrences in the statistics for breast conservation, they should be treated as completely new cancers, much as with new cancers in the opposite breast.
• Distant or systemic recurrence or metastasis is much more serious than local recurrence and is synonymous with stage 4 disease. For breast cancer patients, the most common areas of spread are the bone, liver, lungs and brain

Breast cancer recurrence occurs if:

• Cells from the original breast cancer diagnosis break away and hide nearby in the breast or spread elsewhere in the body

• Treatment, including surgery, chemotherapy, radiotherapy and/or hormone therapy have not gotten rid of all these cancer cells from the body.

How Cancer Treatment Impacts Lymph Nodes

Lymphedema is tied to the bodyâs cell waste disposal system, which acts a bit like a garbage pickup service. Cells create waste that are picked up and shuttled along by the lymphatic system and then processed by the lymph nodes, which act as the garbage and recycling plants in the bustling city that is your body.

Unfortunately, when these lymph nodes are blocked or damaged or removed thanks to a tumor, surgery or radiation, our cellâs âgarbageâ starts to pile up and the limbs begin to swell. If left untreated, lymphedema can trigger a chain reaction of complications, most notably sudden, serious and recurrent infections brought on by unchecked bacteria that thrive in the trapped lymph fluid.

âAny patient who has a tumor or surgery that disrupts the lymphatics under the arm or adjacent to the neck or in the groin may end up with edema of the extremities,â said Dr. Gary Lyman, researcher and breast cancer oncologist with Fred Hutchinson Cancer Research Center and its treatment arm, Seattle Cancer Care Alliance.

âIt can be relatively mild to quite severe,â he said. âItâs unsightly, puts patients at increased risk of recurrent infections and pain and quality of life can be dramatically affected. Most breast cancer patients today donât develop severe lymphedema but it still occurs and when it does, itâs a major life event and a lifelong event.â

Fortunately, lymphedema isnât all that hard to manage if caught early.

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Breast Cancer: Lymphedema After Treatment

Lymphedema is a problem that may occur after cancer surgery when lymph nodes are removed. Lymphedema can occur months or years after treatment. Its a chronic condition that has no cure. But steps can be taken to help keep it from starting, and to reduce or relieve symptoms. If left untreated, lymphedema can get worse. Getting treatment right away can lower your risk of infections and complications.

Re: Pain In Breast Nearly 5 Months After Lumpectomy

HiI had a lumpectomy on 15 oct 09 and since then have had real problems with my breast, it was massively bruised after the op and since then had tohave another ‘clean up’ op to clean and restitch. Since then again I have had leakage. Was sent for an ecograph and told there is still a hole of 20 by 25mm and the liquids are gathering and turning septic and then leaking. So am now on a course of antibiotics . How long before this hole closes up and will it? A definite mishape and loss of size. Also the points where the biopsy needles and other wires went in before op and very visible and itchy. And they are on the top/centre of my breast. Also find myself rubbing my breast!!Pat

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What Kind Of Treatment Follow

The major goal of follow-up is, if possible, to detect and treat recurrences in the irradiated breast or lymph nodes and new cancers developing later in either breast before they can spread to other parts of the body. Theroutine use of bone scans, chest x-rays, blood tests and other tests to detect the possible spread to other organs in patients without symptoms does not appear to be useful. Your physician will determine a follow-upschedule for you. This may include a physical exam every few months for the first several years after treatment and then every six to 12 months or so after that. Annual follow-up mammograms are an important part of your care. If symptoms or clinical circumstances suggest a recurrence, diagnostic tests such as blood tests, ultrasound,computed tomography , magnetic resonance imaging , chest x-ray , or bone scan may be needed.

How Long After Breast Cancer Treatment Do Recurrences Occur

The risk of recurrence for all breast cancers was highest in the first five years from the initial cancer diagnosis at 10.4%. This was highest between the first and second years after the initial diagnosis. During the first five years after the initial diagnosis, patients with oestrogen receptor positive breast cancer had lower rates of recurrence compared with those with ER negative disease. However, beyond five years, patients with ER positive disease had higher rates of recurrence.

The late recurrence or relapse of breast cancer refers to cancers that come back after five years, but may not return for 10 years, 20 years, or even more. For people who have estrogen receptor-positive tumours, the cancer is actually more likely to recur after five years than in the first five years.

In contrast to the common belief that surviving for five years after cancer treatment is equivalent to a cure, with hormone-sensitive breast tumours there is a steady rate of recurrence risk for at least 20 years after the original diagnosis, even with very small node-negative tumours.

An awareness of the risk of late recurrence is important for a number of reasons. People are often shocked to learn that their breast cancer has come back after say, 15 years, and loved ones who dont understand this risk are often less likely to be supportive as you cope with the fear of recurrence.

Bone Metastases

• The long bones of the arms and legs

Symptoms and Detection

Treatment

Liver Metastases

Treatment

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Pain After Breast Cancer Treatment

Pain and changes in sensation can be a late effect of surgery or radiotherapy treatment for breast cancer.

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Some breast cancer treatments can cause pain or changes to sensation due to nerve damage. Your doctor can prescribe painkillers to help. They can also refer you to a physiotherapist who can give you advice about exercises that will help.

If these problems continue or develop after treatment finishes, they are called late effects.

Surgery can cause changes in sensation in the chest area, the armpit, and the shoulder and arm on the affected side.

These can include:

• sharp, shooting or burning pain
• sensitivity to touch or to the cold
• numbness or pins and needles.

These symptoms happen because the nerves in the chest area or armpit are cut or injured during surgery. These symptoms are common, particularly after surgery to remove all the lymph nodes in the armpit. Symptoms usually improve with time, but in some cases they may take months or years to get better.

If you have an aching pain in the breast, wearing a supportive sports bra during the day and a soft bra with no underwire at night may help. You may find that bras with adjustable straps, soft seams and full cups are more comfortable.

Late Effects After Radiation For Breast Cancer

The physical side effects of radiation treatment are directly related to the area of the body being treated. Any area in the treatment field has a risk of being damaged, causing side effects. As radiation techniques have improved over the years, the risk of late effects has decreased.

Skin Problems

Radiation can lead to permanent changes in the skin.

• You may develop new scars or notice changes in the color or texture of your skin. Radiation can also change the color and texture of your hair or can cause permanent hair loss in the treated area.
• The soft tissue and muscles under the skin can develop scarring and/or shrinkage, which can lead to a loss of flexibility and movement or chronic swelling in this area.
• You may develop chronic or recurring ulcers of the skin in the area treated. Blood vessels of the skin may become dilated and more visible, although this is not harmful.
• If the skin feels tight or sore, you can apply vitamin E to the skin.
• Use fragrance and dye-free soaps and moisturizers in the area if your skin is sensitive after radiation.

After radiation, the skin in the treated area is more sensitive to sunlight. This sensitivity will last for your lifetime. Practice sun safety, use plenty of sunscreen, wear a wide-brimmed hat, and keep skin in the treated area covered with clothing. Try to avoid being out in the sun between the hours of 10 am-4 pm when it is the strongest.

Lymphedema Risk

Heart Problems

Damage to the Bones

Nerve Damage

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Seeking The Right Diagnosis

If you have complaints of pain or discomfort after breast cancer surgery, you may find that it can be hard to get a diagnosis. The surgeon has removed the cancer and the oncologist has done his or her job, but how does the leftover pain get diagnosed and treated?

If you think you may have PMRS, make an appointment with a physiatrist in your area, Dr. Ibanez advises. He or she will need to take a detailed medical and functional history. A comprehensive physical exam, which includes seeing how well you can move, may help your doctor determine if there are underlying problems with your nerves, muscles, or other tissues.

Sometimes, blood tests or an imaging test such as an MRI may be needed. A test called an electromyography can help to see if there is abnormal muscle or nerve function in the area.

Support If Youre In Pain

Managing pain can be difficult, and there may be times when you feel unable to cope.

If you want to talk things through, you can call our Helpline free on 0808 800 6000.

Our Someone Like Me service can put you in touch with someone who has had a similar experience to you, to talk about pain and other side effects.

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