Everyone reacts differently to surgery, most people recover well with few major side effects. But some common problems may arise (see below).
You may have wound drains in place following surgery, although some surgeons do not 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 two to seven days after surgery.
In some cases 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 should pass within a day or two. 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 lasts for longer than two months 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. You may also notice that your urine, stools and tears are discoloured for a few days after your operation.
Occasionally, blood collects in the tissues around the wound causing swelling, discomfort and hardness called a haematoma.
The body can take several weeks to reabsorb the blood. If the haematoma is very large, your surgeon may suggest drawing off the fluid using a syringe and needle. Rarely, a small operation is needed to remove it.
Pins and needles, burning, numbness or darting sensations in the chest area and down the arm on the operated side are quite common and can go on for weeks or even months following surgery.
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 and DVD Getting fitter, feeling stronger: exercises to help recovery after breast cancer surgery also demonstrates some exercises that can help.
If you have radiotherapy it is extremely helpful to continue these exercises throughout and after your radiotherapy. Many physiotherapists advise doing them for up to two years; others recommend doing them permanently.
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.If you have any of the following symptoms it’s important to speak to your GP or specialist team as you may need a course of antibiotics:
- the wound feels tender, swollen or warm to touch
- redness in the area
- discharge from the wound
- feeling generally unwell with fever.
Pain and discomfort
You are 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 are more likely to feel pain and discomfort around that particular area. It is important to continue taking regular pain relief until your symptoms subside as this will help you to maintain your arm exercises. If you continue to have problems with pain, tell your GP or specialist team.
Many people who have had breast cancer surgery or lymph node removal develop a collection of fluid called a seroma. This can either be under the arm and/or in the breast or chest wall. The build up of fluid may cause some discomfort, but is not a cause for concern and is usually reabsorbed by the body over time.
If the seroma is large, restricts arm movement, causes discomfort or doesn’t subside, your specialist or breast care nurse may decide to draw off (aspirate) the fluid using a needle and syringe. This is usually a painless procedure as the area around the wound is still likely to be numb.
Sometimes a seroma will refill after it has been aspirated. Some people may need to be aspirated several times over a period of weeks before it goes away completely. This can be a frustrating experience.
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 running through the armpit 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 are 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.
Surgery to the lymph nodes under the arm can affect the vessels that drain lymph fluid from the arm. This can lead to a build up of lymph fluid causing swelling. Any swelling soon after the operation will usually settle over time as the lymph vessels open and drain better.
For some people the swelling can last and may never completely go away, although it can usually be controlled. This is known as lymphoedema and can occur weeks or months after surgery, or even years later.
If you are concerned about your risk of developing lymphoedema, talk to your breast care nurse or specialist. If you notice any swelling in your arm or fingers it is important to contact your breast care nurse or specialist team for an assessment.
Download or order our publication Your operation and recovery for more information.
Content last reviewed March 2012; next planned review 2013.