Mastectomy. How to live after breast removal (05/14/2013). Complications after breast cancer surgery Life after breast removal

Doctors consider it quite natural that after certain surgical actions on the affected breast, women feel helpless and overwhelmed.

Many people do not understand how, after a mastectomy, they can return to normal life, regain their former self-confidence and restore the joy of life.

Despite the fact that the physical condition of women after breast removal does change, for their own family and friends, women remain the same as before. Even if the patients themselves don’t want to believe it.

According to statistics, after mastectomy, thousands of women find the opportunity to feel great again, without being embarrassed at all, to be in society. However, rehabilitation requires time and some effort.

As a rule, in order to recover, women need to actively work on themselves, adhere to a certain diet, follow all doctor’s instructions, attend regular preventive examinations, and thereby gain self-confidence.

In any case, it should be understood that the process of postoperative rehabilitation, the process of breast restoration (if a woman decides to reconstruct it surgically) cannot be simple and immediate.

Although, of course, it is also impossible to call this process of recovery after a mastectomy impossible or unbearably long.

How can I correct or restore an operated breast?

We have already written more than once that there are several ways to restore what was removed during mastectomy: firstly, through plastic surgery, and secondly, through exo-prosthetics.

Of course, various plastic surgeries that allow you to restore the former shape of the breast after surgical treatment are possible.

But decisions on the possibility of carrying out such operations are always made strictly individually.

There are only two main options for performing such operations. This:

• An operation using a special silicone prosthesis, when the procedure is somewhat reminiscent of operations associated with increasing breast volume for completely healthy women.
• And an operation that uses the patient’s own tissue, which is borrowed from other parts of the body, to restore the former shape of the breast.

In addition, after radical breast removal surgery, you can restore your femininity thanks to modern exo-prosthetic techniques. These are situations when a special removable silicone prosthesis is made for a woman, which matches the patient in shape, size, etc.

However, it cannot be said that full-fledged rehabilitation of women after mammary gland removal is not limited only to restoring the shape of the breast. This process includes a whole range of measures aimed at:

• To prevent the development of lymphedema.
• To maintain the operated tissues and nearby tissues in proper condition.
• To prevent the development of concomitant diseases.
• To normalize (correct) the patient’s weight.
• For breast reconstruction.
• And to maintain a woman’s psychological balance.

Several rules of correct postoperative behavior

Rule one: after removal of the mammary gland, you should never ignore the appearance of even minor swelling of the arm or chest (even if the swelling is noticeable only on the hand or fingers).

Rule two: When removing the mammary gland (especially in the postoperative period), the patient must observe the necessary daily hygiene.

You should shower regularly and use special moisturizing lotions, deodorants or eau de toilette.

Rule three: It is necessary to discuss with the doctor the set of physical exercises required in a particular situation that corresponds to the patient’s state of health and is sufficient to keep the muscles in good shape.

Rule four: It is advisable to think about possible options for restoring the shape of the breast, naturally, discussing such issues with an experienced, qualified surgeon.

Rule five: You should try to maintain a physiologically normal weight for a particular patient. Ideally, women should choose a diet based on reducing salt intake.

The diet should also be enriched with fiber and perfectly balanced.

It is very important not to smoke or drink alcohol during the rehabilitation period, since these are the addictions that can be the most dangerous for women during the rehabilitation period - leading to the development of very specific complications.

Details about proper nutrition in the postoperative period

It is important to remember that all products that a woman who has undergone a mastectomy will consume must be absolutely fresh, and accordingly, dishes must only be freshly prepared (but not fried).

It is equally important, in this case, to follow the correct diet. For example, you will have to forget about snacking on sandwiches or fast food forever.

The diet of operated women should include foods that will be selected to minimize the load on the kidneys and liver.

At the same time, it is very important that a woman receives a sufficient amount of the right fats, healthy carbohydrates and proteins.

The correct diet for women during the rehabilitation period should be based on the body’s average daily needs for fats, proteins, carbohydrates, microelements and vitamins:

• Thus, the female body’s need for fat is about 90 grams per day. Of these, at least 30 grams should be vegetable fats.
• Loss of proteins after surgical treatment will have to be replenished. So, the body needs about 80 grams of this component per day. Preference should be given to beef, lean pork, cottage cheese, and sea fish.
• With carbohydrates, women need to be as careful as possible. It is advisable to keep the daily amount of sugar consumed to a minimum. It is advisable to consume no more than 350 grams of starch, fiber, and pectin per day. It is important to eat the right carbohydrates - vegetables, fruits, cereals, bran bread.

But, in any case, a detailed correction of the diet in the postoperative period should be carried out by a doctor who is familiar with the medical history of a particular patient in detail.

Our expert - Doctor of Medical Sciences, Professor Gennady Chepelenko.

It is necessary to fight swelling

During the operation, it is necessary to remove not only the lymph nodes, but also the axillary lymph nodes and areas where tumor cells accumulate. As a result, every third patient, or even more often, develops lymphatic edema of the arm in the next 1-3 months: removal of the lymph nodes located in the armpit disrupts the transport of the most important biological fluid - lymph.

Whether swelling appears or not depends primarily not on the patient herself or on the skill of the doctors, but on the degree of damage to the lymphatic vessels during the illness. Edema can be avoided only in cases where the patient’s lymph nodes are not completely affected by tumor cells, and some of them do not need to be removed during surgery. Such healthy ones, preserved after surgery, take on the “work” of the victims and protect them from complications.

However, incomplete removal can lead to recurrence of the tumor disease. Therefore, most doctors remove the lymph nodes, which removes many small vessels that are associated with these nodes. As a result, lymph stagnates in the soft tissues of the hand and swelling develops. This swelling increases when a woman undergoes radiation therapy necessary for treatment after surgery, and also if she develops inflammation.

In some patients the swelling is insignificant, while in others, on the contrary, it leads to severe complications. This does not depend on age or even on health status, although, of course, physically strong women have fewer complications. Women suffering from venous insufficiency are at risk. With this disease, the ground for future edema is “prepared” by disruption of metabolic processes in cells and increased vascular permeability.

Consult a doctor

1. If the hand becomes pale, cold. At first it is soft, although swollen, but then the swelling becomes more dense and tight. It may be painless and remain insignificant for a long time, but nevertheless it is dangerous.

2. If you feel stiffness of movement in the shoulder and elbow joints, weakness in the arm.

3. If the swelling increases sharply, moving quite quickly from above over the entire surface of the arm.

4. If the swelling becomes like a mosaic: the hand does not swell completely, but in separate areas, starting from the armpit area, along the forearm and to the hand.

When specialist intervention is required. If swelling or inflammation cannot be avoided, you should immediately begin treatment on the recommendation of a doctor.

Hardware segmental massage of edematous tissues

Not long ago, doctors discovered that areas of the arm can swell to varying degrees, alternating with healthy areas. This is how local, segmental edema appears. For them, a method of segmental massage and alternating compression of the swollen tissues of the hand was developed, which is very effective for mild swelling.

Drug therapy

Two groups of drugs are usually used: benzopyrones, which have anti-edematous and anti-inflammatory effects, improve metabolic processes in tissues and skin resistance, and nicotinic acid preparations, which expand the lumen of lymphatic vessels and improve blood circulation. All together helps reduce swelling of the hand. For advanced, already pronounced and rapidly progressing edema, treatment in the clinic is advisable.

What can you do yourself

Do special gymnastics. The set of exercises that the doctor recommends should be done every day. These exercises improve muscle tone, joint mobility, lymph and blood flow. And they reduce the likelihood of developing both edema and inflammation.

Strengthen blood vessels. To do this, it is good to take vitamins, especially niacin and B vitamins.

Take care of your skin. To prevent the skin on your hand from losing its elasticity, regularly lubricate it with special plant-based cosmetics, natural cosmetic oils - peach, olive, jojoba oil.

Watch your hand. You can even record signs of swelling, especially if it changes quickly. There are edema of I, II and III degrees of severity. With grade I lymphatic edema, the circumference of the swollen area of ​​one arm does not exceed the circumference of the healthy arm by more than 2 cm. With grade II edema, this difference increases to 4 cm, and grade III - to 6 cm.

Buy an elastic sleeve. It is sold in specialized pharmacies. By covering the area of ​​swelling, the sleeve improves lymph flow and creates a feeling of comfort. The doctor will help you choose the right sleeve size and teach you how to use it. It is recommended to replace the sleeve with a new one every 2-4 months.

Do not load the sore arm with muscle work. Lifting heavy objects, excessive stretching, and a long forced position in a state of flexion or extension are contraindicated for her.

Do massage. It is especially effective in the first stages of edema development.

Protect your hand from injury. A sore, swollen hand requires increased attention. Wounds, abrasions, bruises, and insect bites are contraindicated for her. All this can become an additional source of infection and intensify pathological processes in the area of ​​edema. You should never measure blood pressure or give injections on your sore arm, or take blood tests.

You should also protect your hand from hot objects, water, and direct sunlight.

If your hand was accidentally injured, see a doctor and do not refuse to undergo a course of antibiotic treatment without waiting for inflammation, for prevention. After all, the body’s defenses in women who have undergone surgery are depleted, and the likelihood of inflammation is much higher than in healthy women.

Successful treatment of a serious illness cannot do without a balanced diet for breast cancer. The diet requires compliance with certain restrictions and rules. There is no specifically developed menu for cancer, but there are general recommendations approved by oncologists. This means that this diet is also suitable for patients with other malignant and benign tumors.

To improve the patient's condition when diagnosing breast cancer, a nutritious diet is recommended. First of all, the daily menu should be balanced in essential nutrients, vitamins and minerals. Fasting is strictly prohibited. It is important to follow the following rules:

• eating small portions of food;
• eating 5 - 6 times a day;
• chew food thoroughly in a calm environment;
• eating food at room temperature, neither hot nor cold;
• eating fruits and vegetables raw or after slight heat treatment;
• cooking with filtered and purified water, tap water must be completely excluded;
• Drink plenty of purified water, green tea, still mineral water. Limit consumption of tea, coffee, especially instant coffee.
• food should be unsalted, without dyes, preservatives, flavor enhancers, etc.

An important direction in creating a competent diet for a malignant breast tumor is to reduce the caloric content of food. Reducing high-fat foods in the daily menu significantly slows the growth of cancer cells

For breast cancer, the daily menu should be aimed at increasing local general immunity, fighting free radicals, detoxifying the body, radioprotective protection, and preventing relapses after surgery.

Proper nutrition for a woman with breast cancer implies a balanced diet, including vegetables, fruits, lactic acid products, lean meats, and fish. The vegetables that will be most beneficial for cancer patients are:

• broccoli (sulforaphane fights malignant cells);
• celery (high content of vitamin C and trace elements);
• pumpkin (rich in fiber and microelements);
• tomatoes (rich in antioxidant lycopene);
• beets (contains anthocyanins and antioxidants);
• watercress (phenethyl isothiocyanate destroys free radicals).

Fruits and berries are high in vitamins, antioxidants, and pectins. These biologically active substances increase immunity, fight free radicals, and reduce the risk of relapse after treatment.

If a malignant tumor is detected in the mammary gland, it is necessary to exclude fried, smoked, pickled, canned, and refined foods. The same rules are followed after surgery to remove a tumor.

Remember! The consumption of coffee, cocoa, strong tea, carbonated drinks, canned juices, and alcoholic beverages is prohibited.

Nutrition in the initial phase of the disease

When a malignant disease is detected, in addition to the prescribed treatment, benign food is important for a woman. A well-chosen menu helps the body fight malignant manifestations and eliminates the provocation of tumor growth after surgical treatment.

The basis of the menu should be foods rich in fiber. It is very important to maintain normal gastrointestinal function and prevent constipation. To do this, include fruits and vegetables in the daily menu as a source of dietary fiber.

The diet of a patient with breast cancer should not be high in fat. It is necessary to choose milk and lactic acid derivatives with low fat content. It is better to use low-fat kefir, cottage cheese, fermented baked milk, and sour cream. Hard cheeses should not be fatty or salty.

Diet at stage 2 of the disease

The specificity of the development of the disease in the 2nd phase of the pathological process determines the trend in a woman’s diet. It is aimed at strengthening local and general immunity. To achieve this goal, close attention is paid to the sufficient content of vitamins and minerals in food. Vitamins A, D, E, and ascorbic acid are valuable for maintaining the body’s immune system. The main part of the patient's menu should be plant foods rich in vitamins.

It is useful to prepare freshly squeezed juices from vegetables and fruits. Such drinks will allow you to consume vitamins and minerals in a more concentrated form. It is useful to consume apple, carrot, celery, orange, beet, and pumpkin juice.

Plant foods rich in pectin and antioxidants help reduce intoxication and the negative effects of chemotherapy and radiation therapy. Many fruits and berries have radioprotective properties.

Advice. Patients' menus should include medicinal herbs in the form of tea and vitamin drinks. Rosehip tea is an excellent source of vitamin C and flavonoids. Nettle is rich in ascorbic acid and vitamin D. The use of medicinal herbs as herbal medicine for breast cancer is recommended only with the permission of the attending physician

The daily menu for breast tumors during this period includes foods rich in fiber. This is important for normalizing digestion. It is also necessary to maintain optimal liver and kidney function.

After a successful operation and treatment, the principle of nutrition is to prevent relapses. The diet is aimed at maintaining the immune system, preventing intoxication and slagging of organs and tissues. The same principles are observed as in the development of cancer at different stages.

Features of the diet at stages 3 and 4 of cancer

The diet of a woman with breast cancer at this stage of the disease is aimed at detoxifying the body after treatment. At this stage of the disease, it is important to reduce the negative impact of toxins during tumor decay. For this purpose, a sufficient amount of fiber is introduced into the patient’s menu.

Natural foods remove toxins and waste from the body. They prevent the development of intoxication of the body, which is important at this phase of the disease.

Protection from exposure to radioactive radiation is important for the patient in this phase of development of breast cancer. At this stage of the disease, radiation therapy and chemotherapy are used for treatment.

You can reduce the harmful effects of medications and radioactive radiation using a competent menu. Vegetables and fruits containing high concentrations of selenium, pectin, carotene, and antioxidants protect healthy cells of the body from the effects of ionizing radiation.

The fourth stage of cancer is the most severe, characterized by metastases to the brain, lungs, bone tissue, and liver. The period is an irreversible form of malignant damage to the entire body. The principle of the menu during this period is to maintain the patient’s strength, improve the quality of life against the background of metastatic processes. Meat and fish are completely excluded from the menu. It is based on vegetables, fruits, and easily digestible cereals.

A competent diet for malignant breast formation at any stage of the pathological process improves the general condition of the patient, strengthens the strength to fight the disease, and increases immunity. The use of useful ingredients reduces the negative impact of the use of chemotherapy, radiation therapy, and reduces the intoxication of the body that accompanies the process of tumor decay. A balanced menu helps to resist the disease and prevents the development of relapses. This factor should not be neglected in the complex treatment of malignant diseases.

After a mastectomy, as after any surgical operation, it is important to follow the principle of proper nutrition and adhere to a strictly defined diet.
The principles of choosing a diet in the postoperative period are not very different from the general principles of proper nutrition for a healthy person.

But, since the body is always weakened after surgery, the patient’s diet after surgery has its own characteristics and nuances.

Principles and features of proper nutrition and diet selection in the postoperative period

1. There is a strict rule for all women who have undergone surgical mastectomy of the mammary glands that nutrition during this period, first of all, should be complete in the composition of proteins, fats, carbohydrates, vitamins and mineral salts and microelements. At the end of the article, the necessary and sufficient amount of useful substances for a full and speedy recovery are published.
2. Equally important for women who have undergone surgery is regularity of nutrition. Only adherence to a strict diet will create the right conditions for speedy rehabilitation and recovery after mastectomy surgery.
3. The principles and approaches to proper nutrition in the postoperative period should include a careful selection of products according to the following criteria that reduce the load on vital organs, liver, kidneys, pancreas:

- Products should only be fresh; large amounts of preservatives are not allowed
- A proper diet after surgery should include more fresh vegetables and fruits, grains, fish and lean parts of meat and poultry.
- to eat healthy, you need to exclude spicy, fried, salty and canned foods
- like any diet, proper nutrition after a mastectomy categorically excludes any fast food and a quick snack of sandwiches between meals.
- the post-mastectomy diet also involves avoiding carbonated drinks
- The diet after surgery involves limiting sugar intake. The consumption of sucrose and glucose will have to be reduced, even if the patient does not have increased tolerance to sugar and diabetes. The fact is that high blood sugar negatively affects the rate of wound healing. Of course, you don’t need to completely give up sweets; carbohydrates are necessary for complete and proper nutrition of the body, but the postoperative diet forces you to keep strict records of sugar, including polysaccharides, sucrose, glucose and fructose as part of your total carbohydrate intake. It is a good idea to replace sucrose with fructose during this period. It’s good to replace pure sugar with sweet fruits, but you’ll have to keep track of them too. For this you will need scales or a steelyard.

Daily requirements for nutrients for proper nutrition after surgery.

For rapid recovery and rehabilitation of patients after mastectomy, certain daily amounts of proteins, fats and carbohydrates, vitamins, mineral salts and microelements are required. The recovery process will depend on their sufficient quantity:

What should be the diet of a woman diagnosed with breast cancer?

First, and the most important rule: all products must be fresh, and dishes must be freshly prepared. It is equally important to store food correctly. For example, vegetable oil does not “tolerate” metal utensils, air and light, so it is better to store it in a dark glass bottle.

Second rule : follow the diet. You will have to forget about sandwiches and other “dry food”.

Third rule: products should be selected so as to minimize the load on the liver and kidneys.

Which products should be given preference, and which should be ruthlessly “banished” from the diet? Let's start with fats, the average daily requirement for which is 90 g. Of these, 30 g are of plant origin. But these same 30 g are not recommended for frying (during heat treatment, toxic substances are formed in the oil). The remaining 60 g comes from butter, cottage cheese, sour cream and meat.

To compensate for the loss of proteins (the reason for which is specific treatment of tumors), the body requires approximately 80 g of this component. Proteins should not be overused - in larger quantities they create additional stress on the liver and kidneys. Beef, lean pork and cottage cheese, sea fish, eggs are reliable sources of proteins.

And of course, vegetables and fruits. Proteins should not be abused - in larger quantities they create additional stress on the liver and kidneys. Beef, lean pork and cottage cheese, sea fish, eggs are reliable sources of proteins.

There are proteins of plant origin that are found in soy. Unfortunately, for some reason this product is rarely used. But in vain, because it is capable of removing radionuclides. Up to 30 g per day - this should be the proportion of soy in the daily diet.

But with products rich in hydrocarbons, the situation is more complicated. The amount of regular sugar during specific treatment should be kept to a minimum - 30-40 g per day, and if there is no allergy to bee products, it is better to replace it with honey. The body needs about 350 g of starch, fiber, and pectin per day. But it is very important to make the right choice: from cereals you should prefer buckwheat and oatmeal (semolina should be in last place on this list), and from flour products - bread with bran (if there are no contraindications - peptic ulcers and gastritis with high acidity).

And of course, vegetables and fruits... Of course. Firstly, they are rich in fiber, which stimulates the functioning of the gallbladder and intestines. Secondly, they contain natural antioxidants - vitamin C and beta-carotene. Thirdly, red and yellow vegetables and fruits contain bioflavonoids, which help cell membranes recover after a course of chemotherapy and radiation.

Fish oil or fatty fish varieties that contain substances that “restore” cell membranes; dried apricots, raisins - they contain a lot of potassium, which enhances the excretory function of the kidneys; seaweed - it holds the record for the content of microelements.

What foods should be taboo?

We advise you to avoid dishes made from liver, since it is considered a detoxification “factory” in the body. Don't get carried away with vegetables grown in greenhouses. It is better to replace pickled ones with pickled ones. And spicy foods - smoked meat, fish, herring - should be completely excluded from the diet. Refuse fried foods in favor of boiled, steamed, stewed ones. And be sure to monitor your weight - if it has changed by more than three kilograms, consult a specialist.