A feeling of tightness in the chest and armpit is normal following a mastectomy. People may also experience other sensations in the chest during the healing process, such as soreness, numbness, tingling, or burning.

In a mastectomy, surgeons remove the entire breast. They may do this for various reasons, which include the following:

  • A person may choose to have a mastectomy instead of a breast-conserving surgery called a lumpectomy.
  • Doctors may not be able to treat a person with a lumpectomy.
  • A person may have a high risk of developing a second breast cancer and choose to undergo a double mastectomy.

This article looks at what causes chest tightness after a mastectomy and whether it is a sign that a person needs to contact their surgeon.

It also discusses how to ease chest tightness and what else a person can expect following a mastectomy.

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Chest tightness after a mastectomy is normal. A 2019 study notes that once the surgeons have removed the breast, the muscles in the front of the chest can tighten.

This can occur for different reasons, such as the development of scar tissue, shortening of the muscle, or effects of breast reconstruction on the muscle.

Why does this happen?

The muscles in front of the chest and those around the shoulder may tighten after a mastectomy. The strongest and largest of these muscles, called the pectoralis major, performs two main actions. It pulls the arm inward and pushes it forward.

A mastectomy can affect the pectoralis major and result in a limited range of motion of the arm.

This can happen due to:

  • Shortening of the muscle: The surgeon removes the covering of the pectoralis major, called the fascia, in a simple mastectomy or the pectoral muscles under the breast in a radical mastectomy. They also remove surrounding tissue and skin. This may cause the muscle to shorten, which can cause a feeling of tightness.
  • Inflammation and muscle spasms: Inflamed muscles, spasms, and tender nerve endings after surgery can also cause tightness and pain.
  • The development of scar tissue: An overgrowth of tissue or the shrinking of skin at the source of a wound can cause scar tissue. This tissue is less elastic than normal skin or tissue. It can feel thick and tight and may restrict movement.
  • Breast reconstruction: If a person opts to have their breast or breasts reconstructed, the surgery can affect the muscles and cause a temporary feeling of tightness.

A common risk of reconstructive breast surgery is capsular contracture.

This occurs when scar tissue forms around the implant and begins to tighten and squeeze the implant. It can cause a feeling of tightness and appear hard and distorted.

A person may require surgery to remove the scar tissue and remove or replace the implant.

The length of time a person experiences chest tightness after a mastectomy may depend on the cause of the sensation.

Most people are fairly functional within 4 weeks of a mastectomy, but recovery can take longer. It can sometimes take several months, particularly if a person undergoes breast reconstruction.

While recovery and exercise can usually alleviate tightness, a person may require medical assistance in some cases. For example, if a person experiences capsular contracture after reconstructive surgery, the chest tightness may not resolve unless a person undergoes surgery to remove the scar tissue.

The American Cancer Society (ACS) notes that following breast reconstruction, the swelling and bruising that can cause chest tightness can last up to 8 weeks. Tight scar tissue can take up to 2 years to fully heal.

After a mastectomy, a person’s healthcare team will usually give them a series of exercises to do with a physical or occupational therapist and at home.

These should help to alleviate pain and tightness in the chest and other areas that a mastectomy can affect, such as the neck and shoulders.

Tightness is an expected side effect of a mastectomy. However, a person may wish to contact a surgeon if the exercises are not providing relief in the time frame the surgeon has suggested or if their pain intensifies.

Exercise can help to relieve chest tightness after a mastectomy. It can also help to return a person’s range of motion to their arms and shoulders.

A person’s surgeon or another member of their healthcare team will provide the person with exercises they should complete with their physical therapist or at home.

The ACS states that a person is typically able to begin the exercises 3–7 days after surgery. However, it is important not to perform these exercises until a doctor says it is OK to do so.

People may try:

  • raising their affected arm as they normally would when brushing their hair, bathing, or getting dressed
  • raising their arms to shoulder height and then lowering them 3 or 4 times per day
  • raising their arm and then opening and closing their hand 15–25 times
  • raising their arm and bending the elbow to touch the shoulder on the same side, and repeating on the shoulder on the opposite side
  • performing deep breathing exercises 6 times per day

If the feeling of tightness in the chest does not decrease with exercise, a person should contact their doctor.

A person may have to care for a temporary drain, which is a rubber tube that extends from the surgery site and collects fluid.

A doctor will inform them of how to properly care for the drain, the surgery site, and the wound dressing.

Some people may require further treatment after a mastectomy. This can involve:

Individuals may also experience side effects of a mastectomy. These can include:

  • bleeding
  • pain and tenderness
  • numbness in the chest or arm
  • swelling
  • the buildup of clear fluid in the wound
  • shooting pain in the chest, armpit, or arm
  • lymphedema, or the buildup of lymph fluid in the tissues just under the skin

After a mastectomy, it is normal for a person to experience tightness in the chest and surrounding areas.

This may be due to the shortening of the pectoralis major muscle, inflammation, scar tissue, or the effects of breast reconstruction on muscles.

Prescribed exercises can alleviate the tightness over time. If the pain does not decrease, a person should contact their doctor.