What To Expect After Breast Cancer Surgery

Where Can You Get A Breast Form

You can find breast forms at most surgical supply stores and lingerie storesand even the lingerie departments of some department stores. Breast forms can also be purchased over the Internet.

Most experts recommend getting the help of a trained fitter. When you go for a fitting, wear a close-fitting top so that you can really see how the breast form looks and moves.

Take a partner or good friend with you for a second opinion and support.

Transportation Lodging Child Care And Elder Care Assistance

You may not live near the hospital where youll have your surgery.

Sometimes, there are programs that help with local or long-distance transportation and lodging. Some also offer transportation and lodging for a friend or family member going with you.

There are also programs to help with child care and elder care costs.

Learn about transportation, lodging, child care and elder care assistance programs.

In The Months After Mastectomy

Your body will continue to adjust to the effects of the surgery over a period of months. Here are some things to keep in mind:

• You may have phantom sensations or phantom pain in the months after mastectomy: As nerves regrow, you may feel a weird crawly sensation, you may itch, you may be very sensitive to touch, and you may feel pressure. Your discomfort may go away by itself, or it may persist but you adapt to it. Analgesics and NSAIDs such as acetaminophen and ibuprofen usually can address the pain related to this type of nerve injury. Opioids also can be used to treat this type of pain. Read more about managing phantom pain.
• Continue doing regular arm exercises: Stay with your arm exercise routine to keep your arm limber.
• You may experience fatigue from time to time in the early months after surgery: If youre having trouble with fatigue, ask your doctor about things you can do.

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Arm Care After Lymph Node Removal

Removing lymph nodes during BCS may affect how lymphatic fluid drains from your arm. Problems with lymphatic drainage can cause swelling in your arm. You may also be at greater risk for infection from injury to your arm. And there is a higher risk for blood clots in your armpit veins after surgery to the area.

You will have to follow certain safety steps for the rest of your life after lymph node removal. This will help prevent problems in the affected arm. These safety steps include:

• No needle sticks or IVs placed in the affected arm

• No blood pressure measurements in the affected arm

• Follow instructions about arm exercises carefully

• Avoid injuries, such as scratches or splinters, to the affected arm

• Raise the arm, with your hand above your elbow, to help drain lymphatic fluid

• Wear gloves when gardening or doing any activity where there is a risk for getting a cut on your fingers or hands. Also wear gloves when using strong or harsh chemicals, such as detergents or household cleaners.

• Avoid sunburns

• Use a clean razor to shave under your arm

• Avoid wearing any tight items on the affected arm. This includes elastic cuffs, tight watches, or other jewelry.

• Use your good arm or both arms to carry heavy packages, bags, or purses

• Avoid insect bites or stings by using insect repellents or wearing long sleeves

Your doctor may give you other instructions, depending on your situation.

Recovering From A Mastectomy: What To Expect

In general, women having a mastectomy stay in the hospital for 1 or 2 nights and then go home. How long it takes to recover from surgery depends on what procedures were done, and some women may need help at home. Most women should be fairly functional after going home and can often return to their regular activities within about 4 weeks. Recovery time is longer if breast reconstruction was done as well, and it can take months to return to full activity after some procedures.

Ask your health care team how to care for your surgery site and arm. Usually, you and your caregivers will get written instructions about care after surgery. These instructions typically cover:

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What To Expect After Breast Surgery

If you have any questions about your recovery, ask the doctors and nurses caring for you. Many people are referred to a breast care nurse for information and support. How long you stay in hospital will depend on the type of surgery you have and how well you recover.

If you have breast-conserving surgery, you can usually go home the same day. If you have a mastectomy, you usually need to stay in hospital overnight. If you have a reconstruction after mastectomy, you will usually need to stay in hospital for several days.

Learn more about:

Talk With Your Doctor

Breast cancer is scary, but it can be successfully treated.

Talk with a breast cancer surgeon about your choices. Find out:

• what happens during surgery
• the types of problems that sometimes occur
• any treatment you might need after surgery

Be sure to ask a lot of questions and learn as much as you can. You may also wish to talk with family members, friends, or others who have had surgery.

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Talk To Your Doctor About Mammograms

Women who have had a mastectomy to treat breast cancer generally do not need routine screening mammograms on the side that was affected by cancer . There isnt enough tissue remaining after a mastectomy to do a mammogram. Cancer can come back in the skin or chest wall on that side, but if this happens its more likely to be found on a physical exam.

Its possible for women with reconstructed breasts to get mammograms, but experts agree that women who have breast reconstruction after a mastectomy dont need routine mammograms. Still, if an area of concern is found during a physical exam, a diagnostic mammogram may be done.

If youre not sure what type of mastectomy you had or if you need to have mammograms, ask your doctor.

Radiation Therapy After Lumpectomy

Radiation therapy is usually given after lumpectomy to get rid of any cancer cells that might be left in the breast. These cells are too small to see on mammograms or other imaging tests, or to measure with lab tests.

Radiation therapy can lower the risk of :

• Breast cancer recurrence
• Breast cancer death

If lumpectomy and mastectomy are both options for surgery, survival with lumpectomy plus radiation therapy is the same as with mastectomy .

After lumpectomy, chemotherapy, hormone therapy and/or HER2-targeted therapy may also be given.

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When To Contact Us

Contact us for the following problems, any unanswered questions and emotional support needs. Call 353-7070 and ask to speak with a nurse during the day, or the answering service in the evening to reach your doctor or the doctor on call.

• Pain that is not relieved by medication
• Fever more than 100 degrees Fahrenheit or chills
• Excessive bleeding, such as a bloody dressing
• Excessive swelling
• Discharge or bad odor from the wound
• Allergic or other reactions to medication
• Constipation
• Anxiety, depression, trouble sleeping, need more support

Nipple Reconstruction And Fat Grafting

The last stages of reconstruction include nipple reconstruction and fat grafting, if needed. Fat grafting is when fat is taken from a part of your body and injected into your breast area. Its done to improve your breast areas shape. The fat is most often taken from your thighs, abdomen , or breast. For more information, read Fat Injection After Breast Reconstruction.

About nipple reconstruction

Some people also want to have nipple reconstruction to recreate their nipple and areola. This procedure is most often done 2 to 4 months after the permanent implant is placed. Options for nipple and areola reconstruction are:

Depending on your skin and type of reconstruction, 3D tattooing may be your only option for nipple and areola reconstruction. Talk with your surgeon about which option is right for you.

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What Is The Timeline For Breast Reconstruction After A Cancer Diagnosis

After a mastectomy, Dr. Tamburrino will use different techniques to create a breast that matches, as close as possible, in size, shape, and texture to a womans natural breasts. With reconstructive breast surgery, there is timing involved as it relates to each patient.

1. Immediate breast reconstruction is done at the same time as the mastectomy. Some women choose this option, when possible, to avoid the emotional and visual grief caused by losing a breast.

2. Delayed breast reconstruction, which means a patient will wait until a later date after completing treatments, such as chemotherapy or radiation. With this option, women should wait at least six months after radiation, and four weeks after chemotherapy ends before considering breast reconstruction surgery. Delaying is a womans personal choice, and reconstruction can be performed weeks, or even years, after having a mastectomy.

Caring For Yourself At Home

When you leave the hospital, your incision will be covered with a gauze pad. Its normal to see some staining on the gauze pad for 24 to 48 hours after surgery. If you see drainage coming from your incision, call your doctors office.

Wear your surgical bra 24 hours a day until your doctor gives you other instructions. Take it off when you shower.

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What To Expect After Lumpectomy

Women may choose lumpectomy over mastectomy to keep their breast and have it look like it did before surgery.

However, lumpectomy will change the look and feel of the breast. Because some tissue is removed, the breast may be smaller. There will also be a scar and some numbness. Ask your health care provider about products that might help reduce the appearance of the scar.

Radiation therapy can also affect the look of the breast. It can further shrink the breast and change its texture or make the breast feel firmer.

The look and feel of your breast will continue to change during the first 1-2 years after surgery and radiation therapy.

What To Expect During Surgery

You will receive general anesthesia before your surgery, so youll be asleep during the procedure. Unless youve decided on a nipple-sparing surgery, the surgeon will remove as much of the tissue as possible from both your breasts. This includes the skin, nipple and areola.

Sometimes that also includes the lymph nodes from under the arm. The doctor may also remove the pectoral muscles, located under the breasts.

As part of the surgery, the surgeon will remove breast tissue and insert one or two tubes for fluid to drain into from an attached soft-rubber ball.

Sometimes breast reconstruction is performed at the same time as a mastectomy. Choices for reconstruction include breast reconstruction using breast implants or whats known as tissue flap surgery, which reconstructs the breast by using muscle, fat and skin taken from other parts of the body.

At the end of the surgery, the area is closed with stitches.

A woman who has undergone a mastectomy typically stays in the hospital for one or two nights.

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Who Cannot Have Radiation Therapy

Not everyone can have radiation therapy. Being pregnant, having certain health conditions or having some inherited gene mutations can make radiation therapy harmful.

• Pregnancy. Radiation can harm a fetus. Depending on the timing of the pregnancy and the breast cancer diagnosis, a woman may be able to have a lumpectomy and safely wait until after delivery to have radiation therapy.
• Scleroderma. Radiation therapy can cause harm to normal tissue during and after treatment in people who have scleroderma. In some women at higher risk of breast cancer recurrence, radiation therapy may still be used.
• Some inherited gene mutations. Radiation therapy can cause harm to normal tissue during and after treatment in people who have certain inherited gene mutations. In some women at higher risk of breast cancer recurrence, radiation therapy may still be used.
• Past radiation therapy to the same breast or to the same side of the chest. In general, radiation therapy to the breast can only be given once. In rare cases, radiation therapy to the same breast or overlapping parts of the body can be considered after talking with your radiation oncologist.

Looking After Your Drains And Wound

When you leave hospital follow any instructions you are given about caring for your wound. This will vary from hospital to hospital and depends on the kind of surgery you have.

If youre discharged with your drains still in place, they may be regularly checked at home by a nurse or you may be asked to telephone or return to the hospital each day so that the drainage can be checked. This may sound frightening, but if your treatment team suggests it, they will give you all the information and support you need.

You can usually bathe and shower normally following surgery , but its advisable not to use any soaps or deodorant products on or around the area of your wound. The nursing staff on the ward will give you specific advice on caring for your wound and any dressings. They will also make any arrangements for the removal of your stitches if they are not dissolvable.

If you have questions about caring for your wound, or what kind of follow-up care youll receive, contact your breast care nurse or another member of your specialist team.

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Chronic Pain After Mastectomy

Some individuals may develop chronic pain following a mastectomy. A 2018 observational study estimated that 20 to 30 percent of people who undergo breast surgery experience some type of chronic pain.

Chronic pain after mastectomy happens due to nerve damage. Its most often felt in the areas of the chest wall, armpit, or arm.

In addition to general pain or discomfort, its possible to feel:

Fluid Collecting Around The Wound

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.

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What Kinds Of Prosthetics Are Used After Breast Surgery

A wide variety of breast forms and accessoriesfrom mastectomy bras to stick-on nipplesare available to a woman who has had one or both breasts removed or who has had part of a breast removed. They come in many different shapes, colours, and materials, depending on what you need.

• Breast form shapes
• Full. A full breast form can be used to replace an entire breast.
• Partial. This form is for use by a woman who has had breast-conserving surgery. She may want a partial form to fill out that side of the bra.
• Shell. This form is hollow and fits over the breast tissue. A woman’s reconstructed breast may not look exactly like her other one. She may want to use a shell on either the reconstructed breast or the natural breast to make the chest look more balanced.
• Nipple only. This artificial nipple sticks onto the reconstructed breast when reconstruction does not include a nipple or you just don’t like the way the new nipple looks. It can also be stuck onto a breast form that does not have a nipple.
• Nipple cover. This can be used to cover a natural nipple when you don’t want it to show through clothing. Sometimes reconstructed breasts don’t have nipples, so you can use a nipple cover on your other breast to create a more balanced look.

If The Cancer Comes Back

If cancer does return, your treatment options will depend on where it comes back, what treatments you’ve had before, and your current health and preferences. For more information on how recurrent cancer is treated, see Treatment of Recurrent Breast Cancer.

Its important to know that women who have had breast cancer can also still get other types of cancer. In fact, women who have had breast cancer are at higher risk for certain other cancers. Because of this, its important to follow the American Cancer Society guidelines for the early detection of cancer, such as those for colorectal cancer and cervical cancer. To learn more about the risks of second cancers and what you can do about them, see Second Cancers After Breast Cancer.

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