Costochondritis After Mastectomy: Symptoms, Causes and Management

by | Mar 17, 2023 | Common Conditions, Costochondritis

What is costochondritis?
Costochondritis is an inflammation of the costal cartilages, the flexible connective tissues that join the ribs to the sternum (breastbone), contributing to the structural integrity of the chest wall. While it can occur in various populations, it is particularly common among patients who have undergone treatments for breast cancer, such as mastectomy. The condition can precipitate a range of symptoms, most notably discomfort and pain in the area surrounding the breastbone. The severity of this pain can fluctuate, potentially ranging from a mild annoyance to a debilitating condition that may profoundly affect the individual’s daily activities and overall quality of life.
Definition of mastectomy
A mastectomy is a surgical procedure that involves the removal of one or both breasts. It is commonly performed to treat or prevent breast cancer. Depending on the specifics of the case, different types of mastectomy procedures may be recommended by the medical team. These range from a total (or simple) mastectomy, where the entire breast tissue is removed, to more complex procedures like a radical mastectomy that involves removing the breast, chest muscles, and all the lymph nodes under the arm. The type of mastectomy performed can play a role in the likelihood of developing conditions like costochondritis post-surgery.
Connection between mastectomy and costochondritis
The connection between mastectomy and costochondritis is often attributed to the surgical trauma and subsequent changes in the chest wall following the removal of the breast. This trauma can lead to inflammation of the costal cartilages, resulting in costochondritis. Additionally, the physical changes in the chest wall after a mastectomy can cause discomfort, with patients often reporting feelings of lumpiness or denseness in the chest area. These changes can sometimes be mistaken for costochondritis, making it crucial for healthcare providers to conduct thorough assessments and accurately diagnose the source of the pain.
Why understanding costochondritis after mastectomy is important
Understanding costochondritis after a mastectomy is important for several reasons. Firstly, it aids in the early diagnosis and appropriate treatment of the condition, preventing unnecessary distress for the patient. Secondly, costochondritis can significantly affect a patient’s recovery journey and overall quality of life post-surgery. Persistent chest pain can limit physical activity, cause sleep disturbances, and lead to anxiety and fear, impacting the patient’s emotional well-being. Therefore, being aware of the symptoms and risk factors of costochondritis can lead to timely interventions, improving patient outcomes.
Physical symptoms
The physical symptoms of costochondritis can vary from person to person. The most characteristic symptom is chest pain, which can manifest as a sharp or dull ache near the breastbone. This pain can sometimes radiate to the back, stomach, or arms, further complicating the diagnosis. Patients with costochondritis often report tenderness in the chest area, particularly where the ribs meet the sternum. This pain can worsen with certain movements or activities, such as lifting heavy objects, or even with deep breaths. It is crucial to be aware of these symptoms and seek medical advice promptly to receive the right treatment.
Psychological impact
In addition to the physical symptoms, costochondritis can also have a significant psychological impact on patients. Persistent chest pain can lead to anxiety and fear, particularly as the pain is located in the same area where the patient had previously been diagnosed with cancer. This can trigger fears of cancer recurrence, causing a great deal of emotional distress. Moreover, living with chronic discomfort can negatively affect the patient’s mood and overall mental health. It is therefore crucial to address these psychological aspects when managing costochondritis after a mastectomy.
Common misconceptions about symptoms
There are several misconceptions about the symptoms of costochondritis. One common misconception is that the pain associated with costochondritis is always severe. In reality, the intensity of the pain can vary from mild to severe. Another misconception is that all chest pain after a mastectomy is due to costochondritis. While costochondritis is a common cause of chest pain post-mastectomy, other conditions can also cause similar symptoms, making it crucial to get a proper diagnosis. Lastly, it is important to understand that chest pain does not always indicate a recurrence of cancer. It is natural to worry about cancer recurrence when experiencing chest pain after a mastectomy, but it is important to remember that there are many potential causes of chest pain, including costochondritis.
Common factors contributing to PMPS
Several factors can contribute to the development of PMPS. These include the type of surgery performed, particularly if the surgery involved removing tissue from the upper outside portion of the breast or the underarm area. Procedures that involve the removal of a significant number of lymph nodes to check for cancer have also been associated with a higher risk of PMPS. Furthermore, treatments such as radiation therapy following surgery can increase the risk of PMPS. Mental health conditions like anxiety or depression prior to surgery have also been linked to a higher likelihood of persistent post-surgery pain. Genetic factors and the patient’s overall health status can also influence the risk of developing PMPS.
Risk factors

Surgical factors
Surgical factors play a significant role in the development of costochondritis post-mastectomy. The trauma and inflammation caused by the surgery can trigger costochondritis. Also, certain surgical techniques and procedures may increase the risk of developing this condition. For instance, procedures that involve manipulation or removal of the costal cartilages may lead to inflammation and subsequent costochondritis. Therefore, understanding these surgical factors can assist in the prevention and early detection of costochondritis post-mastectomy.

Pre-existing conditions
Pre-existing conditions can also contribute to the development of costochondritis after a mastectomy. Conditions that affect the cartilage, such as osteoarthritis, rheumatoid arthritis, or ankylosing spondylitis, can increase the risk of costochondritis. Additionally, any previous chest wall injuries or trauma can predispose a patient to develop this condition post-mastectomy. Therefore, a comprehensive medical history is important in assessing the risk of costochondritis.

Lifestyle factors
Lifestyle factors are another important aspect in the development of costochondritis after a mastectomy. Overuse of the arms, whether due to work or physical activities, can trigger or worsen the symptoms of costochondritis. Activities such as heavy lifting, sweeping, or any movement that overextends the upper body can lead to flare-ups of pain. Consequently, making certain lifestyle adjustments can be a key part of managing and preventing costochondritis.

Unforeseen Complications
Unforeseen complications can also lead to costochondritis after a mastectomy. For instance, infections after surgery, particularly in patients who have had chest wall surgery or who use intravenous drugs, can cause inflammation leading to costochondritis. Additionally, the presence of tumors, both benign and cancerous, in the chest area can also contribute to the development of this condition. Therefore, being aware of these potential complications can aid in the timely diagnosis and treatment of costochondritis.

Treatment options

Physical therapy
Physical therapy can be helpful in managing costochondritis after a mastectomy. It can help in reducing pain, improving mobility, and enhancing the patient’s overall quality of life. Various physical therapy techniques, such as ice therapy, thoracic mobilization, breathing techniques, and stretching exercises, can provide relief from the symptoms of costochondritis. In some severe cases, more intensive interventions like cortisone injections or even surgery may be considered. However, these are typically last-resort options and are used only when other treatment modalities have failed to provide relief.

Medical options
Medical treatment options for managing costochondritis, particularly after a mastectomy, can be varied and should be tailored to the individual’s specific pain levels and overall health condition. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen), Motrin (ibuprofen), or Aleve (naproxen) can help alleviate the inflammation and pain associated with costochondritis. For those experiencing severe pain that does not respond to oral medications, corticosteroid injections may offer significant relief. However, because of potential side effects, these injections are typically reserved for cases where other treatments have not been effective.

As with any medical treatment, it’s essential to have a thorough discussion with your healthcare provider. This conversation should encompass potential benefits, risks, and side effects of these medications, as well as their compatibility with your post-mastectomy recovery. Each treatment option should be carefully considered to formulate the most effective and personalized pain management strategy.

Lifestyle adjustments
Making certain lifestyle adjustments can also be beneficial in managing costochondritis after a mastectomy. Avoiding activities that overuse the chest muscles, such as heavy lifting or excessive sweeping, can help prevent flare-ups. Practicing good posture can also alleviate pressure on the chest wall and reduce pain. Regular exercise and stretching can improve flexibility and strength, which can help manage the symptoms of costochondritis. It’s important to remember that these adjustments should be made in consultation with your healthcare provider or a trained therapist to ensure they are safe and beneficial for you.

Myofascial release therapy
Myofascial release (MFR) therapy is a hands-on therapeutic technique that can be particularly effective in managing costochondritis post-mastectomy. This therapy involves applying gentle, sustained pressure and stretch to the myofascial connective tissue of the body to eliminate pain and restore motion. MFR therapy can help in reducing pain, enhancing flexibility and movement, and improving overall quality of life. At MFR Health, our certified MFR therapists have advanced training in John F. Barnes’, the leading expert in the field of MFR, methodology of MFR.

More information on MFR therapy
As mentioned above, MFR is a hands-on therapeutic technique that involves applying gentle, sustained pressure and stretch to the myofascial connective tissue. This pressure helps to eliminate pain and restore motion to the fascia, providing relief from the symptoms of conditions like costochondritis. MFR therapy is a part of a holistic approach to pain management, focusing not just on the site of the pain, but on the entire myofascial system. By targeting the root cause of the pain, MFR therapy can bring about long-lasting relief and improvement in overall function and mobility.
Benefits of MFR therapy for costochondritis
MFR therapy offers several benefits for patients dealing with costochondritis after a mastectomy. One of the key benefits is pain reduction. The hands-on approach of MFR therapy can help alleviate the chest pain associated with costochondritis. This can also enhance flexibility and movement, further aiding in pain management. Moreover, MFR therapy can improve the overall quality of life for patients, enabling them to carry out their daily activities with less discomfort. An added advantage of MFR therapy is that it can be tailored to the individual needs of the patient, ensuring a personalized and effective treatment approach.
What to expect during an MFR treatment
During an MFR treatment, the MFR therapist applies gentle, sustained pressure and stretch to the myofascial connective tissue. This pressure is crucial for helping to relieve tension and alleviating pain in the affected area. Sessions can vary in duration, typically ranging from 30 to 90 minutes, and the frequency of sessions will depend on the severity of the patient’s condition and their response to treatment. Open communication with your MFR therapist is encouraged, allowing you to discuss your expectations and any concerns prior to beginning your personalized MFR treatment regimen.
Finding a certified MFR therapist

Finding a certified MFR therapist is a crucial step in managing costochondritis effectively. At MFR Health, we connect patients with highly qualified MFR therapists who can provide effective treatment tailored to their specific needs. It’s important to ensure that your therapist is certified in MFR, as this signifies that they have undergone rigorous training and are well-equipped to provide the highest standard of care. You can use our platform to find a certified MFR therapist near you.

Final words of encouragement

Living with costochondritis after a mastectomy can indeed be a challenging experience. However, it’s heartening to know that you are not alone in your journey. The road to recovery is paved with a host of effective treatments and a supportive community that understands your struggles. It’s essential to stay positive and proactive in your approach to recovery, and embrace the various resources at your disposal. Your journey towards pain relief and enhanced wellness is not just a possibility — it’s an attainable goal with the right help. Remember, each step you take is a move towards a more comfortable and fulfilling life. Find a certified MFR therapist near you to get started on your healing journey.