Everyone reacts differently to surgery, most people recover well with few major side effects. But some common problems may arise.
You may have wound drains in place following surgery, although not all surgeons use them. These are tubes that drain any blood and fluid from the wound area into a small bottle or bag. You can walk around and move normally with the drains in place. Drains will usually be removed from around two to up to seven days after surgery.
Sometimes you may be able to go home with any drains still in place. Staff caring for you will advise you on their care and removal
You may feel sick after surgery because of the anaesthetic. This is more likely in some people than others. For example people having very long operations such as those involving breast reconstruction. Any nausea is usually only short-term. Anti-sickness drugs (anti-emetics) given as a tablet or injection can help to relieve it.
Bruising and swelling
Bruising is common after surgery but will gradually disappear. Swelling is common after any surgery and may affect your breast, chest wall, shoulder and arm. This is a normal part of healing and should lessen after six to eight weeks. Wearing a soft, supportive bra may help if you are uncomfortable. If the swelling persists after your surgery, particularly if you've had your lymph nodes (glands) removed, tell your breast care nurse or cancer specialist.
Discoloration following sentinel node biopsy
If you have a sentinel node biopsy including the use of blue dye, your breast may be discoloured. This is temporary and usually fades slowly. The blue dye usually flushes out in your urine, which will make it look a green colour for a few days.
Occasionally blood collects in the tissues surrounding the wound causing swelling, discomfort and hardness. This is called a haematoma.
The blood will eventually be reabsorbed by the body but this can take a few weeks. If a very large haematoma develops after your surgery, your surgeon may suggest removing it by drawing the blood off with a needle and syringe. Occasionally, a small operation is needed to remove it. Contact your breast care nurse or ward if you have any concerns after you have left the hospital.
Whatever breast surgery you have will leave some type of scar. Scar tissue is produced naturally by the body during healing. At first your scar will feel uneven to touch. Your scar(s) may feel tight and tender and you may not be able to wear a bra or anything that puts pressure on the affected area.
If you have had a mastectomy without a reconstruction you will be given a lightweight prosthesis (a false breast form) before you leave hospital. This is designed to be worn after surgery during the time when the area feels most tender.
Your arm and shoulder on the operated side will probably feel stiff and sore for some weeks. Your breast care nurse or physiotherapist will give you some gentle exercises to help you regain the movement you had before the operation. Our leaflet Exercises after breast cancer surgery demonstrates some exercises that can also help.
It’s important to have a full range of shoulder movement before starting radiotherapy as you will need to be able to raise your arm up and behind your head. If you have had or are having breast reconstruction, talk to your breast surgeon or physiotherapist before you start your exercises and follow their advice.
A wound infection can develop at any time until the wound is healed. It usually takes about two to three weeks for the skin to heal and around six weeks for any internal stitches to dissolve. Contact your GP, breast care nurse or specialist straight away if you think you may have a wound infection. Any of the following symptoms could mean you have a wound infection:
- the wound feels tender, swollen or warm to touch
- redness in the area
- discharge from the wound
- feeling generally unwell with fever.
You may need a course of antibiotics if you have any of these symptoms. These should stop the infection and discomfort.
Pain and discomfort
You're likely to have some pain or discomfort following surgery, but everyone’s experience is different. The pain should improve after a few weeks, though you may experience discomfort for some months depending on the extent of the surgery. If you’ve had the lymph nodes from under your arm removed, you're more likely to feel pain and discomfort around that particular area. It’s important to continue taking regular pain relief until your symptoms improve as this will help you to maintain your arm exercises. If you continue to have problems with pain, tell your GP or specialist team.
After surgery some people may develop a collection of fluid called a seroma. This can occur either under the arm and/or in the breast or chest wall and is usually reabsorbed by the body over time.
If the seroma causes discomfort or doesn’t subside, your specialist or breast care nurse may decide to draw off the fluid (aspirate) using a syringe and needle. Sometimes a seroma will refill after it has been aspirated so it may need to be aspirated several times over a few weeks before it goes away completely. This is usually a painless procedure as the area is likely to be numb.
If the seroma restricts your arm movement and prevents you doing your arm exercises, speak to your breast care nurse or surgeon for advice.
After surgery, some people develop a cord-like structure, causing pain and restricting arm movement. The ‘cord’ may not be visible but can usually be felt.
Cording is thought to be caused by hardened lymph vessels and can appear six to eight weeks following surgery or even months afterwards. Stretching the cord can improve the symptoms though you may need physiotherapy to help with this. Some people develop cording more than once.
Change in sensation
If you’ve had your lymph nodes removed you may temporarily experience a change in, or loss of, sensation down the inner side of your upper arm. Some people who have had lymph nodes removed may be left with a degree of permanent numbness or altered sensation in their upper arm.
This happens because the nerves under the arm have to be disturbed to reach the lymph nodes that lie behind them. This can lead to a number of symptoms:
- loss of sensation or reduced sensation or feeling
- numbness or coldness
- weakness in the arm
- sensitivity to touch or pressure
- burning or tingling sensations
- pins and needles
- shooting pains.
If you’ve had a mastectomy with or without reconstructive surgery, you might have similar symptoms in your chest area.
If you have breast reconstruction using a flap of your own tissue you may also feel a change in sensation in the area from where tissue was taken. For more information see our Breast reconstruction booklet.
These symptoms are usually temporary and improve or disappear with time. Some people who have had lymph nodes removed are left with some permanent numbness or changed feeling in their upper arm.
If you're concerned about these symptoms, tell your specialist or breast care nurse. Although it may not be possible to relieve all of your symptoms, some helpful treatments are available.
Lymphoedema is swelling of the arm, hand or breast area caused by a build up of lymph fluid in the surface tissues of the body. This can occur as a result of damage to the lymphatic system because of surgery. Although this type of swelling can usually be controlled it may never completely go away. It can occur weeks or months after surgery, or even years later. If you're concerned about your risk of developing lymphoedema, talk to your breast care nurse or specialist. For more information see our Reducing the risk of lymphoedema booklet.
If you notice any swelling that doesn’t settle after your surgery in your breast/chest, arm or hand, tell your breast care nurse. They will be able to refer you to a lymphoedema specialist for further advice and treatment if necessary.
If you develop lymphoedema, you may find it useful to read our Living with lymphoedema after breast cancer booklet.
Content last reviewed May 2014; next planned review 2017.