Health Comes First




  • You may have just been diagnosed with a lump in your breast. Remember breast cancer lumps are painless so do not be mislead by the fact that there is no pain. The older you are the more chances that the lump is malignant. Breast cancer is amongst the curable cancers provided we treat it scientifically. You will first need an ultrasound of the breast or a mammography. Mammography is highly specialised, and few radiologists do it to well. Please speak to Dr. Kamran Khan before you do a mammography. If you have already done a mammography and are concerned do not worry. Please let doctor decide if you need to repeat another one. You will also need a biopsy which will always be a “trucut” biopsy not an FNAC. A “trucut” biopsy is done in the minor operation theatre and is a 15 minute procedure. It gives more information regarding the type of cancer in in most cases is absolutely necessary before treatment is started.

Breast cancer is an abnormal growth of the cells lining the ducts of the breast or of the lobules which produce the lactational fluid in the breast.

                         Breast cancer: questions to ask your doctor

If you've been diagnosed with breast cancer you may want to talk to your doctor to find out more.

Here are some questions you might want to ask.

• Has my breast cancer spread outside my breast? What stage is my cancer?

• How big is my tumour?

• Can I have surgery that removes only the lump (breast-conserving surgery) and not the whole breast (mastectomy)?

• Did my breast cancer happen because of genes I have inherited?

• What will you do to find out if my breast cancer has spread to the lymph nodes in my armpit and to other nodes?

• What treatment will I need after surgery?

• What side effects can I expect from surgery and other treatments?

• Is my breast cancer affected by the hormone oestrogen (is it oestrogen-receptor positive)?

• Do I have HER-2 positive breast cancer (this means the cancer cells make too much of a protein called HER-2)?

• Will my surgery be done by a specialist breast surgeon who does more than 20 breast operations a year? (This can be a difficult question to ask, but the risk of your cancer coming back where it first started depends on whether your surgeon removes enough of the tissue around your cancer along with the cancer itself. Research suggests that experienced surgeons are better at doing this.)

• Do any of my lymph nodes have cancer cells in them? If so, how many?

• How abnormal do the cancer cells look under a microscope? (This can tell you how likely it is that your tumour will spread and what kind of treatment you need.)

• Will I need chemotherapy after surgery? If so, what type and for how long?

• Will I need radiotherapy? If so, for how long?

• Will I need hormone therapy? If so, what type and for how long?

• If I have a mastectomy, should I have breast-reconstruction surgery? If so, when should it be done and what sort of surgeon should do it?

• Are the other women in my family more likely than most women Breast cancer, locally advanced: what is it?

Locally Advanced Breast Cancer

It can be frightening to be told that you have breast cancer. But good treatments are available. Women with breast cancer now have a much better chance of surviving their illness than they did in the past.

What is locally advanced breast cancer?

When your body's cells are healthy they divide, grow, and are replaced in an orderly way. But if you get cancer some of your cells grow too fast and don’t develop properly. These abnormal cells form a lump called a tumour. This gradually gets bigger.

Breast cancer usually starts in thin tubes in the breast, called ducts. When women breastfeed, the ducts carry breast milk from the milk-producing glands to the nipple.

If you have invasive breast cancer it means that cancer cells have spread beyond the ducts into the fatty tissue of your breast. From there it can spread around your body.

Early breast cancer is cancer that is still within your breast. It might also be in glands under your arms, called lymph nodes.

If the tumour is large (5 centimetres or more across) or has spread to the skin or the front of the chest, this is locally advanced breast cancer. The lymph nodes under the armpit might also have become matted together by the tumour.

What causes breast cancer?

The first question many women ask is: "Why me?" A few women get breast cancer because they have inherited a gene that makes it much more likely. But for most people there is no obvious cause.

You are more likely to get breast cancer when you are older. There are some other things that are linked to a greater chance of getting breast cancer, such as not having had children (or not having given birth before the age of 30), never having breastfed, drinking alcohol, and being very overweight (obese). But many women who get breast cancer don't have any of these 'risk factors'.

Breast cancer, locally advanced: what is it?

What are the symptoms?

Many women learn that they have breast cancer before they get any symptoms. They find out after they have a mammogram. A mammogram is an x-ray of the breast. Mammograms can reveal lumps that are too small to feel.

Symptoms of breast cancer include:

• A lump or thickening in your breast

 • A change in how your breast feels or looks. For example, it may feel heavy, warm, or uneven, or the skin may look pitted

 • Changes in your nipple. For example, the nipple might be pulled back into the breast (known as an inverted nipple)

 • Discharge from your nipple, such as blood.

Before you are diagnosed with breast cancer, you may have an ultrasound scan of your breast. Your doctor might also remove some tissue from your breast lump, often by using a needle. This is called a biopsy. The doctors will examine the tissue for cancer cells.

What will happen to me?

It’s hard to predict what will happen to you, because everyone responds differently to treatment. The good news is that more women are now living longer after being diagnosed with breast cancer.

Breast cancer can sometimes come back, so you will probably always need to be watchful for symptoms and have regular check-ups as advised by your doctor.

However, if breast cancer is going to come back, it's most likely to do so within the first two years.

Treatment for Locally Advanced Breast Cancer

What treatments work?

Women who have locally advanced breast cancer often need to have surgery to remove the breast that has the tumour.

But some women may be able to have breast-conserving surgery. This means that just the tumour is removed and most of the breast tissue is left intact. Improved breast-scanning techniques mean that more women are now able to have breast-conserving surgery. You can discuss with your doctor which type of surgery is the right one for you.

Other treatments that can help stop breast cancer spreading or returning include:

• chemotherapy (drugs that kill cancer cells)

• radiotherapy (x-rays that kill cancer cells)

• hormone therapy.



The operation to remove a complete breast is called a total mastectomy. All of the breast tissue is removed along with some of the skin over the breast and the nipple. Some lymph nodes in the armpit are also removed.

Breast cancer, locally advanced: what treatments work?

Doctors used to do an operation called a radical mastectomy, which also removed some of the muscles under the breast. But this is not usually done any more, because for most women a total mastectomy works just as well.

A mastectomy is a serious operation. As with any operation, there are risks. For example:

• Fluid sometimes builds up around the scar on your chest and in your upper arm. You may need to have this fluid drained in hospital.

• Removing the breast cannot guarantee that the area around your breast will be free from cancer cells. The breast cancer could return in the scar. But this is rare.

• You could get an infection in the wound and need antibiotics.

Many women find it hard to come to terms with losing a breast. Breast reconstruction surgery may help. You may be able to have your breast removed and reconstructed during the same operation.

Breast-conserving surgery

In this operation the surgeon removes the tumour but leaves the breast intact. You might have heard it also called lumpectomy. The aim is to remove the cancer while changing the appearance of the breast as little as possible.

But this operation isn't suitable for all women with locally advanced breast cancer. Often the cancer has spread so far that it's safest to remove the whole breast.

Chemotherapy (cancer drugs)

Most women who have locally advanced breast cancer have chemotherapy. It’s the standard treatment.

Chemotherapy drugs kill stray cancer cells left in the body. Chemotherapy is used after breast surgery and radiotherapy to:

• reduce the chance of breast cancer coming back

• reduce the chance that breast cancer will spread further, and

• control breast cancer that has spread to other parts of the body.

Some women have chemotherapy before surgery to reduce the size of their tumour and make it easier to remove their breast.

Some chemotherapy drugs are given as tablets and others as a drip. You may get treatment at a clinic or hospital as an outpatient. You'll probably need to take a combination of drugs for several months.

Chemotherapy can have unpleasant side effects. You may feel sick and vomit during or after your treatment. You may also lose your hair, put on weight, and get symptoms of the menopause.

Breast cancer, locally advanced: what treatments work?

A lot of women feel very tired during chemotherapy. This tiredness may be overwhelming, and it can continue after you stop treatment. It’s a good idea to arrange help from friends and family while you’re having chemotherapy, to help with everyday tasks like shopping and cooking.

Drugs for HER2-positive cancer

About 1 in 5 women with breast cancer have a type called HER2-positive breast cancer. These cancers grow faster and are more likely to come back than cancers that are HER2 negative.

Women with HER2-positive disease may be offered drugs called monoclonal antibodies. These drugs slow down or stop the growth of HER2 cancer cells. You may have heard of one called Herceptin (trastuzumab).

But monoclonal antibodies can cause side effects, including serious heart and lung problems. So women who have HER2-positive breast cancer are carefully checked to see if they are healthy enough to be treated with these drugs. Women are also monitored throughout their treatment.


If you have locally advanced breast cancer, having radiotherapy after surgery may reduce the chance that your breast cancer will come back. Radiotherapy may also help you live longer.

Radiotherapy uses radiation to kill any cancer cells in your breast left behind after surgery. If you have radiotherapy you will probably need sessions several times a week for several weeks.

Your doctor may suggest radiotherapy if there's a high risk that your cancer will come back in the chest wall. You may be at higher risk of your cancer coming back if your cancer is large and is growing quickly, or you have cancer in lots of your underarm lymph nodes.

Your skin may itch or change colour after radiotherapy, and your breast may feel tender. Some women feel more tired than usual. These problems are usually mild and go away after a few weeks.

A few people get nerve damage or inflammation (swelling) in their lungs some time after radiotherapy. These problems sound serious, but they are rare and they can be treated.

Radiotherapy and mastectomy treat only the breast area. If you have locally advanced cancer, you will also need chemotherapy to stop cancer spreading further and growing in other parts of your body.

Hormone therapy

Some women have hormone treatment (sometimes called endocrine therapy) after chemotherapy or radiation. You may have heard of a treatment called tamoxifen, which is commonly used to treat breast cancer. But there are others, including drugs called aromatase inhibitors.

Breast cancer, locally advanced: what treatments work?

The type of hormone treatment you are offered might depend on whether you have been through the menopause. For example, aromatase inhibitors only work for women who are post menopausal (have been through the menopause).

Tamoxifen and other hormone treatments are used to treat breast cancers that are sensitive to the hormone oestrogen. Oestrogen encourages these cancers to grow. Your doctor will do tests on your tumour to find out if it is oestrogen-receptor positive or progesterone-receptor positive. If it is, your doctor may prescribe tamoxifen or another hormone treatment for you for up to five years.

These treatments stop oestrogen from working in the body. The aim is to reduce the chance that your cancer will come back.

Tamoxifen can cause side effects in some women, including symptoms of the menopause. This is more common if you haven't been through the menopause already. About half the women taking tamoxifen get hot flushes, irregular periods, and vaginal dryness. Tamoxifen may also cause indigestion or make you feel sick. Rare side effects of tamoxifen include cataracts and deep vein thrombosis.

Aromatase inhibitors can cause stiffness and pain in the muscles and joints.

Drugs to prevent bone damage (osteoporosis) caused by cancer treatments

Some cancer treatments can cause bones to become weaker, which makes fractures more likely. Drugs called bisphosphonates can help reduce this bone damage and help prevent fractures. But it's possible that they only help women who have been through the menopause.

Early Breast Cancer and DCIS (Ductal Carcinoma in Situ)

This information is about a type of very early breast cancer called ductal carcinoma in situ (DCIS) in women.

What happens in breast cancer?

When your body's cells are healthy they divide, grow, and are replaced in an orderly way. But when you get cancer your cells grow too fast and don’t develop properly. Abnormal cells form a lump called a tumour. This slowly gets bigger.

Breast cancer usually starts in thin tubes in the breast, called ducts. When women breastfeed, the ducts carry breast milk from the milk-producing glands to the nipple.

If you have the earliest form of breast cancer, called ductal carcinoma in situ (DCIS for short), the cancer cells are still inside the ducts. They haven’t yet spread into the fatty tissue of the breast.

The first question many women ask is, "Why me?"

A few women get breast cancer because they have inherited a gene that makes it much more likely. Breast cancer is also much more common in older women than in younger women.

Other things that seem to make a woman more likely to get breast cancer include:

• Not having had children (or having them after the age of 30)

• Not having ever breastfed

• Drinking alcohol

• Being very overweight (obese).

But many women who get breast cancer don't have any of these risk factors. For most women there's no obvious reason why they get breast cancer.

Breast cancer: DCIS (very early breast cancer) in women

What are the symptoms?

Unlike women with more-advanced breast cancer, if you have DCIS you won't usually have any symptoms. For example, you won't feel ill and you won't usually be able to feel a lump in your breast. This is because the cluster of cancer cells is too tiny to be able to feel or to cause any problems that you would be aware of.

Women who have DCIS usually find out after they have a mammogram. A mammogram is an x-ray of the breast.

As well as detecting clusters of cancer cells, mammograms can also detect small lumps of calcium in the breast, called microcalcifications. These are usually not linked to cancer. But they can sometimes be a sign that cancer is starting to develop.

What treatments work?

Different types of breast cancer need different treatment.

• Most women with DCIS have an operation to remove the cancer cells.

• You might also need to have radiotherapy after surgery.

• Depending on the type of cancer cells, you might also take a medicine called tamoxifen after surgery.


Most women with DCIS can have an operation called breast-conserving surgery. You might also have heard this operation called a lumpectomy. This removes the cancer cells and a small amount of surrounding breast tissue, but it leaves the healthy breast tissue in place.

Your surgeon will try to leave your breast looking as much as possible like it did before. But you will have a small scar afterwards and your breast will probably look different. Talk to your surgeon about how you can expect your breast to look after surgery.

But if you have DCIS in more than one place, or if the amount of DCIS is very large compared with the size of your breast, you may need to have the whole breast removed. This is called mastectomy.

For either type of surgery you’ll have a general anaesthetic, so you won't be awake during the operation and won’t feel any pain. You will need pain relief afterwards. Be sure to ask the nurses for more pain relief if you are in discomfort.

If you have breast-conserving surgery your surgeon will remove the cancer cells through a small cut in your breast.

If you have surgery to remove your whole breast you might have more peace of mind that all the cancer has been removed. But many women find it difficult to come to terms with losing a breast. Reconstruction surgery to replace your breast tissue with an implant may help. You might be able to have your breast removed and reconstructed during the same operation.

Breast cancer: DCIS (very early breast cancer) in women

As with any type of operation, surgery for DCIS carries some risks. These include getting an infection in the wound, or having an allergic reaction to the anaesthetic.

Some women get fluid under the scar (a seroma) or bleeding under the cut, which causes a large bruise (a haematoma). A seroma can be drained with a needle. If you have a lot of bleeding you may need another operation to stop it. A mastectomy is a more serious operation than breast-conserving surgery and it may take you longer to recover.

If you are finding it hard to decide which operation to have, take your time and talk to your doctors and nurses about the options. You don’t have to rush into a decision. Waiting a week or two won’t make a difference.


Radiotherapy is usually only used for women with DCIS who have breast-conserving surgery. It's not usually necessary for women with DCIS who have a mastectomy.

Unless your doctor thinks it's highly unlikely that your DCIS will come back, he or she will probably recommend that you have radiotherapy after breast-conserving surgery, to reduce the chance of recurrence.

The chance of your DCIS returning is smaller if the area of DCIS in your breast is very small and the cells don't look like they are growing very fast under a microscope.

Radiotherapy uses x-rays to destroy cancer cells in your breast. If you have radiotherapy you'll need sessions several days a week for between four and six weeks. Each session takes only a few minutes.

Having radiotherapy after breast-conserving surgery reduces the chance of cancer coming back in your breast and reduces the chance that you'll need to have your breast removed because your cancer has spread.

Radiotherapy doesn't hurt, but it has side effects. Your skin may itch or change colour after treatment, and your breast may feel tender. Some women say that having radiotherapy makes them feel tired. These problems are usually mild and go away after a few weeks.

A few people get nerve damage or inflammation in their lungs some time after radiotherapy. But newer techniques minimise the dose of radiation and reduce the chance of harm.


Some breast cancer cells grow when they come into contact with the female hormone oestrogen. They are called oestrogen receptor positive. Other cells, called progesterone receptor-positive cells, grow when they come into contact with the hormone progesterone. You might hear these two types of cancer cells called hormone receptor positive.

Your cancer cells will be tested to see if they are hormone receptor positive. If they are, your doctor may recommend you take a drug called tamoxifen. It blocks the effects of the hormones.

Breast cancer: DCIS (very early breast cancer) in women

If you have hormone receptor-positive cancer, taking tamoxifen after surgery and radiotherapy reduces your chance of your DCIS returning. It also reduces the chance that you'll get breast cancer that spreads into the breast tissue.

If you have had breast-conserving surgery or mastectomy that affected one breast, treatment with tamoxifen also reduces the chance of cancer developing in the other breast.

Because tamoxifen stops these hormones working in your body, it can cause symptoms of the menopause, such as hot flushes, irregular periods, and vaginal dryness.

Tamoxifen may also cause indigestion or make you feel sick. Tamoxifen can also cause side effects such as cataracts and deep vein thrombosis, but this is rare.

What will happen to me?

Women now live longer after being diagnosed with breast cancer than ever before, especially if the cancer is at an early stage. Women whose cancer has not spread outside the ducts (DCIS) are nearly always cured.

Breast Pain

Breast pain can be distressing, but it's not usually a sign that there's something seriously wrong. Often there's no obvious cause. However, there are treatments that can help.

We've brought together the best research about breast pain and weighed up the evidence about how to treat it. You can use our information to talk to your doctor and decide which treatments are right for you.

What happens?

Breast pain is also called mastalgia. It's very common.

Most breast pain falls into two general categories.

• Cyclical breast pain follows a usual pattern, coming on in the week or two before your period. This is the most common type of breast pain among women who haven't gone through the menopause.

• Non-cyclical breast pain isn't linked to your periods. Your breast (or breasts) feels painful some of the time, or even constantly. Usually, there doesn't seem to be a cause. But sometimes non-cyclical breast pain is caused by things like an infection or a cyst (a fluid-filled sac in the breast). If this is the case, your doctor will treat these underlying problems, which should improve your breast pain.

Many women worry that breast pain means they have breast cancer. But pain on its own is not a common symptom of breast cancer. However, if you are worried about breast pain, or you have other symptoms such as a lump or a red or inflamed area on your breast, see your doctor.

What are the symptoms?

Cyclical breast pain can be dull, heavy, or aching. It starts in the two weeks before your period. The pain may get worse until your period starts and then get better. You may get pain in both breasts.

Non-cyclical breast pain can be sharp and burning. It may come and go, or be there all the time. You may get pain in just one brea

Both types of breast pain can be distressing, particularly during sex.

See your doctor urgently if you have:

• Discharge from your nipples

• Signs of infection, like redness, pus, or fever

• A new lump in one of your breasts.

What treatments work?

If your breast pain has no obvious cause, and it isn't bothering you too much, you may not need treatment. But if it is disrupting your life, there are treatments that might help.

Things you can do for yourself

You may find it helps to have a bra properly fitted, or to try one with more support. A sports bra for exercise may help.

Some women find that reducing the amount of caffeine or salt in their diet improves their breast pain. But there isn't enough research to say for certain whether this helps.


There isn't much good research looking at taking supplements to improve breast pain. But some women say that taking evening primrose oil helps.

Pain medicines

Doctors often recommend taking over-the-counter pain medicines for breast pain. These include paracetamol and ibuprofen. Many women find this improves their pain.

Hormone treatments

If your breast pain is very bad, disrupts your life, and has lasted more than six months, your doctor may suggest taking hormone treatments. Medicines your doctor might recommend include tamoxifen, bromocriptine, and danazol.

These medicines can reduce breast pain. But they can also sometimes cause side effects. Your doctor will discuss possible problems with you. Danazol isn't used very often because many women find its side effects difficult to tolerate. These may include weight gain, a deep voice, heavy periods, and muscle cramps.

What will happen to me?

Breast pain often goes away on its own without any treatment. But it may come back again. However, many women with breast pain linked to their period find they no longer have breast pain after the menopause.


What is breast reconstruction?

Breast reconstruction is surgery to rebuild a breast that was removed to treat or prevent cancer. Reconstruction can be done using man-made materials, called "implants," or using tissue taken from other parts of your body, called "flaps."

If you are planning to have surgery to remove a breast, called a mastectomy, talk to your surgeon about reconstruction before you have the mastectomy. Your mastectomy might need to be done in a certain way for you to be able to have the type of reconstruction you want.

Do I need breast reconstruction after mastectomy?

No, you do not need it. The decision to have reconstruction is totally up to you. Some women feel better about themselves or feel more normal if they have reconstruction after mastectomy. The important thing is that you have a choice about what to do.

What if I decide not to have reconstruction?

If you decide not to have reconstruction, you can wear a special bra called a "mastectomy bra." It has a pocket for a soft plastic breast on the side where your breast was removed. That way you'll look more even, and your clothes will probably fit better.

When can I have my breast reconstructed?

Breast reconstruction can be done at the time of mastectomy or later. The timing for you will depend on the stage of your cancer and what other treatments you need. Also, if you want to delay reconstruction for personal reasons, you can ask your doctor about doing that.

Women with early-stage cancer or who are having mastectomies to prevent cancer can have the reconstruction at the same time as their mastectomy. This is called "immediate reconstruction."

Women with a later-stage or large cancer sometimes need to have radiation after mastectomy. (Radiation is a treatment that kills cancer cells or stops them from growing.) These women sometimes need to delay reconstruction until the radiation treatment is finished. This is called "delayed reconstruction." The delay is needed because radiation could damage the reconstructed breast. There is also concern that an implant could keep radiation from reaching the right areas.

What are the different ways that surgeons can reconstruct a breast?

The 2 main ways are with implants or with flaps. Plus, there are several kinds of flaps. The best reconstruction approach for you will depend on:

●How big your breasts are to begin with

●How much extra body fat you have and where

●Whether you are overweight or have health problems (such as diabetes or heart or lung disease)

●Whether you have had surgery before and on what part of your body, because scars might affect which tissue can be used

How does reconstruction with an implant work?

A breast implant is basically a breast-shaped container that is filled with salt-water (called "saline") or something that feels like Jell-O (called "silicone"). The implant can be inserted partly or completely under a layer of muscle in the chest.

Getting an implant usually involves 2 steps. First, the surgeon inserts a device called an "expander." Often another piece of material (called "ADM") is added to support the expander, and later the implant. The expander stretches the skin and muscle in the chest. The surgeon gradually adds more and more fluid to the expander until the skin and muscle are stretched enough for the size of the implant being used. Then, the surgeon does another surgery to replace the expander with the implant.

. Implants are best for women with smaller breasts that don't droop.

How does reconstruction with a flap work?That depends on which type of flap is used. The most commonly used flaps are:

●DIEP flap – A DIEP flap is taken from the belly. It is made up of skin and fat, but not muscle. Connecting these flaps to a good blood supply can be harder than for other flaps. That means the surgery can be more complicated and take longer.

●TRAM flaps – A TRAM flap is also taken from the belly, but is made up of skin, fat, and muscle. There are 2 kinds of TRAM flaps. Both kinds of TRAM flaps can be done only in women who have enough belly fat to make a flap. After surgery, the belly looks flatter, like it does after a "tummy tuck." Women who have this type of flap have a scar along their bikini line from hip to hip.

•When the muscle in the flap stays attached to the blood vessels that supply it, it is called a "pedicled TRAM flap" . This type of flap is tunneled under the skin from the belly to the new breast pocket.

•When the flap is completely disconnected from the belly and its blood vessels, it is called a "free TRAM flap". This type of flap is attached to a new set of blood vessels in the chest. It doesn't stay connected, so it does not have to be tunneled to its new location.

●Lat flap – A Lat flap is taken from the back and is made up of skin, fat, and muscle. The flap stays attached to its blood supply and is tunneled under the skin from the back to the chest. Women who have this kind of flap have a scar on their back beneath the bra line. They also often also get an implant, because there is not enough fat on the back to make a new breast .

●Flaps taken from other places – Women who do not have enough belly fat to make good TRAM or DIEP flaps can have flaps taken from other parts of their body. For instance, doctors sometimes take flaps from the rear end or inner thigh.

Will my nipple be reconstructed?

If you want it to be, yes. Nipple reconstruction is usually done a few months after the breast construction is done. To make a new nipple, the surgeon can rearrange the tissue that is already there or use tissue from another part of the body. Surgeons also sometimes tattoo the nipple and the area around the nipple to make it the right color.

Will my new breast match my other breast?

As much as possible, yes. But the new breast will never be exactly like the breast you had before or exactly like your other breast. Plus, you won't have normal feeling (sensation) in the new breast. If you don't like the difference between them, your surgeon might be able to operate on your other breast to make them look more similar.

Can I choose which kind of reconstruction to have?

Maybe. Only some of the reconstruction types will be appropriate for you. But if you think you would rather have 1 type of reconstruction over another, ask your surgeon if that approach would work for you. He or she can tell you if your choice makes sense, and if not, why not.

What problems should I watch for after surgery?

Most women do not have serious problems after breast reconstruction. But there are some problems that can happen, either right after the surgery or later on:

●If you had either type of reconstruction (implant or flap) – Problems can include infection, blood or fluid coming from the area where you had surgery, or pain that does not go away.

●If you had an implant – The most common problem is called "capsular contracture." This is when scar tissue around the implant becomes hard and tight. This can cause the breast to feel firm or sore, or change shape. Other possible problems include the implant deflating, bursting, or moving out of place.

●If you had a flap reconstruction – In some cases, the flap does not get enough blood. This can lead the skin to change color, or the breast to feel hard. Some women can develop a bulge or hernia where the tissue was removed to make the flap.