- Question from Binney: Eight months ago, the lining of my rib became inflamed from radiation; it still aches, and it makes wearing my prosthesis difficult, especially as the day wears on. The oncologist says women learn to live with that, but is there something I can do to relieve it?
- Answers - Ann Berger That's not easy. That's probably partly neuropathic, and it may be partly inflammatory, so try medications for nerve pain. Try some nonsteroidal-type medicines. I have the implants, and I have found that I cannot wear a bra at all because of the same problem. I did not have radiation. I had bilateral mastectomies and saline implants, and I have constant chronic pain at the end of the day if I wear any kind of real bra. Basically, what I wear are sports bras.
Marisa C. Weiss, M.D.
The surface around the bone, called the periosteum, is very sensitive. The implants can put a lot of pressure on the rib cage and can actually depress it, and this is one source of discomfort. Radiation-related chest wall discomfort is not uncommon. It does tend to ease up over time. It may take weeks or months. It can be made worse by extra bursts of activity. The muscle that connects the shoulder to your chest, called the pectoralis muscle, is in most radiation treatment fields and can become stiffer and tender. This type of discomfort responds to regular symmetrical conditioning.
Some of my patients find yoga to be helpful, as well, because it gently stretches the muscles and tissues of the body, and it increases muscle tone and helps strengthen your mind's ability to focus away from the pain. It also strengthens the muscle and improves the tone of the general area.
- Ann Berger But you should know that what you're feeling is normal. When I said something to my plastic surgeon, he didn't understand. I've gone to another here, and the response was the same. They don't understand. They say, "Most people don't have this problem." I think most people just don't say they have the problem. The reality is, I suspect, that this is rather normal, and you do learn to live with it. But if the prosthesis hurts halfway through the day, then take it off. My solution is not to wear a bra at all. And at this point, even for important formal events, I just won't do it. I don't want to pay the price later.
- Marisa C. Weiss, M.D. After breast cancer surgery, many of the cushions are removed that normally protect the tissues of the chest wall and the armpit. The breast, besides being a source of nutrition for a baby and a sexual organ, also function as a cushion for your chest wall. Lymph nodes are removed from under your arm along with a pad of fat that cushions the movement of your arm against your body. When these cushions are removed, the structures underneath lose some of their protection and can become sensitized.
On Wednesday, April 17, 2002, our Ask-the-Expert Online Conference was called Breast Cancer Pain. Ann Berger, R.N., M.S.N., M.D. and Marisa Weiss, M.D. answered your questions about managing pain caused by breast cancer and breast cancer treatments.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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