Brenda Spriggs, MD, MPH, MBA
A mastectomy is a surgical procedure performed to remove one or both breasts. It is usually performed to treat or prevent breast cancer, and it involves removal of all breast tissue and nearby lymph nodes. Like any major surgery, a mastectomy can lead to complications, so it is important that you talk with your doctor about these risks and promptly report any unusual symptoms.
A mastectomy may lead to problematic complications after surgery. The National Institutes of Health reports that wounds on the chest wall may persist long-term, leading to skin loss or infection. A build-up of blood at the surgical site (called a hematoma), formation of hard scar tissue at the surgical site, and bleeding into the area where the breast used to be may also occur. In some cases, another operation is necessary to stop the bleeding.
Post-Mastectomy Pain Syndrome
According to the Mayo Clinic, 20 to 60 percent of women will experience chronic pain after a mastectomy--a condition known as Post-Mastectomy Pain Syndrome (PMPS). Symptoms of this condition include pain in the chest wall, pain or itching in the shoulder or armpit, pain around the surgical scar and tingling down the arm.
A study published in the August 2008 issue of the "British Journal of Cancer" reports that women who have had previous breast surgery, women whose tumors are located in the upper lateral quarter of the breast and younger women are at increased risk of developing post-mastectomy pain syndrome. The authors note that PMPS may develop immediately following surgery or not until several months afterward. For some, the pain may persist for years. The cause of PMPS is not entirely clear, although it may be the result of nerve damage in the chest wall or in the armpit region.
Complications Related to Lymph Node Removal
Lymph nodes underneath the armpit may be removed during a mastectomy to prevent breast cancer from spreading. Lymph node removal can cause shoulder pain and stiffness, severe stabbing or burning sensations, and pins and needles in the breast and armpit area, according to the National Institutes of Health. Lymphedema, or a swelling of the arm, may also occur on the same side as the breast that was removed. Nerve damage may also lead to a numbing on the inside of the arm or muscle weakness in the back and chest wall.
Mastectomies may lead to serious complications that are possible with any surgical procedure. According to the NIH, potentially serious complications include breathing problems, infection of the surgical wound, infection that spreads throughout the body, blood loss, reaction to anesthesia or medications, heart attack or stroke during the surgical procedure and blood clots that form in the legs and may travel to the lungs.