Breast cancer treatment and the scarring experienced afterward can be upsetting for many women. As well as an altered body image, breast cancer scars can be tender, itchy, tight, irritating, and sometimes painful after surgery.
However, with some care and understanding, scars can become less prominent and be seen as signs of power instead of distress.
In this article, we explain why scars happen and how to care for breast cancer scars post-surgery.
What Is Scarring and Why Does It Happen?
Scarring is a natural process whereby the body helps to heal wounds by producing new collagen. Blood supply also increases at the location of the wound, which can result in the skin becoming red, raised, and sometimes lumpy.
Over time, however, and with some gentle care tips, the collagen around the healing wound begins to break down, the blood supply decreases, and the scar gradually becomes smoother, softer, and paler.
Scarring Caused By Breast Cancer Treatment
To be prepared for the type of scarring you may experience after breast cancer surgery, it is important to understand the procedure you will undergo and ask your doctor to clarify the type of scar you can expect.
For instance, it is not only procedures like mastectomies or lumpectomies that leave a scar. Additional treatments linked to breast cancer can also cause scars.
Surgical drains, for example, leave small circular scars once removed; chemotherapy ports leave scars at the site of incision; blisters or chafing associated with radiation therapy can result in permanent marks or thickening of the skin, and lymph node removal can result in scaring close to the underarm.
Breast reconstruction, which is often performed after one or more of the above-mentioned procedures, is usually performed by a plastic surgeon who will normally try to use the same incision as for the previous surgery.
If large parts of the skin were removed during a mastectomy or lumpectomy, the surgeon may suggest a breast reduction to limit scarring. However, if tissue needs to be harvested from another part of the body (like the buttocks) to perform a flap procedure, then there will be scarring there too.
Additional Factors That Affect Scarring
Other factors that affect scarring include genetics and skin type. For example, people with fair skin, freckles, or dark skin are believed to be more susceptible to abnormal scarring.
For some, genetics may cause the body to overproducecollagen, which can result in scars becoming more raised than usual. This type of scar is called hypertrophic and it can take several years to soften and settle.
Younger people, due to the faster production of collagen, are also considered more susceptible to hypertrophic scars, in addition to smokers, and those who suffer from post-surgery infections.
Genetics and certain skin types can also result in a keloid scar, which is similar to a hypertrophic scar, but differs in that it continues to grow in height and width long after it has healed.
How To Reduce Scarring
Although some scarring cannot be avoided after breast cancer treatment, there are methods of care that can be used to heal scars properly and improve their appearance over time. Caring for your scars will begin immediately after surgery and continue in the long term for up to a year afterward.
Post-Surgery Scar Care
Most breast cancer patients are advised not to raise their arms for a few weeks after surgery to avoid any pulling on the skin around the scar. In these cases, it helps to be organized with front-button clothing and loose-fitting pants for easier dressing.
The most vital care tip for scars is to prevent any type of infection from setting in. Carefully following your surgeon’s care instructions for showering, washing, and bandage changes will ensure your incisions are given the appropriate care and time to heal.
Consider a Surgical Drain
Surgical drains, which allow fluids to drain from the incision site after surgery should be kept clean and dry. In addition, it is best not to let the drains hang or dangle in case they become loose and allow bacteria to access an open wound.When showering, it’s helpful to have a drain lanyard that holds surgical drains and prevents them from dangling and pulling on the incisions.
Protect the Wound
Protecting the wound is also imperative to the healing process. Special underarm post-surgery recovery pillows & seat belt pillows are now available for breast cancer patients to protect the surgical site from the aggravation of seatbelts and provide comfort while sleeping.
Smoking has been proven to delay healing, so it is best to avoid it during the healing phase after surgery. Alcohol should also be avoided due to its dehydrating effects on the body, which can hinder the flow of blood and oxygen to the wound.
It is also highly recommended by dermatologists to prevent scars from sun exposure. The sun increases inflammation of the skin and can make scars that are still healing more prominent. If you do need to go out in the sunshine, make sure your scars are covered with light clothing and apply sunscreen to any exposed skin.
Long-Term Scar Care
As soon as you receive the all-clear from your surgeon that your scars have adequately healed, you can begin to massage the scar tissue by gently manipulating the skin above and below the scar.
To learn more about this type of massage, schedule an appointment with a physiotherapist (physical therapist) and ask for instruction on Transverse Friction Massage.
Other massage methods that physiotherapists use to reduce scarring are Deep Tissue Massage and Soft Tissue Massage. Gentle arm stretches will also help to improve upper body strength and mobility, as well as release any tightness in scar tissue.
Applying topical creams or ointments to the surgical site at least twice per day will help too. The type of cream used will not directly impact or improve the scar, but gently moisturizing cream into the scar will help to keep the skin hydrated and promote a softening of scar tissue.
Cosmetic Scar Care
When a breast cancer scar is fully healed, approximately one year later, some women choose to use cosmetic options to reduce the visibility of the scar.
Chemical peels and laser therapy, for example, are believed to reduce scar tissue, and other women choose to conceal their scars with a poignant tattoo that gives them strength and reminds them that they are survivors.
Scarring after breast cancer treatment can lead to body image worries, infection, skin tightening, and intimacy issues for some. However, proper care after surgery, along with a positive attitude can help to release any negative connotations you might attach to your scars.
If you are struggling to accept the changes to your body, consider joining a support group or speaking to a therapist to help you accept the changes and celebrate your newfound health.
BreastCancer.Org – Scar Tissue Formation- https://www.breastcancer.org/treatment-side-effects/scar-tissue-formation
Cleveland Clinic – Hypertrophic Scar - https://my.clevelandclinic.org/health/diseases/21466-hypertrophic-scar
Medline Plus – Closed Suction Drain Maintenance- https://medlineplus.gov/ency/patientinstructions/000039.htm
American Academy of Dermatologists Association – How to Minimize A Scar - https://www.aad.org/public/everyday-care/injured-skin/burns/wound-care-minimize-scars
Verywell Health – Preventing or Minimizing Scars After Surgery - https://www.verywellhealth.com/preventing-or-minimizing-scars-after-surgery-3156926