October is Breast Cancer Awareness Month
PT for Whole-Body Recovery
October is Breast Cancer Awareness Month, a time to talk about early detection and also about what recovery looks like afterward. Surgery (mastectomy or lumpectomy), radiation, chemotherapy, and hormone therapy are life-saving, but they can leave physical side effects that last well beyond the final appointment.
The Side Effects Most People Hear About
Shoulder stiffness, pain, and lymphedema (swelling, most often in the arm, hand, or chest) are the best-known after-effects of treatment. Scar tissue and tightness around the chest and underarm can also make everyday movements like reaching, lifting, or getting dressed feel harder than they used to.
Lymphedema is common, but how common depends on who you ask. Reported rates vary widely because of differences in how it is measured and diagnosed, with some sources estimating 15 to 20 percent of survivors and more conservative analyses estimating up to 40 percent. It can also show up later than people expect. Research following survivors over time found new cases continuing to emerge through 60 months after surgery.
The Side Effects Few People Talk About
Treatment can affect the body well beyond the chest and shoulder. Up to 75% of breast cancer survivors report at least one genitourinary symptom, such as vaginal dryness, pain with intercourse (dyspareunia), urinary urgency, or leakage. Chemotherapy-induced early menopause, ovarian suppression, and aromatase inhibitors are the treatments most closely linked to these changes.
Urinary symptoms are part of this picture too. In one small study of women taking oral hormone therapy for breast cancer, 27 of 58 women (46.5%) reported urinary incontinence symptoms.
These symptoms are also easy to leave out of the conversation. In a survey of 506 women with breast cancer, only 44% recalled being warned by their cancer doctor that treatment could cause these symptoms, and 38% said they had never been asked about them. If this sounds familiar, you’re far from alone, and these symptoms are treatable.
How Physical Therapy Can Help
Exercise has good evidence behind it for the shoulder. A Cochrane review of randomized trials found that upper-limb exercise, such as range-of-motion work and stretching, helps people recover movement after breast cancer surgery. The same review found no evidence that upper-limb exercise led to more cases of arm lymphedema.
Recovery Looks Different for Everyone
There’s no single timeline for healing after breast cancer treatment. Some people begin PT soon after surgery, while others seek help months or even years later. Either way, it’s okay to ask for support, and it’s never too late to address symptoms that are getting in the way of daily life.
If you’re noticing lingering pain, swelling, stiffness, or pelvic symptoms after treatment, mention them to your care team and consider an evaluation with a physical therapist who specializes in oncology and pelvic health. Our team is happy to answer questions and talk through what recovery could look like for you.
References
- Armer, J. M., & Stewart, B. R. (2010). Post-breast cancer lymphedema: Incidence increases from 12 to 30 to 60 months. Lymphology, 43(3), 118-127.
- Cochrane Database of Systematic Reviews. (2022). Exercise interventions for upper-limb dysfunction due to breast cancer treatment (Issue 2, CD005211).
- Genitourinary symptoms in women with breast cancer: Frequency, severity and impact. (2025). Supportive Care in Cancer. https://doi.org/10.1007/s00520-025-09297-w
- Stahlschmidt, R., Ferracini, A. C., de Medeiros, L. M., de Souza, C. M., Juliato, C. R. T., & Mazzola, P. G. (2020). Urinary incontinence and overactive bladder symptoms in women with breast cancer being treated with oral hormone therapy. Revista Brasileira de Ginecologia e Obstetrícia, 42(11), 726-730. https://doi.org/10.1055/s-0040-1718440
