Back of Arm and Armpit Complete Numbness After Bilateral Mastectomy

Unfortunately, it is common to have nerve sensation loss after a mastectomy and lymph node dissection.  If you had eleven nodes removed, that is pretty extensive.  The sensory nerves get very beat up, and cut sometimes, and there is not alot you can do about it.  Only time will tell - it can take up to 2 years for nerves to fully come back, so be patient.  If, after two years, it has not improved, chances are that is how it is going to stay.  I hope this helps.

Numbness in the axillary region and upper arm are common post-mastectomy, especially if axillary surgery was performed.  There are several nerves that course through the axillary region.  Continue to be patient...often times it takes up to a year before sensation returns to any peri-incisional area.  Unfortunately, there is a nerve, the intercostobrachial nerve, which provdes the sensation to the area that you describe.  If injured, sensation may not return.  However, as the surrounding cutaneous nerves regenerate, some sensation, albeit a little bit different, may likely return.  But, a neuropraxia is is not uncommon with the nature of surgery, which then ameliorates with time.

The more tissues are disrupted under the armpit, the more likely there is to be reduced sensation to the inner arm and armpit. This is often permanent, but can certainly improve if the surrounding nerves regenerate into the area over time. It is important to note that tingling, shooting sensations, and "creepy crawly" feelings can happen as the nerves are waking back up. If there is pain with movement, physical therapy can be immensely helpful. Also - the more lymph nodes removed, the need for post mastectomy radiation, and patients who have weight issues or who are elderly have a higher risk of lymphedema (fluid accumulation in the arm) after surgery. Seeing a lymphedema specialist as well before problems occur is a great way to have the best outcome possible and to be on top of any arm-swelling changes if they happen in the future.

What you are experiencing in terms of the numbness and sensory changes is very common after mastectomy and axillary lymph node dissections.  In terms of range of motion exercises, I generally clear patients to start some range of motion exercises several weeks after mastectomy.

Unfortunately it is fairly comon to get numbness in the armpit and along the arm from the distrribution of some of the sensory nerves that may have been divided during your mastectomy. This may or may not get better

Unfortunately, it is not uncommon to lose arm sensation after mastectomy especially after extensive dissection has been performed, in case of lymph node dissection.  Some of the sensation may come back in the future as nerves grow back; however, the sensation may not be the same as before.  It will take some time to get some of the sensation.  In terms of range of motion, you can start utilizing your left arm and exercising in 3-4 weeks.  If you do not use your left arm, you will get stiff on that side.  Plastic surgeons vary when they want their patients to start ROM exercise.  You should talk with your plastic surgeon.  In my area, there are several breast cancer support groups that offer exercise regimen (ROM, lymphatic massage) as well as moral support.  It may be helpful if you can also talk with other women with breast reconstruction.  Hope your recovery is soon.

Sensation may return to some degree, but will most likely not be the same.  The inner arm sensory nerve is occasionally sacrificed during axillary node dissection.   I do believe it necessary to begin range of motion exercises by 4 weeks to minimize stiffness and limited mobility. I wish you a safe and healthy recovery.

Paul S. Gill, M.D.

Gill Plastic Surgery

Houston Double Board Certified Plastic Surgeon

I am sorry for what you are going through. It is horrible enough to have a diagnosis of cancer and undergo mastectomies without having any other complications. Unfortunately the nerve supplying sensation to the inner arm runs close to where the lymph nodes are located. To increase the likelihood of getting all the cancers cells, your surgeon had to remove all the nodes including any nerve fibers in them.

Sensation may return but it will take time. It will regenerate slowly (at a rate of 1mm a day) and in some people the regeneration can be followed clinically. There is nothing you can do to speed this process up except for taking care of yourself and follow your doctors' suggestions.

As regards your range of motion, I WOULD ask your surgeon to enroll you in a Physical Therapy treatment. To function better you may need people to work with you and help you regain full arm movement.