Post-Surgery Concerns: Arm Tightness and Pain After Sarcoma Removal

[Postoperative Issue] Postoperative stretching of the surgical side arm, with slight tightness on the surgical side?

Hello, doctor.
I underwent a resection surgery for a phyllodes tumor about three weeks ago, almost a month now, and I have a few questions I would like to ask you:
1.
According to the postoperative rehabilitation instructions provided by the hospital, I have been performing arm exercises.
I noticed that when I extend my arm upward, the surgical site feels somewhat tight.
Is this a normal phenomenon?
2.
Additionally, when I extend my arm to the maximum limit, I observe a cord-like structure appearing beneath my breast, accompanied by pain.
Is this normal?
3.
When I perform massage, I find that the area of resection feels hard to the touch, and sometimes pressing it firmly causes sharp pain, with occasional shooting pains.
Should I schedule a follow-up appointment, or can I wait for the originally planned follow-up in three months? Thank you.

Niming, 20~29 year old female. Ask Date: 2018/10/22

Dr. Yuan Tianmin reply Breast and Thyroid

After the local excision of a breast tumor, the wound may feel firm for a period of time due to an inflammatory response.
There is no need to worry too much, but it is important to ensure regular follow-up appointments for monitoring and check-ups.

Reply Date: 2018/10/22

More Info

Post-surgery concerns, especially after a significant procedure like the removal of a sarcoma, are common and can be quite distressing. It’s important to address your specific questions regarding arm tightness, pain, and the sensations you are experiencing.
1. Arm Tightness During Movement: It is not uncommon to experience tightness in the arm after surgery, especially in the area where the surgery was performed. This tightness can be attributed to several factors, including swelling, scar tissue formation, and muscle stiffness due to reduced mobility during the recovery period. After surgery, the body undergoes a healing process, which can lead to temporary changes in muscle and connective tissue flexibility. Gentle stretching and rehabilitation exercises, as advised by your healthcare provider, can help alleviate this tightness over time. However, if the tightness is accompanied by severe pain or limits your range of motion significantly, it would be wise to consult your physician or physical therapist for further evaluation.

2. Pain and Visible Changes When Extending the Arm: The sensation of a "muscle popping out" or a visible change in the area under the breast when you extend your arm could be related to the healing process. After surgery, the surrounding muscles and tissues may react differently due to the surgical trauma. The pain you feel when reaching your arm up could indicate that the muscles or connective tissues are still healing or that there is some irritation in the area. If the pain is sharp or persistent, it is essential to discuss this with your healthcare provider, as they may want to assess for any complications such as nerve irritation or issues related to the surgical site.

3. Hardness and Pain in the Surgical Area: It is not unusual for the area around the surgical site to feel firm or hard as it heals. This hardness can be due to scar tissue formation, which is a normal part of the healing process. However, if you are experiencing sharp pain or "stabbing" sensations when you press on the area, it could indicate that the healing process is not proceeding as expected, or there may be underlying issues such as inflammation or nerve involvement. It is advisable to monitor these symptoms closely. If the pain worsens or does not improve, or if you have concerns about the hardness of the area, it would be prudent to seek a follow-up appointment sooner than the scheduled three months.

In summary, while some discomfort and changes in sensation are expected after surgery, it is crucial to listen to your body. If you experience significant pain, changes in sensation, or any new symptoms, do not hesitate to reach out to your healthcare provider. They can provide a thorough evaluation and determine if any additional interventions are necessary. Regular follow-ups are essential to ensure proper healing and to address any complications early on. Remember, your recovery is a process, and it’s important to be proactive about your health.

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