Some people who undergo a mastectomy may choose to have reconstructive surgery afterward. Although the recovery process can bring relief and positive changes, it is not uncommon to experience various types of pain while healing. Sharp, stabbing pain in the reconstructed breast may be alarming but isn’t necessarily a cause for concern.

One member of MyBCTeam explained, “Shooting pain from either breast surgery or radiation is common, and I had it from both treatments on my ‘bad’ days. It sometimes takes months and even years to get past that. Just remember, it is normal as tissue and nerves regenerate. Give it time, talk to your doctors, and take pain meds as needed.”

Learning to tell the difference between normal pain and pain that needs medical attention is essential to staying safe and comfortable while you recover. When in doubt, you should always contact your health care provider. But here’s some background on different causes of stabbing pain after reconstruction and what to expect.

Post-Reconstruction Pain: What’s Normal?

Pain during the first few weeks following reconstruction should be expected. Your surgeon will send you home with instructions on how to keep the pain under control so you can get the rest you need to recover. In a 2018 study, researchers found factors associated with more severe postoperative pain included:

• Being of younger age
• Having bilateral reconstruction
• Having preoperative pain
• Experiencing anxiety and depression

Continue reading to learn about several types of side effects you may experience after surgery.

Incisional Pain

Surgical incisions, whether made for autologous tissue reconstruction (when a person's body tissue is used to rebuild or repair an area after surgery) or implant-based reconstruction, can cause localized sharp pain. Usually, this pain goes away as the incision site heals.

Inflammation and Swelling

Swelling and inflammation are common after any surgical procedure, including breast reconstruction. These symptoms can contribute to discomfort and aching sensations in the reconstructed breast. Swelling usually peaks within the first few weeks and gradually goes away within about eight weeks.

Muscle Pain

Flap-based reconstruction may involve the transfer of muscles from another area of the body, such as the back or abdomen. The muscles in the donor site and the reconstructed breast may experience temporary discomfort and soreness as they adapt to their new positions.

Neurologic Pain

Nerve injuries to the intercostal and pectoral nerves can lead to nerve-related pain, such as tingling, burning, or shooting sensations. This may improve as the nerves regenerate.

Sometimes, nerve pain is temporary. But nerves that get caught in the scar tissue can lead to chronic pain that requires surgical treatment or long-term management. Your doctor can perform a nerve block to determine whether nerve pain is causing your symptoms.

When Is Post-Reconstruction Pain Cause for Concern?

Severe stabbing pain that doesn’t improve with time or treatment may require medical attention. Following are some issues that warrant follow-up with your doctor.

Capsular Contracture

Capsular contracture happens when the scar tissue around a breast implant becomes tight and squeezes, causing pain, hardness, and changes in how the breast looks. If you feel sharp, stabbing pain along with significant changes in how your reconstructed breast looks or feels, talk to your doctor about these symptoms.

Implant-Related Complications

Sharp, stabbing pain in the reconstructed breast may be a sign of complications such as implant leakage or rupture. If the pain is accompanied by changes in breast size, shape, or hardness, you'll need to consult with your medical team promptly.

Infection

Pain that is persistent, accompanied by fever, chills, or discharge from the incision site, may be caused by an infection. In such cases, seeking medical attention is crucial to prevent further complications.

Pain should resolve once your body heals, but some MyBCTeam members have noted lingering pain years after treatment. “The scarring from the radiation goes under my armpit also and aches and burns,” said one member. “Basically, I was told that happens sometimes, so it has been just living with that and the very sharp stabbing pains at times in the breast/chest area when I move. Thankfully, that doesn’t happen as often as the first few years.”

Chronic pain (which lasts more than three months) affects about half of people who have had a mastectomy. It's crucial to discover healthy methods for handling or treating long-lasting pain. This practice helps you steer clear of relying too much on opioid medications and makes sure you can move forward with your life after reconstruction surgery.

When Is Stabbing Pain a Medical Emergency?

While sharp stabbing pain in the chest after breast reconstruction is not always a cause for immediate concern, there are instances when it may be a medical emergency. It is important to recognize the signs and symptoms of potentially life-threatening conditions, such as a pulmonary embolism (sudden blockage in your pulmonary arteries) or heart attack.

Signs of a pulmonary embolism may include:

• Coughing up blood
• Dizziness
• Leg pain or swelling
• Rapid heartbeat or palpitations
• Shortness of breath
• Sudden, sharp, stabbing pain in the chest that worsens with deep breaths
• Unexplained anxiety or lightheadedness

Signs of a heart attack may include:

• Cold sweats
• Intense, crushing chest pain (usually in the center or left side)
• Pain in the arms, jaw, neck, or shoulders
• Nausea or vomiting
• Shortness of breath
• Weakness or feeling faint

If you experience sharp stabbing pain in the chest along with any of these signs, seek immediate medical attention. In addition, infections can also be life-threatening and should be treated right away.

Managing Normal Pain at Home

Your health care provider might recommend some of the following ways to manage pain at home. Discuss these strategies at your follow-up appointments to find out if you’re ready.

Try Gentle Exercises

Engaging in gentle exercises and stretching as recommended by your health care provider can help improve circulation, reduce stiffness, and ease pain over time. It is important to avoid strenuous activities that may strain the healing tissues. A physical therapy referral can help you learn safe ways to rebuild your strength after surgery.

Apply Ice Packs

Applying ice packs wrapped in a cloth to the affected area can help reduce inflammation and provide temporary pain relief. However, ensure that the ice pack is not applied directly to the skin to prevent potential damage. You can wrap it in a towel and use a timer to avoid overdoing it.

Use Pain Medications — as Directed

Follow your health care provider's instructions regarding prescribed pain medications. Take them as directed to manage discomfort effectively. Some pain meds cause constipation, so discussing stool softeners to manage this side effect may be helpful.

Practice Relaxation Techniques

Practice relaxation techniques such as deep breathing, meditation, or guided imagery to manage pain and promote overall well-being. See if there’s a breast cancer support group you can join to participate in these activities with others.

Communicating With Your Medical Team

It is crucial to maintain open communication with your medical team throughout the recovery process. Take notes on the type of pain, how long it lasts, and when it occurs. Experiencing sharp, stabbing pain in the reconstructed breast can be distressing, but your health care provider can give you support and peace of mind. You can also ask to meet with a mental health professional for strategies to address the emotional impact of dealing with pain.

Reach out for help from others to get the supplies you need to manage pain at home. If you suspect a more serious issue, don’t hesitate to get a professional opinion.

Talk With Others Who Understand

On MyBCTeam, the social network for people with breast cancer and their loved ones, more than 64,000 members come together to ask questions, give advice, and share their tips with others who understand life with breast cancer.

Did you experience any sharp or stabbing breast pain after breast cancer surgery? What pain management techniques helped improve your quality of life during recovery? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.