Living with breast cancer

Friday 1 July, 2016

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On this page: Nerve pain | Lymphoedema | Cording | Menopause and fertility | Sexuality and intimacy | Body image | Breast forms and prostheses | Wigs | Key points


Side effects of treatment for early breast cancer can vary. Some people will experience a few side effects, while others will have more.

Nerve pain

Mastectomy and axillary dissection can cause nerve pain in the arm. This may feel like pins and needles. It usually settles within a few weeks. If pain is ongoing, ask your doctor about ways to manage it.

Some chemotherapy drugs can cause nerve damage to the hands and feet. This is called peripheral neuropathy and it can cause numbness, pins and needles and, occasionally, pain. These symptoms are usually temporary, but in some cases they can be permanent.

Lymphoedema

Lymphoedema is a swelling of part of the body, usually a limb such as the arm. When lymph nodes have been damaged or removed, lymph fluid may not be able to drain properly. The fluid builds up, causing swelling.

Some breast cancer treatments, such as radiotherapy to the armpit or axillary surgery, can cause lymphoedema. People who have had surgery followed by radiotherapy to the armpit are more at risk.

Symptoms of lymphoedema are easier to manage if the condition is diagnosed and treated early. Signs of lymphoedema include swelling, heaviness or fullness in the arm, redness and skin warmth. These signs may begin gradually and they may come and go. Some people experience pain or fever, which may mean an infection in the arm with lymphoedema called cellulitis. If you have swelling, see your doctor as soon as possible.

Preventing and managing lymphoedema

Lymphoedema can develop months or years after treatment, although some people who are at risk never develop it.

In many hospitals, a lymphoedema practitioner will assess you before you have surgery. Some hospitals have specialist physiotherapists who can teach you simple exercises to reduce your risk of developing lymphoedema.

If you develop lymphoedema, the swelling can be reduced by wearing a professionally fitted elastic (compression) sleeve or by massage from a lymphoedema practitioner, physiotherapist, nurse or occupational therapist. You may also benefit from laser treatment by a lymphoedema practitioner.

Long periods of physical inactivity, such as when travelling, may worsen lymphoedema symptoms. Talk to your doctor or lymphoedema practitioner about wearing a compression sleeve during air, rail or car travel.

To find out more about lymphoedema, read Cancer Australia’s booklet Lymphoedema – what you need to know. The Australasian Lymphology Association website has a directory of lymphoedema practitioners.

Cording

Cording, also known as axillary web syndrome, can happen weeks or months after breast conserving surgery, mastectomy or axillary surgery. It feels like a tight cord running from your armpit down the inner arm, sometimes to the palm of your hand, and is caused by hardened lymph vessels. Some people can see and feel raised cord- like structures across their arm, and these may restrict movement.

The condition usually improves over a few months. Gentle stretching during the first weeks after surgery can help. If there is no improvement or the cording is getting worse, try physiotherapy, massage, or laser treatment from a lymphoedema practitioner.

Menopause and fertility

Chemotherapy for early breast cancer can cause your periods to stop and affect your ability to become pregnant. If your periods stop permanently, this is known as early menopause, and it means you will no longer be able to have children.

Some of the symptoms of menopause include hot flushes and sweats, trouble sleeping, vaginal dryness, reduced sex drive (libido), tiredness, dry skin, aches and pains, mood swings, poor concentration, weight gain and osteoporosis. Symptoms can range from mild to severe. Talk to your doctor or breast care nurse about ways to manage symptoms.

If preserving your fertility is important to you, ask your doctor for a referral to a fertility clinic before treatment starts.

See Fertility and Cancer for information about fertility treatment options.

If you learn you may be permanently infertile, you may feel a great sense of loss. You might be devastated that you won’t have your own children or additional children, and you might worry about the impact of this on your relationship. It’s normal to feel this way even if your family is complete or you weren’t planning on having children. Talking to a counsellor or someone in a similar situation may help − call Cancer Council 13 11 20 for information about counselling services and support groups in your area.

Sexuality and intimacy

Cancer can affect your sexuality in physical and emotional ways. The impact of these changes depends on many factors, such as treatment and side effects, your self-confidence, and if you have a partner. Although sexual intercourse may not always be possible, closeness and sharing can still be part of your relationship. If you don’t have a partner, you may worry about starting a new relationship after cancer treatment, especially if your body has changed. For more information, call 13 11 20 and ask for free copies of Sexuality, Intimacy and Cancer and Emotions and Cancer.

If you are able to have sex, you may be advised to use certain types of contraception (e.g. condoms) to protect your partner, or avoid pregnancy for a certain period of time. Your doctor or breast care nurse will talk to you about the precautions to take.

Body image

Any change in your appearance after breast surgery may affect your self-esteem and feelings of femininity. The loss of a breast or breasts, or losing your hair, may cause a type of grief.

Having a breast reconstruction or wearing a prosthesis can help improve your self-confidence. Try to focus on yourself as a whole person and not just on the part of you that has changed.

Look Good Feel Better is a free program that teaches techniques to help restore appearance and improve self-confidence.

Breast forms and prostheses

Breast forms and prostheses are synthetic breasts or parts of a breast worn inside a bra or attached to the body with adhesive to give the appearance of a real breast. They can be used after a mastectomy or breast conserving surgery.

Breast form

In the first couple of months after surgery, you may choose to wear a temporary soft breast form. This will be more comfortable next to your scar. A free bra and breast form (or forms) are available through Breast Cancer Network Australia as part of the My Care Kit. Ask your breast care nurse to order you a kit.

Breast prosthesis

Your doctor or breast care nurse will discuss the best time for you to be fitted for a permanent breast prosthesis. This is usually once your scar has healed.

A prosthesis is usually made from silicone and has the shape, feel and weight of a natural breast. It can help you to maintain good posture and prevent neck and back problems. It is recommended that you see a trained fitter who can help you choose the right prosthesis. To find out where you can get fitted for a prosthesis, call Cancer Council 13 11 20 or ask your breast care nurse. You can read about different types of prostheses in Breast Prostheses and Reconstruction.

The cost of a permanent prosthesis ranges from about $250 to $450. Financial assistance towards the cost is available from Medicare through the External Breast Prostheses Reimbursement Program. Women with private health insurance may be able to get a further rebate for a prosthesis depending on their cover.

Wigs

If you lose your hair during chemotherapy treatment, you may want to wear a wig, scarf, turban or hat while it’s growing back. Another option is to leave your head bare.

You can borrow a wig – some hospitals and cancer care units provide wigs for free or a small fee. Cancer Council Victoria also offers a free wig service. You can also buy a wig, although some types can be expensive. Call Cancer Council 13 11 20 or ask your treatment team for more details about borrowing or buying wigs. Some private health funds cover part of the cost of wigs – check with your health fund.

Key points

  • Side effects of treatment vary depending on the treatment you have.
  • Lymphoedema is a swelling of part of the body, such as the arm. It can happen if the lymph nodes are damaged or removed and lymph fluid is unable to drain properly.
  • There are ways to prevent or treat lymphoedema. Exercises, massage, laser treatment or wearing a compression sleeve may reduce or prevent swelling.
  • Cording, also known as axillary web syndrome, feels like a tight cord running from the armpit to the palm of the hand. It usually gets better over several months. Gentle stretching can help.
  • Some treatments, such as chemotherapy, can cause a woman’s periods to stop temporarily or permanently. This can lead to symptoms of menopause such as hot flushes, vaginal dryness and tiredness. Talk to your doctor about managing symptoms.
  • If you would like to have children, talk to your doctor before treatment begins about ways to reduce the risk of infertility, and ask for a referral to a fertility clinic.
  • After a mastectomy, the breast can be replaced with a temporary soft breast form, or you can be fitted for a permanent breast prosthesis. Breast forms and prostheses have the shape and feel of a natural breast, and can help prevent back and neck pain.
  • If you lose your hair during chemotherapy treatment, you could wear a wig. Free or low-cost wigs are available from treatment centres or Cancer Council, or you can buy a wig.

Please note: This information is about early breast cancer. For information about secondary breast cancer (also called metastatic or advanced breast cancer), visit Breast Cancer Network Australia or Cancer Australia.

Related topics: Genetics and breast cancer | Breast reconstruction and prosthesis | Breast cancer trials | Breast health

Reviewed by: A/Prof Meagan Brennan, Breast Physician, Westmead Breast Cancer Institute, NSW; Carole Andary, Cancer Council Nurse, Cancer Council SA; Tracey Bretag, Consumer; Terri-lee Cooper, McGrath Breast Care Nurse, Cancer Screening and Control Services, Tasmanian Health Service, TAS; Dr Richard de Boer, Medical Oncologist, Royal Melbourne and Epworth Hospitals, VIC; Miss Jane O’Brien, Specialist Breast and Oncoplastic Surgeon, Epworth Breast Service, VIC; Susan Schwabe, Breast Cancer Care: Clinical Nurse Consultant, W.P. Holman Clinic, Launceston General Hospital, TAS; Dr Anita Taylor, Deputy Director, The Wesley Breast Clinic, QLD.

 

Updated: 01 Jul, 2016