After surgery for breast cancer
Exercises that might help after surgery for breast cancer
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This video provides a general overview of cancer and its treatment.
The information in this video was correct as of 1 December 2011.
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This video describes some of the exercises that might be helpful if you have had surgery for breast cancer. You may find it helpful to look at our general information on breast cancer as well as this explains some of the terms you hear in more detail. If there are any problems with the wound such as redness or swelling, check with your physiotherapist or nurse that it’s OK to do the exercises. It’s important when doing them that they are not painful. If you have any difficulties in doing the exercises, or if you have any pain when doing them, it’s important to speak to your physiotherapist or a member of the hospital team looking after you.
A lumpectomy is usually done as a day case, but some women will have to stay in hospital for 1-2 days.
Women who have a mastectomy usually stay in hospital for 2-4 days after their operation. If you have breast reconstruction at the same time, your stay could be 5-7 days, depending on the type of reconstruction you’ve had. If you have all the lymph nodes in your armpit removed, you’ll usually be in hospital for 3-5 days.
You’ll be encouraged to start moving around as soon as possible after your operation. You may have a long, thin plastic drainage tube attached to a bottle that fluid from the wound drains into. It’s usually removed a few days after the operation, but you may be sent home with the drain still in place.
If you have a mastectomy you may have a drip (infusion) in your arm giving you fluids for a short time after the operation.
You’ll have a dressing covering your wound. This may be left undisturbed for the first few days. After this, you’ll usually have the dressings changed if there’s some leakage from the wound. If you had a small area of tissue removed, your wound will usually heal quickly and you can probably change the dressings yourself. Your nurse will show you how to do this. How long the wound takes to heal will depend on the type of operation and how much tissue has been removed.
Any drains will stay in until they’ve stopped draining most of the fluid. This may take 2-7 days. When you go home, your wound and drain (if it’s still in) can be checked by a district nurse. Or you may be asked to go back to the hospital every few days to have it checked. If you don’t have the type of stitches that self dissolve, you’ll usually have your stitches removed about 7-10 days after your operation..
Depending on the extent of your surgery you may have one or two thin plastic drainage tubes leading from the operation site, with bottles attached to them to collect any fluid from the wound site. This helps the wound to heal properly.
Any wound drains will stay in place until they’ve stopped draining fluid. This may take 2-7 days. When you go home your wound and drain (if it’s still in) can be checked and dressed by a district nurse if necessary. Or you may be asked to go back to the hospital every few days to have it checked there. If you don’t have the type of stitches that dissolve, you’ll usually have your stitches removed about 7-10 days after your operation.
A wound infection can be a complication of surgery. Symptoms include redness, swelling, warmth or an increased discharge from the wound. Tell your nurse or doctor if you get any of these symptoms, even after you’ve left hospital.
For the first few days you’ll probably have some pain or discomfort around your wound and under your arm if you’ve had the nodes removed. You’ll be given painkillers to take regularly until it settles down. If you still have pain, let your doctor or nurse know so they can prescribe stronger painkillers.
After a mastectomy you may have a PCA (patient controlled analgesia) pump that you can press to give yourself painkillers for the first few days. It’s usually attached to your drip (infusion).
Usually any pain or discomfort goes away as the wound heals. Occasionally, some women continue to have pain in their breast and arm. Let your doctor know if this is a problem..
Fluid collecting around the wound (seroma)
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The area around the wound will be bruised and there may be a build-up of fluid, making it swollen and puffy for a while. This gradually disappears over a few weeks.
Fluid can sometimes build up in the area around the wound (seroma). The fluid lessens and usually stops building up within a few weeks. It may need to be drained off with a fine needle and syringe by your nurse or doctor.
If you had a mastectomy or the lymph nodes in your armpit have been removed, you may have pain or stiffness in the shoulder or arm.
It’s important to do the arm exercises you’ve been shown by the physiotherapist or breast care nurse. This improves your range of movement and reduces the risk of long-term problems with pain in your shoulder or arm. You should start the exercises the day after your operation. As you recover, you’ll be able to gradually do more and increase your range of movement.
Breast Cancer Care can send you a leaflet that shows the exercises you can do.
Numbness and tingling in the upper arm
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You may have numbness and tingling in your upper arm because nerves in the area have been injured during the operation. There’s a high risk of this happening after all the lymph nodes in the armpit have been removed.
It may last for several months and can sometimes be permanent.
Swelling and bruising is common after any breast operation. It should improve after a few weeks, but let your breast care nurse or cancer specialist know if it doesn’t get better. Some women find it more comfortable to wear a crop top or sports bra during this time.
All breast surgery leaves some type of scar, which will depend on the operation you have. After a lumpectomy the scar is usually small and in the area where the cancer was, but this depends on where the surgeon makes the cut (incision). A mastectomy scar is across the skin of the chest and into the armpit. After surgery to the lymph nodes, you’ll have a scar in the armpit that shouldn’t be noticeable from the front.
To begin with your scar will be red, or darker if you have dark skin, quite firm and may be slightly raised, but over time it will flatten and fade. Everyone’s skin heals differently. If you have dark skin or fair, freckled skin, scars can take longer to settle and they may be more noticeable for longer. If you have concerns about how your scar is healing, talk to your nurse or breast surgeon.
Before surgery your surgeon or breast care nurse will explain how your breast will look afterwards. They may have photographs of other patients following their surgery that they can show you. You can ask if there is anyone they’ve treated who would be happy to talk to you. Or you can contact a local support group or Breast Cancer Care.
Coping with a changed appearance
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After your operation you may prefer to see what the area looks like for the first time alone. Or you may want the support of your partner, family member, close friend, or your surgeon or breast care nurse. After a few weeks the swelling will go down, the bruising will fade and the scar will become less obvious.
Any change to your appearance can affect your confidence and how you feel about yourself as a woman. You may worry that your partner may be put off by your scars or a change in your body shape. If you’re feeling self-conscious about how you look, talking with your partner about how you feel can help you regain some confidence.
We have more information about possible effects on your sex life.
Breast Cancer Care has information about prostheses, bras and clothing, which may help you become more confident in your appearance. If you wear a prosthesis, your confidence will gradually come back as you get more used to it.
For some women breast reconstruction helps restore their self-confidence, feelings of femininity and sexual attractiveness. Your surgeon or breast care nurse can discuss this further with you.
After a mastectomy, unless you’ve had breast reconstruction, you’ll be given a soft, lightweight prosthesis (false breast) which you can put inside your bra. This is sometimes called a ‘cumfie’ or ‘softie’. It’s designed to be worn immediately after the operation when the area feels tender. Your breast care team will arrange this for you.
When your wound has fully healed, you’ll be able to choose a permanent prosthesis. This is a false breast that closely matches the size and shape of your other breast and is worn inside your bra. They’re made of soft plastic (silicone) and feel pliable. Prostheses are available to match your skin colour. Several different types are available from the NHS, and Breast Cancer Care can give you a list of stockists.
Taking care of yourself when you get home
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It’s important to take things easy for a while. How you’ll feel depends on the operation you’ve had. Although your physical recovery might be faster than you expected, you may feel emotionally exhausted.
Try to get plenty of rest and eat well. Do some light exercise, such as walking, that you can gradually increase. This will help you build up your energy and help you feel better.
It’s very important to carry on with the exercises you were shown in hospital. You’ll be advised not to lift or carry anything heavy and not to drive for a few weeks. You can gradually get back to these activities as your wound heals. The length of time you should wait before doing any heavy lifting or driving depends on what type of operation you’ve had.
Some insurance policies give specific time limits for not driving after surgery; you may need to check this with your insurance company. Most women are ready to drive about four weeks after their operation. Don’t drive unless you feel you have full control of the car.
You will be given an appointment to attend the outpatient clinic so the surgeon can check the wound is healing properly. You’ll be given more information about the stage of the cancer (its size and if it has spread to the lymph nodes). Your cancer specialist and breast care nurse will then talk to you about any further treatment you need.
Late effects of surgery
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Some women may have problems with the effects of surgery for some months or longer after their operation. There’s usually something that can be done to improve this and things you can do to help yourself. Let your breast care nurse know if you experience any of the following late effects:
Some women have an uncomfortable sensation that feels like a tight cord running from their armpit to the back of their hand. This is called cording. It may develop weeks or months after surgery and is thought to be due to hardened lymph vessels. Sometimes it makes it difficult to move the arm, but it usually gets better gradually over a few months. Some women may need physiotherapy and massage to improve it.
Pain and changes in sensation
Sometimes women continue to have numbness and tingling in the upper arm, or pain because of injury to the nerves during surgery. It can often be treated using antidepressant drugs and anticonvulsants (drugs used to treat epilepsy).
Changes in arm/shoulder movement and strength
Problems with movement and strength usually improve after surgery, but some women continue to have problems. Carrying on with your exercises, even for a few years, may help reduce the risk of this happening. Your cancer specialist can arrange a referral to a physiotherapist and make sure your pain is well controlled with painkillers.
Surgery or radiotherapy to the lymph nodes in the armpit can sometimes lead to lymphoedema, which is a swelling of the arm on the affected side. Women who have all or a large number of lymph nodes in the armpit removed are more at risk, especially if they also have radiotherapy to the armpit. There are things you can do to reduce your risk of getting lymphoedema.