Before your operation, you may be seen at a pre-assessment clinic. You may have tests to check your general health. These can include:
- blood tests
- a chest x-ray
- a recording of your heart (ECG).
Your surgeon or specialist nurse will talk to you about how your breast will look after your surgery. They may show you photographs of other women who have had breast surgery. They may also put you in contact with someone who has had the same operation. Or you can contact a local support group or Breast Cancer Care.
You will usually come into hospital on the day of your operation. You will meet the doctor who gives you the anaesthetic (anaesthetist). The nurses may give you elastic stockings (TED stockings) to wear during and after the operation to help prevent blood clots.
Your recovery after surgery will depend on the type of operation you have.
Most women who have breast cancer surgery can go home the same day or the following day. If you have breast reconstruction at the same time as a mastectomy, you will stay in hospital for longer (1 to 5 days). This will depend on the type of reconstruction you have.
Your healthcare team will encourage you to start moving around as soon as possible after your operation. This can help reduce the risk of problems that can happen after surgery.
You will usually have a dressing covering your wound. This may not be removed for the first few days after your operation. The nurses will tell you how to look after it before you go home.
How long it takes for the wound to heal depends on the operation you had. Your wound may be closed with glue or stitches that dissolve and do not need to be removed.
If you do not have stitches that dissolve, they are usually removed about 7 to 10 days after your operation. You can arrange this with your practice or district nurse, or it may happen at your outpatient appointment.
You may have a long, thin plastic drainage tube coming from your wound. This is attached to a drainage bag or bottle. Fluid from the wound drains into the bag or bottle.
The drain is usually left in for a few days. You can go home with the drain still in place. A practice nurse or a district nurse may check it when you are at home. Or you might have it checked and removed at the hospital.
You will probably have some pain or discomfort around the wound. If you had lymph nodes removed, you may also have some pain or discomfort in your armpit.
It can help to take painkillers regularly until the pain starts to improve. This usually takes a few days. Your specialist nurse will usually give you the painkillers to take.
If you have had a mastectomy, you may need painkillers for 1 or 2 weeks. Tell your cancer doctor or specialist nurse if the painkillers are not helping. They may be able to prescribe different ones for you to try.
Signs of a wound infection can include:
- swelling around the wound
- discharge coming from the wound
- feeling unwell with a fever.
Tell your nurse or doctor or GP if you get any of these symptoms, even after you go home.
Fluid collecting around the wound (seroma)
A seroma is a soft bulge or swelling around, or very close to, the wound. It is caused by a build-up of fluid. It usually goes away within a few weeks. Talk to your surgeon or breast care nurse if you are worried about swelling that does not seem to be going away. Your cancer doctor or breast care nurse may need to drain the fluid with a needle and syringe. This may cause some discomfort while its being done.
Stiff shoulder or arm
After a mastectomy or having the lymph nodes removed, your shoulder or arm may feel sore or stiff. Your physiotherapist or nurse will show you arm exercises to do. This will help improve the movement in your shoulder and arm, and reduce the risk of long-term problems. Breast Cancer Care have a leaflet about these exercises.
Numbness and tingling in the upper arm
You may have numbness or a tingling feeling in your upper arm. This is more likely if you had all the lymph nodes in your armpit removed. It is caused by swelling and damage to the nerves in your breast and armpit during or after the operation. It may slowly improve over a few months, but it can sometimes be permanent. Talk to your surgeon or specialist nurse if you are worried.
If you had surgery to remove lymph nodes in the armpit, you may develop cording (or axillary web syndrome) after the operation. This feels like a tight cord going from your armpit down the inside of your arm.
You may be able to see the cord as well as feel it. Sometimes there is more than one. It can feel tight and painful and can affect the movement in your arm and shoulder.
Cording may happen days or weeks after surgery, or sometimes months later. It is less likely to happen if you only had 1 or 2 lymph nodes removed. It is not clear exactly what causes cording. It may be because of changes in the lymphatic vessels after surgery.
Ask your breast care nurse for advice. Cording often gets better on its own, but you may need to see a physiotherapist. Sometimes cording takes longer to improve.
Your recovery will depend on the type of operation you have, but you may need to avoid lifting or carrying anything heavy for a few weeks.
Some insurance policies give specific time limits for not driving after surgery. Contact your insurance company to let them know you have had an operation. Most people are ready to drive about 4 weeks after their operation. Do not drive unless you feel in full control of the car.
When you are home, it is important to follow the advice you were given by your specialist nurse. You should carry on with the exercises you were shown in hospital and try do some light exercise such as walking. This can help to build up your energy, so you can gradually get back to your normal activities.
You will have a clinic appointment to see your surgeon and specialist nurse to check your wound is healing properly. They will also tell you about the tissue removed during surgery (pathology) and the stage of the cancer.
Invasive breast cancer
If you had a WLE, your surgeon will explain whether the margins around the cancer were clear. Sometimes cancer cells are found very close to, or in, the margin. Although this can be upsetting news, it can usually be treated successfully with another operation.
For some women, a tumour profiling test may be done to help them decide whether to have chemotherapy after surgery. Your doctor or breast care nurse will discuss this with you.
If you have had a WLE, your surgeon will tell you if the margins around the DCIS are clear. If the margins are not clear, you may need another operation.
Sometimes a small area of invasive cancer is found within the DCIS. Although this can be distressing news, it is usually very early breast cancer, which can be treated successfully.
Below is a sample of the sources used in our breast cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
European Society for Medical Oncology. Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of oncology 26 (supplement 5): v8–v30. 2015.
Morrow M, et al. Chapter 79: malignant tumors of the breast. DeVita, Hellman and Rosenberg’s cancer: principals and practice of oncology (10th edition). Lippincott Williams and Wilkins. 2014.
National Institute for Health and Care Excellence (NICE). Early and locally advanced breast cancer: diagnosis and management. July 2018.
Scottish Intercollegiate Guidelines Network. SIGN 134. Treatment of primary breast cancer: a national clinical guideline. September 2013.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Rebecca Roylance, Consultant Medical Oncologist.
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