A Touchy Subject: Breast Suppleness

I’ve read women’s accounts and listened to women describe disappointment and frustration over the firmness or hardness of their breast weeks, months, even years after lumpectomy and radiation.   Throw in the gnarled tender scar that lies just beneath the surface of the skin and fear jumps up front and center.

I remember the first time I tried to touch my wound the day after surgery.  My site had been finished (or top coated as I imagined) with some kind of industrial body glue which left the side of my breast feeling waxy and harder than even I was prepared for.  My fignertips lighted on the area tentatively and produced a wave of nausea.  Under the hard shell I could feel the sutured rope of tissue beneath it.  An image of Frankenstein’s monster with the raised, railroad track scar popped into my mind.  What is this?  How long will this last?  I was swollen nearly twice the size I am now.  The image and sensations were alot to take in.

A week later at my follow up surgical appointment Dr. Robert Goulet, my cancer surgeon, took my hand and showed me how he wanted me to work and knead the scar.  Using a vein on the top of my hand he demonstrated how I was to stretch and pull the area on either side of the scar apart from the scar diagonally.  His fingers dug deep into the top of my hand and his twisting movement was uncomfortable.  You want me to touch this that way? I wondered to myself.  Are you kidding me!

My next agonized thought was that he was going to use that technique on my breast as I sat there in front of him.  No way I was going to allow him to touch my wound in the appointment.  I was direct.  I looked down at my foot hanging off the end of the exam table and commented on its proximity to his crotch, unprotected, as he sat legs spread open on the stool in front of me.  “You’re pretty exposed from where I’m sitting,” I said, still looking down toward his position.  As I raised my head and brought my eyes to meet his I added,  “You touch me.  I’ll hurt ya.” He looked down to assess the situation then let loose a hearty laugh.

“Are you still tender?” he asked sounding a little surprised.  Who wouldn’t be, I wondered?  “Well give yourself another week or so.  Then I want you to go in there every day and work that scar.”

As the days and weeks progressed I tried to follow his directions.  At first I did it standing up in front of the mirror.  I’d hold my breath as I placed my finger and thumb on either side of the incision.  The lumpy, swollen feeling beneath my fingers made my skin crawl.  The pain associated with trying to move the tissue beneath would bring tears to my eyes.  Once I was finished I’d massage the entire breast gently with Jergen’s lotion.  I would do this procedure before I went to bed.  I wanted to put the pain and queasiness behind me at night so I could rest and recover while I slept.

Once radiation began I continued the massaging and kneading but switched from using Jergen’s lotion to using Aquaphor along with a steroid prescription cream as directed by my radiologist.  My breast continued to feel hard and gnarly under my touch but I pressed on, working the scar, massaging the breast and hoping for the best.

My radiologist added another massaging component:  manual lymphatic draining.  I was instructed to take an oil or lotion (I started by using Aquaphor.  I’ve learned it’s good for just about anything!) and beginning on my hand massage and knead up the arm all the way through to the armpit and breast, ultimately finishing over the chest up toward the neck.  At the beginning it was painful.  But I persevered.  My morning routine went as follows: I’d shower, dry off a little, massage my arm, move to the scar, twist and knead the scar, move to massage the breast…then since I was so utterly moisturized I’d continue on with my face cream application and then move down to my legs.  I adopted a “have fun with it” attitude despite the fact that the serious part was painful.  I worked to breathe while I was kneading and massaging.  Overtime I went from being afraid and anxious about touching my breast to actually coming to the experience with a patience and tenderness.  This was an important part of my healing process.

It’s been four months and one week since my surgery.  My breast is no longer swollen.  The incision scars are non-existent.  The firmness is gone.  In fact my radiologist commented during my follow up appointment earlier this week that my breast tissue felt normal, soft, supple.  “Your breast tissue isn’t hard or firm like we see in many patients after radiation,” he said matter-of-factly.  When I explained that I’d been doing my massage exercises and had included another type of massage,  myofascial release, he seemed pleased.  “Keep it up!”

My surgeon, Dr. Goulet, explained to me that I would need to massage the scar and my breast everyday for the rest of my life.  I was a little discouraged when I heard that news.  “You can’t do it too hard,” he said when I protested that perhaps I was working on things with too much pressure.  After all, it hurt to work the scar and I didn’t want to damage my body.  But he was steadfast.  “You won’t hurt yourself.”   I work things over now each morning before I get dressed instead of at night before I go to bed.  The process takes a good 15 minutes if done correctly.  But the time I’m investing I believe is what has given me the excellent post-surgical/rad results!

If you’re struggling with firmness, tenderness, hardness in your breast and under the incisions, talk with your doctor about proper massage technique.  If you haven’t gotten into working your scar or the breast following your lumpectomy ask your doctor about how you should start.  Also, check into myofascial release as a means of helping to loosen up the breast tissue.  The session takes an hour.  The intensity can be painful but doesn’t need to be.  Work with your therapist on what pressure you can tolerate.  If you’re in Fort Wayne, I’d recommend Patrick Vondereau.  That’s who I use and trust.  I’ve known him for 30 years!  Never thought I’d need his help in this way, though.  But let me tell you, his work has made the difference in how I feel.  Quite literally!

Here’s to the softer side of you!