Pain and tightness axila to bottom of rib cage

Posted by jlgc @jlgc, Oct 18, 2023

4 months after a week of hypo - fractionated radiation RX and lumpectomy I have developed tenderness under affected axila and tightness on same side to bottom of rib cage. I’m surprised this started so long after radiation, and I remained fairly physically active throughout summer with kayaking and some hiking. Physician ordered physical therapy.
Wondering if anyone else has experienced this.

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I have that! I couldn't figure out what I did wrong. looking forward to some answers.

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I have had very similar. I had 3 lymph nodes removed(all negative for cancer), lumpectomy on left and reconstruction on both. I was having tightness, some lack of ROM and a little swelling start a couple months after radiation. I’m now doing some lymphedema therapy and physical therapy. I am also wearing a light- medium compression bra- very similar to a sports bra. Everything is really helping. I was/am active daily also.

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Also… as I’m getting dressed to go to PT. Compression bra i have is higher up in arm pit. Several out there. Mine is by prairie wear.

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@3dogngt

I have that! I couldn't figure out what I did wrong. looking forward to some answers.

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I don’t think you did anything wrong but I’m not sure why we are not warned that this could happen or told how to prevent it with at home simple exercises.
Just now starting PT and the therapist is trying to evaluate if the discomfort in axila is due to lymphedema. I don’t know if you can develop lymphedema without having had a lymph node resection or biopsy. Question is Can XRT alone cause it. Diagnosing this should not necessarily be in the physical therapist’s wheelhouse so I think now i will contact my surgeon. Will keep you posted.

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@jlgc

I don’t think you did anything wrong but I’m not sure why we are not warned that this could happen or told how to prevent it with at home simple exercises.
Just now starting PT and the therapist is trying to evaluate if the discomfort in axila is due to lymphedema. I don’t know if you can develop lymphedema without having had a lymph node resection or biopsy. Question is Can XRT alone cause it. Diagnosing this should not necessarily be in the physical therapist’s wheelhouse so I think now i will contact my surgeon. Will keep you posted.

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I had a recent PT assessment for Stage 1 lymphedema (truncal/axila)following a lumpectomy and radiation earlier this year, No lymph nodes involved in surgery. My range of arm motion is also reduced. Referred to PT after my post radiation check up. Had compression bra and cami bra fitted a few weeks ago, they have helped, the cami especially. I also kept active.

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@bonaly93

I had a recent PT assessment for Stage 1 lymphedema (truncal/axila)following a lumpectomy and radiation earlier this year, No lymph nodes involved in surgery. My range of arm motion is also reduced. Referred to PT after my post radiation check up. Had compression bra and cami bra fitted a few weeks ago, they have helped, the cami especially. I also kept active.

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Thanks for that info…where did you get the compression bra and cami fitted would that be a specialty store?

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@jlgc

Thanks for that info…where did you get the compression bra and cami fitted would that be a specialty store?

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Yes it was a speciality store, they had a really good choice. If you Google mastectomy bra you should show stores in your area. I tried buying without the fitting and they just didn’t work. My insurance covered costs of the fitted ones.

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I developed 2 months after short course of radiation with boost lymphedema which was treated with PT , compression bra, and home program. I also had pain in my chest wall, over my ribs, and over the pectoralis muscles. Physical therapy really helped regain motion. However, the strength and motion is still not normal. My right shoulder is now anterior to the left because of weakness of pectoralis muscle sand I still have pain which I continue to treat with exercises. This occurred in 2020. I was in an active PT program for over a year. Lymphedema resolved, the cording that developed did not. The chest wall inter rib and muscle pain continued. I finally had a chest MRI which showed significant fibrosis of chest wall, severe fibrosis of pec muscles( my tumor was in the breast over pec muscle) and fibrosis of muscles in between the ribs. Met with radiation oncologist who noted that the shortened radiation length of treatment had been done in UK and was done here during pandemic. He noted that subsequent studies showed increase in fibrosis. He also said that radiation side effects can occur up to five years later. I continue with exercise program and take celebrex and use Voltaren ointment for ache and pain. I feel strongly that all breast cancer patients should see a Breast Cancer PT prior to surgery and radiation for evaluation prior to those procedures for baseline and then see them again after treatment. Patients may not require more treatment but those that do will be able to progress. I thank the PT and the physical rehabilitation physician every day for their expertise and care. The best to all who develop these issues. It is another hurdle that can be overcome!!

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@jlgc

Thanks for that info…where did you get the compression bra and cami fitted would that be a specialty store?

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Forgot to say my Dr wrote a script for the compression bras.

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@jlgc

I don’t think you did anything wrong but I’m not sure why we are not warned that this could happen or told how to prevent it with at home simple exercises.
Just now starting PT and the therapist is trying to evaluate if the discomfort in axila is due to lymphedema. I don’t know if you can develop lymphedema without having had a lymph node resection or biopsy. Question is Can XRT alone cause it. Diagnosing this should not necessarily be in the physical therapist’s wheelhouse so I think now i will contact my surgeon. Will keep you posted.

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Surgical team is scheduling US to take a look. Initial assessment is that lymphedema should not develop if no lymph involvement or resection.

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