Is it normal that after one year and a half after a lumpectomy, my breast still feels very tender to the touch, and sometimes even sharp pains?

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BethDupreeMD (Physician - Surgery - Breast (Verified) ) - 02 / 24 / 2013

Any surgery creates changes in our body that requires time to heal. The initial phase of healing occurs in the first six weeks when collagen is being deposited and created. Then from six weeks to six months the collagen remodels to its eventual final healed state. After a lumpectomy, we typically begin radiation therapy within a few weeks to months, therefore it occurs during the six-month time frame of healing. Radiation therapy stops fast dividing cells from dividing thereby halting the growth of any cancer cells. It also affects the normal cells of the breast as well. There are many changes that take place in the breast and every breast reacts differently. Breast size, fat content, ptosis (droopiness), skin type and density of the breast can all influence the final outcome.

The breast will often retain fluid after radiation therapy, and may experience increased swelling or a sense of fullness. (Women often report increase aching when a low-pressure weather system is rolling in!) Typically the radiated breast will not change in size with weight gain or loss, as the non-radiated breast will do. So the tenderness and the sharp pains are very normal and should not be a concern. If a lump is felt in the breast after radiation therapy it should be brought to the attention of the breast surgeon.
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member1353 (Caregiver) - 03 / 02 / 2013

A very common long-term effect of breast radiotherapy is development of a condition called "breast lymphedema" or "breast edema". This condition can result from the removal of one or more lymph nodes from the breast, which may impair the drainage path for lymphatic fluid from the breast. Radiation of the breast can further impair lymphatic drainage by causing fibrosis of the breast tissue, prevention of regeneration of the breast lymphatic network and functional changes in the autonomous lymph pumping in the lymph vessels.

When the breast skin becomes engorged with lymphatic fluid the breast can swell, become distorted and become tender. Long-standing lymphatic fluid (lymph stasis) puts the breast at risk for infection, often referred to as "delayed breast cellulitis". If not drained for a long length of time, skin changes begin to occur, resulting in proliferation of fat cells, fibrosis and inflammation, and ultimately hardening of the skin.

You should seek a referral from your primary care physician, radiologist or surgeon to a qualified lymphedema therapist for evaluation and treatment, if necessary. These medical specialists are trained in a protocol called "complex decongestive therapy" which may be helpful to you. This non-invasive technique is capable of draining excess lymphatic fluid from the skin, and can be followed by the use of compression garments to help prevent further lymphatic congestion. Specific procedures for maintaining skin softness and integrity can also be helpful.
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