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March 2, 2008

Self-examination after a Mastectomy ?

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It probably sounds strange, but you should still be examining your “breast” after you have had a mastectomy.

Even though the breast is gone, it is impossible for the surgeon to remove every breast-tissue cell, and so some cells will remain — with a few even underneath the horizontal mastectomy incision across your chest. (Keep in mind also that breast tissue extends as high as your clavicle.)

So, what are you looking for then, post-mastectomy? You are doing what is referred to as an incisional examination, still using the same technique of moving three fingers in a circular motion, but now feeling along the mastectomy incision, as well as above and below it, for any lumps or bumps that may arise.

You must also visually check the skin around the incision for any red areas that are new, or for a rash or sores that may have cropped up. If you find any new irregularities, contact your breast surgeon for an examination.

When you go to your doctor, the same procedures apply: he/she should perform a clinical breast exam on your remaining healthy breast, while also doing an incisional exam of the mastectomy site.

What if you’ve had reconstruction — what then? The reconstructed breast also must be examined, but remember that an implant will feel different than your natural breast. If you have a flap, there may be some scar tissue inside it that you need to recognize as your new baseline findings.

The first time you return to the doctor for a long-term follow-up visit after you have healed, ask him/her to do the exam along with you so that both of you are in agreement about the new baseline findings.

Then, going forward, you can compare these agreed-upon baseline findings with any new features you may detect during future self-examinations.

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