What does mastectomy and breast reconstruction mean?

A mastectomy is surgery to remove breast tissue. Some people also choose or require breast reconstruction, which is surgery to rebuild the shape of the breast. Reconstruction may be done at the same time as the mastectomy or later, and there are different reconstruction options depending on the person’s treatment plan and preferences.

After surgery, people may experience:

• reduced shoulder movement

• chest or upper body tightness

• pain or discomfort

• scar sensitivity

• postural changes

• fatigue and reduced stamina

• difficulty returning to normal movement or activity

• concerns about swelling or lymphoedema, especially if lymph nodes were removed or treated.
  
  

How recovery may affect daily function

Recovery after mastectomy and reconstruction may affect:

• reaching and lifting

• dressing and self-care

• posture and upper body comfort

• shoulder movement

• sleep comfort

• return to exercise and work

• confidence with movement

• day-to-day function at home and in the community

Some people may also develop swelling in the arm, breast, chest or surrounding area after breast cancer treatment. Lymphoedema can occur when lymph nodes are removed or damaged, and swelling may affect movement, comfort and function.

Lymphoedema and swelling considerations

Some people are at risk of lymphoedema after breast cancer surgery or radiotherapy, particularly if lymph nodes have been removed or treated. Lymphoedema is swelling caused by a build-up of lymph fluid and can affect the arm, breast, chest, shoulder or hand. Cancer Council Australia states that lymphoedema can occur as a side effect of cancer treatment when lymph nodes have been removed or damaged.

It is important to use careful wording here:

• not everyone develops lymphoedema

• swelling should be assessed early if it appears

• treatment and management depend on the person’s symptoms and overall medical situation

How Palms Physiotherapy & Allied Health may help

Physiotherapy

Physiotherapy may support people after mastectomy or breast reconstruction where there are goals related to shoulder movement, upper body comfort, posture, mobility, scar-related tightness, physical confidence or return to activity. Depending on the person’s needs, physiotherapy may include:

• gentle movement and mobility support

• shoulder range of motion exercises

• posture and upper body movement retraining

• scar-related management advice

• gradual return-to-activity planning

• stretching and physical recovery support

• fatigue-aware exercise progression

Breast surgery recovery information commonly encourages gentle exercise and progressive return to movement after surgery, and physiotherapy exercises are often included in post-operative advice.

Occupational Therapy

Occupational therapy is not routinely needed for every person after breast surgery, but it may be relevant where someone is having difficulty with daily routines, self-care, fatigue management, upper limb function or return to work and home tasks.

Exercise Physiology

Exercise physiology may be appropriate for some people after breast surgery who need support with graded return to exercise, physical reconditioning, endurance or general strength, particularly once they are medically cleared to progress activity.

Speech Pathology

Speech pathology is not usually relevant to routine mastectomy or breast reconstruction recovery unless there is a separate communication or swallowing issue unrelated to the breast surgery itself.

Our approach

At Palms, we take a function-focused, goal-directed approach. That means we look at how recovery after surgery is affecting the person in everyday life and what practical support may help. Therapy may focus on:

improving shoulder and upper body movement

reducing fear or hesitancy around movement

supporting posture and comfort

helping with return to daily tasks

pacing recovery safely

supporting confidence with exercise and activity

We also recognise that support often works best when it is coordinated with the person’s GP, breast surgeon, oncology team and broader medical supports where appropriate.

FAQ

Can physiotherapy help after mastectomy?

Yes. Physiotherapy may help support shoulder movement, upper body mobility, posture, scar-related tightness, confidence with movement and return to daily activities after mastectomy.

Can physiotherapy help after breast reconstruction?

It may. Physiotherapy may support movement, posture, recovery of shoulder function and gradual return to activity after breast reconstruction. Some reconstruction types can also affect the chest, shoulder or donor-site area during recovery.

Is it normal to feel tight after breast surgery?

Yes. Tightness, discomfort and reduced movement can be common after breast surgery, especially in the chest, shoulder and upper body during early recovery. Gentle exercises are often recommended as part of rehabilitation.

Can breast surgery affect shoulder movement?

Yes. Shoulder movement can be affected after mastectomy or reconstruction, and some post-operative information includes exercises specifically to restore shoulder range of motion.

What is lymphoedema after breast cancer treatment?

Lymphoedema is swelling caused by a build-up of lymph fluid. It can happen after cancer treatment when lymph nodes are removed or damaged. It may affect the arm, breast, chest or surrounding area.

Does everyone get lymphoedema after mastectomy?

No. Not everyone develops lymphoedema, but the risk can increase when lymph nodes are removed or treated with radiotherapy.

When can I return to exercise after breast reconstruction?

This depends on the type of surgery, healing progress and your treating surgeon’s advice. Some post-operative resources recommend resuming gentle exercise only once healing is progressing and the surgical team has cleared the activity.

Can reconstruction affect strength or shoulder function long term?

It can, depending on the type of reconstruction. For example, some flap procedures may affect shoulder strength or movement because muscle or tissue has been used in the reconstruction.

When should I see a physiotherapist after mastectomy or reconstruction?

It may be helpful to seek physiotherapy if you are experiencing reduced shoulder movement, upper body tightness, discomfort, fear of movement, difficulty returning to activity, or concerns about swelling and function after surgery.

If you are preparing for breast surgery or recovering after mastectomy or breast reconstruction and would like support with movement, posture, shoulder function or return to activity, our team can discuss whether physiotherapy may be appropriate for your needs. 

Important disclaimer: This webpage contains general information only and is not intended to be relied upon as personal clinical advice. While we aim to keep information accurate and up to date, it may not reflect the most current research or your individual circumstances. Palms Physiotherapy & Allied Health does not accept liability for decisions made based on this information without an individualised assessment by an appropriately qualified health professional. If you have concerns, please contact us to book an assessment or speak with your GP/medical team.