Your Breast Cancer Operation.

Whether you are having a breast conserving surgery or a mastectomy to treat your breast cancer, you are likely to require a short stay in hospital. Your admission may be a number of hours (day surgery) or a number of days. It is likely that you will also be having some or all of the glands (lymph nodes) removed from the armpit at the same time.

This information will give you an idea of what to expect around the time of your operation.

What happens before the operation?

You may be asked to attend a pre-admission clinic a few days before surgery to finalise paperwork and have any tests required by the anaesthetist. You are likely to be admitted to the hospital on the day of the operation, several hours before the surgery is scheduled to start. You will usually be asked to call the hospital the evening prior to surgery. This will confirm the time you need to arrive at the hospital. You will also be asked to have nothing to eat or drink several hours before the operation to minimise the risk associated with a general anaesthetic.

When you arrive at the hospital, a nurse will attend to your admission information. This will include observations such as your temperature and blood pressure. You will be asked if you have a contact person who will be available to take you home. You will also be assessed by a member of the anaesthetic team.

If you are having a sentinel node biopsy, the lymphatic mapping procedure (lymphoscintigraphy) will be performed in the nuclear medicine department before the surgery.

If your operation requires a guide wire localisation (a procedure which marks the breast cancer with a tiny wire), this will be performed in the breast imaging centre or radiology department under local anaesthetic (see the Guide-wire localised breast surgery brochure) before surgery.

How will I feel after the operation?

After the operation you will wake up in the recovery room. You may have a mask with oxygen flowing through it to help you breathe. You may also wake up feeling sleepy.

You will have a small, plastic tube in one of the veins in your arm. This will be attached to a bag of liquid and is called a drip. The drip feeds your body with fluid until you are well enough to eat and drink.

While you are in the recovery room a nurse will check your pulse and blood pressure regularly. When you are well enough you will be discharged home (if you are having day surgery) or you will be transferred to a ward (if you are staying overnight). Sometimes people feel sick after a breast operation. If you feel sick, please tell a nurse and you will be given medicine to control any nausea and vomiting.

Will I feel any pain?

After any operation, it is normal to experience some pain. Each person has a different experience of pain. Before your operation, the anaesthetist will talk to you about different types of pain control that can be given to you after your operation. You should be up and about the next day.

If you feel discomfort, please ask for pain medication, so that your hospital stay will be as comfortable as possible.

How do I care for my wound?

When you wake up you may have tubes (drains) coming from your wound. These tubes remove fluid and blood from the space under the wound to help prevent healing problems.

You may also have a dressing covering your wound. The dressing will help keep the wound clean and it will usually remain in place until your clinic appointment (about a week after surgery). Most surgeons use stitches that dissolve and do not need to be removed. The dressings are usually waterproof.

If you have had breast conserving surgery you will often be advised to wear a supportive, non-underwire bra such as a “crop top” the day after the operation. This provides support and comfort.

How do I look after my arm?

Start by gently moving the arm on the side of your surgery. You should follow the arm exercises prescribed by your doctor or physiotherapist.

Will I be able to eat after the operation?

After the operation you will be able to eat as soon as you are wide awake. This usually takes 2-4 hours. How quickly you return to a normal diet will depend on how you feel. Most patients recover very quickly.

When can I get out of bed?

Generally, it is best to get out of bed as soon as you feel you can. If, on the first day, you cannot get out of bed, move your legs in bed to help prevent blood clots. If you feel dizzy or light headed ask for assistance and sit on the edge of the bed for a short time before standing up.

When can I leave hospital?

People who have had a breast operation can often go home the same day. The time that you stay in hospital will depend on how quickly you recover from your operation, the type of operation, and your doctor’s advice.

When can I get back to my usual activities?

After breast conserving surgery people can return to normal everyday activities within a couple of days. After a bigger operation, such as mastectomy or breast cancer operation with axillary dissection (armpit surgery), getting back to normal can take longer. You can usually begin gentle activities within a week or two, but you may need to wait a little longer for vigorous activity. You will be advised to wait until after your post operative appointment before resuming full activities. If you have a drain in place we recommend you do not drive until this is removed. Once you are feeling comfortable you can usually begin driving again. On average, this will be a week or so after surgery (or after a drain is removed) but this will depend on the type of operation you have had.

If you stay in hospital overnight the surgical team will review you each morning. The breast care nurse will also visit you each week day while you are in hospital.

When will I see my Surgeon again?

When you are discharged from hospital, a follow-up appointment will be confirmed for you. At this appointment, you will be able to discuss any problems and ask questions. Your wound will be checked and your pathology results will be discussed with you. Any further breast cancer treatment such as radiotherapy, chemotherapy or more surgery will be discussed in detail at that visit.

How do I get more help?

It is common to feel a bit “down” after an operation. If you would like to talk with someone, ask your doctor or breast care nurse.

Feel free to contact me at your convenience and i'll be happy to get in touch with you.