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Having your breast cancer operation

Men and women discussing breast cancer

This page tells you about having breast cancer surgery. You can find information about

 

A quick guide to what's on this page

Having your breast cancer operation

Before your operation you may need some tests to check your general health. Your surgeon, anaesthetist and breast care nurse will talk to you in detail about what will happen during the surgery. Do ask them as many questions as you need to. The more you know about what is going to happen, the less frightening it will seem.

Immediately after your operation

When you wake up, you will have some tubes going into your body. You may have drips to give you blood transfusions or fluids until you are eating and drinking again. You may also have one or more drains to take fluid away from your wounds. The wound will be covered with a dressing.

Painkillers

Surgery to the breast and armpit can make you very sore at first. You may have pain for the first week or so but it is usually possible to control this very well with painkillers. Some hospitals may give you an electronic pump, attached to your drip, with painkillers in it. Gradually, you will start to feel less sore.

Going home

If you have just the area of cancer removed (a wide local excision), you will probably go home the same day or the next day. If you have the whole breast removed (a mastectomy), you will probably be able to go home after 2 to 3 days. Ask your nurse or surgeon about what you should expect to be able to do when you get home.

 

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Before your surgery

Before your surgery, you may have some tests and your doctors and breast care nurse will prepare you for your operation. 

Tests you may have

You may have some of the tests described in the diagnosing breast cancer section. You may also have tests to check your general health, including

Information and explanation

Your surgeon, anaesthetist and breast care nurse will talk to you about what will happen during the surgery. They may do this in the clinic before you go into hospital or when you arrive at the hospital for your operation. Your surgeon will explain what they will do and what to expect when you come round from the anaesthetic. Do ask as many questions as you need to. The more you know about what is going to happen, the less worrying it will seem. Don’t worry if you think of more questions later. Just speak to your nurses again.

Marking the area

Your surgeon may use a marker pen to draw an outline on you, to show the area of the operation. The marks may be on the breast and also under the arm.

Smoking and medicines

Your surgeon may ask you to stop smoking and stop taking hormone replacement therapy (HRT) before your operation. If you smoke you are more likely to have problems getting over your anaesthetic and may also heal more slowly. If you take HRT you may have to stop completely. Some breast cancers may be stimulated to grow by the female sex hormones that HRT contains. 

There are also concerns that women taking HRT might be more likely to have blood clots (thrombosis) when they have surgery. You may have elasticated support stockings to wear during your operation and for a short time afterwards. The stockings reduce the risk of blood clots. Your surgeon will also assess whether you need to have medicines to reduce the risk of blood clots during the operation.

Eating and drinking

You may need to stop eating and drinking for a few hours before your operation. Your doctor or nurse will advise you about this.

Shaving your underarm

If you are going to have surgery to the lymph nodes in your armpit, you may need to get rid of any underarm hair on that side just before your operation. Your nurse will give you hair removal cream or ask you to shave with clippers. This is to reduce the risk of infection.

 

Immediately after your operation

After your operation your nurses will keep a close eye on you. 

Waking up

You may wake up in the recovery ward next to the operating theatres. At first you may be wearing an oxygen mask or nasal cannula (tubes into your nose) to give you extra oxygen. As soon as you have come round completely, the staff will take you back to your ward or clinic. You may wake up quickly after an anaesthetic or you may feel dizzy and sluggish for a few hours. 

You may have a blood pressure cuff on your arm and a little clip on your finger to measure your pulse (called a pulse oximeter). Your nurse will measure your blood pressure and check your dressings quite often for the first few hours after you come round from the anaesthetic.

Drips and drains

When you wake up, you may have some tubes going into your body. You may have a drip (intravenous infusion) to give you blood transfusions or fluids until you are eating and drinking again. You may also have one or more drains coming out near your wounds. The wound drains stop blood and tissue fluid collecting around the operation area. Fluid can increase bruising, swelling and the risk of a wound infection. 

If you have had a longer operation, such as breast reconstruction, you may have a tube into your bladder to collect urine (a urinary catheter). The nurses will remove the catheter when you are able to move around on your own.

 

Painkillers

Surgery to the breast and armpit can be very sore for the first few days but it is usually possible to control this well with painkillers. There are many different types of painkilling drugs. It is important to tell your doctor or nurse as soon as you feel any pain. They can help to find the right type and dose of painkiller for you. 

Some hospitals may give you an electronic pump, attached to your drip, with painkillers in it. You may have a hand control with a button to press to give yourself extra painkillers, as you need them. This is called PCA or patient controlled analgesia. Painkillers work best when you take them regularly. If you have a pump with a button you can press to give yourself extra painkillers (PCA), use it whenever you need to. You can’t take too much because the machine is set to prevent that. Do tell your nurse if you need to press the button very often. You may need to have a higher dose in the pump.

Your surgeon may have put a long acting local anaesthetic into the wound while you were still in theatre. This really helps to control pain afterwards.

 

Eating and drinking

Sometimes people feel sick after a general anaesthetic. To try to avoid this, you will be advised to have sips of water at first. If you manage those, you can move on to other drinks such as milk, tea and soup. Once you are able to drink without being or feeling sick, your nurse will take your drip out. You can also start to eat when you feel able to. It can be helpful to have plain, bland foods at first because strongly flavoured foods are more likely to make you feel sick.

 

Your wound

When you come round you may have a pad type dressing over the wound or a clear sticky dressing. Some surgeons use a dressing that stays in place until you come back to the hospital for your first outpatient appointment. Others prefer to have a look at the wound after a day or so. Your wound will probably be covered for at least a couple of days. Then your nurses may change the dressings and clean the wound.

If you have wound drains, they will stay in until they stop draining fluid. They usually stop draining about 2 to 5 days after your operation. After surgery to the armpit, it is not unusual to have quite a lot of fluid draining. You may go home with a drain still in. A district nurse will come to your home to check it. Or you may need to go back to the hospital every few days.

Some surgeons use stitches that dissolve slowly during the couple of weeks after your operation. So you don't need to have the stitches taken out. Or you may have stitches that have to come out after about 7 to 10 days. You will probably go back to the outpatient clinic for the nurse to do this. Most people find that their wounds take about 2 to 3 weeks to heal.

 

Getting up

When you start moving around your nurses will help you because you may feel dizzy at first. Usually by the morning after the operation you can move around and walk on your own. It may take a bit longer if you have had breast reconstruction, especially if you had some tissue taken from your abdomen. 

Moving about helps you to get better more quickly and your nurses will encourage you to sit up and then get up as soon as you can after the operation. You are less likely to get a chest infection or a blood clot if you are moving around. While you are not moving about as you would normally, you can do deep breathing and leg exercises to help stop you getting these problems.

Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.

 

 

View a transcript of the video showing breathing and circulation exercises after surgery (opens in new window).

Your nurse or physiotherapist will help you to begin your arm and shoulder exercises. Make sure you have had painkillers before you start trying to do them.

 

Going home

If you have a wide local excision with sentinel lymph node biopsy you are likely to be allowed home the same day or the next day. If you had a mastectomy you will probably be able to go home after 2 to 3 days, depending on how well you recover. Gradually you will start to feel better and less sore.

Make sure you talk to your nurse or surgeon about what you should expect to be able to do when you get home. People go home very early after surgery these days, and it is important not to do too much and tire yourself. If you've had surgery to your armpit, make sure that you find out what you can and can't do. You may need to rest regularly through the day, at first. Try to do more and more each day, a little at a time. Exercise will help you recover, but it is important not to overdo it.

You will be able to drive again after your wound has healed and you can move your arm freely again. Ask your surgeon for advice if you are worried about this. You may want some padding around the diagonal bit of your seatbelt if it rubs or presses on your scar. Some car insurance companies have rules about when you should drive again after an operation. You may want to check with them before you drive.

There is information about what happens after your surgery, including looking at your wound, and about living with breast surgery in this section.

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Updated: 17 October 2012