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Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 7369
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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. I had a double mastectomy on June the 6th of last year

Resolved Question:

Hi. I had a double mastectomy on June the 6th of last year and after a few months I felt like my arms were recovering well. Recently I have been trying to be more active, swimming, I have helped look after babies and just normal things. ( I did pick the children up) I now feel like I've gone back in time. My arms are quite painful now and I have problems sleeping on them. My worst problem is the arm that I had the pic inserted. I wondered if you could please advise me?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Uzair replied 2 years ago.
Dr Uzair :

Hi. Welcome to JustAnswer. I shall try my best to assist you while you are corresponding with me.

Dr Uzair :

Is there any swelling in the arms?

Customer: yes. I have had to take off my rings
Dr Uzair :

Alright, did you also have an axillary clearance with the mastectomies?

Customer: I'm not sure what that is
Dr Uzair :

Okay, did you have the mastectomy as a prophylactic measure or did you have breast cancer diagnosed>

Customer: Breast cancer. I've had breast reconstruction.
Dr Uzair :

Okay. Did you receive radiation and chemotherapy and when did that end?

Customer: I finished chemotherapy (fec 100) at the end of October. I had radiation when I first had the cancer 12 years ago.
Dr Uzair :

Alright, when one has bilateral mastectomies, the surgeon also clears the axillary lymph nodes leaving very little lymph tissue behind. This causes swelling of the upper limbs and pain and a feeling of weakness.

Customer: Lymph nodes were removed on the right side 12 years ago which is the side of the cancer. This no lymph nodes were removed.
Dr Uzair :

Okay, so they were not removed on the left side?

Customer: That's correct, not from the left side
Dr Uzair :

So, the left breast did not have cancer?

Customer: That's correct only the right side.
Dr Uzair :

Which means the left breast was taken out as a prophylactic measure.

Customer: As a precaution yes
Dr Uzair :

Okay, do you experience any numbness, tingling or pins and needles in the arms or hands?

Customer: All of those mainly in both hands.
Dr Uzair :

Okay, any pain at the back of the neck or the head?

Customer: Neck mainly and left shoulder.
Dr Uzair :

Okay, was the rectus abdomins flap (TRAM) used to reconstruct the breasts or was it the Latissimus Dorsi with an implant?

Customer: I did have the chemo injected up my left arm for two sessions. Then changed to a pic line for the last four.
Customer: The implants were put behind the chest muscles.
Dr Uzair :

Okay, well this doesn't seem related to the mastectomy, reconstruction or the PICC line.

Dr Uzair :

Since, that will not cause simultaneous weakness, paraesthesias and swelling of both the upper limb.

Dr Uzair :

However, this does sound like cervical spondylosis.

Customer: What does that mean ?
Dr Uzair :

It means that there is some compression in your cervical vertebra which is causing impingement of your brachial plexus (nerves that supply the upper limbs).

Dr Uzair :

Pins and needles, numbness (paraesthesias), swelling, back of the neck pain and weakness are all the signs that one can expect with this.

Dr Uzair :

And it is more common in the female gender and in your age group.

Customer: What should I do ? Is their a treatment for this ? Should I try to keep active ?
Dr Uzair :

Yes, this is a condition with a good prognosis. But an evaluation is the first step.

Dr Uzair :

I would advise you to visit your PCP, get x rays of the cervical spine (two views) done and nerve conduction studies and electromyogram done on both the upper limbs.

Customer: Ok thank you for your help. Much appreciated.
Dr Uzair :

The mainstay of treatment will be conservative and some physiotherapy with anti inflammatory medication and postural changes.

Dr Uzair :

It was a pleasure.

Dr Uzair :

Please do leave a positive rating for the service.

Dr Uzair :

Best wishes.

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