After your breast cancer operation
This page tells you about getting over breast surgery. There is information about
Exercises
After a mastectomy or surgery to your armpit, there are exercises to help you recover. Do them until you have full movement back in your arm and shoulder.
Don't lift or carry anything heavy, or drive while your scars heal up. Until your surgeon has given you the okay, don't do any housework (such as vacuuming, mopping or cleaning) with your affected arm.
Your false breast
If you have had a mastectomy, you'll have a lightweight artificial breast shape (prosthesis) to put inside your bra. After about 4 to 6 weeks you will be ready for your permanent prosthesis. Many types of artificial breast shapes are available free on the NHS. Your artificial breast shape sits inside your bra. Women who have had part of a breast removed can use a partial prosthesis or a shell prosthesis.
Possible problems after surgery
After surgery some women may have problems with wound infection, or with fluid collecting around the operation site (known as a seroma). Numbness or tingling in the upper arm is normal at first but should go after a few weeks or months. Swelling of the arm or hand is also normal at first, but needs treatment if it does not go away. If you are worried about any of these, contact your surgeon or breast care nurse.
You can view and print the quick guides for all the pages in the Treating breast cancer section.
How long you stay in hospital depends on the type of surgery you have. The doctors and nurses will encourage you to move around as soon as possible after the operation. You may have soreness or discomfort for a while. But this is usually well controlled with painkilling drugs. If you do have pain, tell your nurse or GP as soon as possible so that they can give you better painkillers.
- For surgery to remove a lump or an area of your breast, you are likely to stay in hospital for just 1 or 2 days.
- For a mastectomy you usually stay in hospital for around 2 to 3 days (but some women may need to stay an extra couple of days)
After a mastectomy or if you have surgery to your armpit, your surgeon and nurse will ask you to do regular exercises to help you recover. Your arm may feel stiff on the side where your breast was removed. Simple arm exercises can help to
- Give you back your full range of movement
- Relive pain and stiffness
- Reduce swelling
After surgery, do the exercises until you have full movement back in your arm and shoulder. Ideally, you should do these twice a day.
To start with, the exercises are quite gentle. The aim is to get your arm and shoulder moving as it was before the surgery. You can begin each session by circling your shoulders, to get the muscles moving. Other early exercises are brushing or combing your hair, putting your arms behind your back and touching your shoulder with your hand. As you get stronger and more confident, you can do more of the exercises and gradually increase the range of movements. Breast Cancer Care's free leaflet 'Exercises after breast cancer' shows the whole exercise programme you need to do.
Talk to your surgeon or breast nurse if you have ongoing problems with arm or shoulder pain, stiffness or swelling. You may need to see a physiotherapist, who can show you further exercises.
If you have had a mastectomy, you'll have a lightweight artificial breast shape (prosthesis) to put inside your bra. These are often called ‘cumfies’. If you want to, you can wear it right after the operation, even if the area still feels tender. Some women are happy with their cumfy and continue wearing it, rather than getting another type of permanent prosthesis.
Once your scar has healed and you have finished any radiotherapy you may need, you will be ready for your permanent prosthesis. You have this fitted by the breast care nurse at the hospital where you had your surgery. It is usually done in out patients about 4 to 6 weeks after your surgery.
Many types of artificial breast shapes are available free on the NHS. If you are a private patient, you may have to pay for this service. The breast shapes come in different sizes, shapes and colours. Most women should be able to find something they are happy with on the NHS. But, if not, there is more choice available if you buy your own from a manufacturer.
Your artificial breast shape sits inside your bra. There are special mastectomy bras available with pockets to hold the prosthesis. But you don't normally need a pocket. If your bra fits well and has full cups (rather than a low plunge), you should be fine. If you want to, you can have pockets sewn inside your own bras free of charge on the NHS. Ask your breast care nurse about this. To look after your prosthesis, you should wash and dry it daily.
If you like to swim, you can wear your usual prosthesis or make your own swimming prosthesis by cutting an ordinary sponge to fit. If you use your usual prosthesis, rinse it in clean water afterwards to get rid of any chlorine or salt. If you use a sponge, you can discreetly press your arm against it when you come out of the water, to squeeze the water out. Many organisations supply bras and swimwear for women who have had a mastectomy. Look in the breast cancer organisations section for some names and addresses.
Women who have had part of a breast removed can use a partial prosthesis or a shell prosthesis. A 'partial prosthesis' is shaped to fit the tissue you've had removed. It can fill out the bottom, top or side of your bra. A shell prosthesis is a hollow breast shape that fits over your remaining breast tissue. With a bra on, your breast will look the same size and shape that it was. To find out abut either of these special types of prosthesis, talk to your breast nurse or contact one of the breast cancer organisations.
You may like to know that you can get a new artificial breast shape every 2 years on the NHS. You may need a new prosthesis if yours gets worn or damaged. Or because you've gained or lost weight.
When you go home, you will be given the date for an appointment to go to the outpatient clinic for a post-op check up. Your surgeon will make sure everything is OK after the surgery and talk about what happens next. You can bring up any problems or things that have been troubling you since you went home. You might want to make a note of any concerns that you have during these first weeks after your operation. Then you can have them to hand at your appointment.
Before this appointment your surgeon will discuss all the results of your surgery and your tests with a goup of doctors and other health professionals known as the breast care multidisciplinary team. Together they will decide which further treatment you may need. So at the appointment, your surgeon may tell you that he is referring you on to a radiotherapy specialist (clinical oncologist) or a medical oncologist (specialist in chemotherapy and hormone therapy).
When you get home, take things gently. You may feel very tired, so have plenty of rest and try to eat a well-balanced diet.
Don't lift or carry anything heavy, or drive, while your scars heal up. After wide local excision this is likely to be after about 2 weeks. After mastectomy this may take longer. Check with your surgeon or breast care nurse when it is okay to do heavier work (such as vacuuming or shopping) with your affected arm. But do carry on with your arm exercises and some light exercise. It will help you to get better more quickly. What you can manage will vary, depending on how much surgery you've had. Some women find even filling a kettle too heavy at first. The main thing is to take it carefully and stop if you feel any strain.
After surgery some women may have problems with
Wound infection
If your operation site becomes red, inflamed, more painful or there is a fluid (discharge) leaking from your wound site, you may have an infection. Contact your surgeon or breast care nurse. If there is an infection, you will need antibiotics to clear it up.
Fluid collecting around the operation site
Sometimes fluid continues to collect near the wound after your wound drains have been taken out. This is called a seroma. It causes swelling and pain and can increase the risk of infection. The fluid usually goes away on its own. Sometimes it has to be drained off with a needle and syringe. For some women, it takes a long time to go - up to a few months after your surgery. Contact your surgeon or breast care nurse if you think you have a seroma developing.
Nerve pain
You may have numbness or tingling in your upper arm, particularly if you had your lymph nodes removed. This is normal and happens because some nerves are cut during the operation and need to repair themselves. It can take a few weeks or months to go. If it continues, get in touch with your breast care nurse or surgeon.
Swelling of your arm or hand
There may be some swelling in your arm or hand after your operation. This is normal. But it should start to go away as you do the exercises to get back the movement of your shoulder and arm.
If you continue to get a lot of swelling, pain or tenderness in your arm or hand, let your breast care nurse or surgeon know as soon as possible. After surgery or radiotherapy to the armpit, there is a risk of developing permanent swelling called lymphoedema. Once you have lymphoedema, it cannot be cured, but it can be effectively controlled with early treatment. Look at the information about lymphoedema for ways of preventing lymphoedema.
Some organisations give information about what to expect after breast cancer surgery. And they can put you in touch with cancer support groups where you can talk to other people who have been through similar experiences to your own.
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