Most people recover well after surgery with few major side effects. But there are some things to be aware of.
You can read more information about aftercare and side effects following breast cancer surgery by downloading our booklet Your operation and recovery.
For information about what happens before an operation for breast cancer surgery, see Going into hospital.
After your surgery you will have an adhesive dressing applied to your wound. You may have dissolvable stitches that don’t need to be removed, or non-dissolvable stitches that need to be removed seven to ten days after surgery. You may also have steristrips (narrow adhesive strips used to close a wound) that will need to be removed.
Sometimes a thick, firm dressing (pressure dressing) is also applied to help reduce swelling or bleeding initially after surgery. Pressure dressings are usually removed after a day or two.
You may have wound drains in place following surgery, although not all surgeons use them. These are tubes that drain blood and fluid from the wound into a small bottle or bag. You can walk around and move normally with the drains in place. These drains will stay in for up to a few weeks (depending on the type of surgery) and will then be removed by a member of the specialist team.
Some people are able to go home with their drains in and either return each day to have them checked and the content measured, or in some hospitals patients or their carers will be taught how to do this.
You're likely to have some pain or discomfort after surgery but everyone’s experience is different. There are different types and strengths of pain relief available and they can be given as tablets, suppositories (waxy pellets placed into your rectum (back passage)) or injections. What you are given will vary according to your needs. Some people find changing position and using pillows to support the wound can help reduce pain or discomfort.
Sometimes pain relief may be given through a device called a PCA (patient controlled analgesia). This is a pump designed to give pain relief straight into your vein when you press a button. It is usually removed a day or two after surgery. This is commonly used if you are having breast reconstruction.
Many people experience pain, numbness and a burning sensation as a result of temporary damage to the minor nerves under the arm and scar area.
If you’re in any pain while in hospital tell the ward staff, as you may need a strong dose of pain relief, or a stronger type. If you don’t feel your pain is controlled when you’re back at home, contact your hospital team or GP.
Bruising and swelling
Bruising is common after surgery but will disappear over time.
Swelling soon after the operation is also common and will usually settle over time. Your treatment team may call this swelling oedema. The swelling may affect your breast, chest wall, shoulder and arm. It’s a normal part of the healing process and should lessen six to eight weeks after your surgery. If the swelling is uncomfortable and feels heavy, wearing a supportive bra day and night can help. If the swelling doesn’t go away, talk to your breast care nurse.
After surgery some people may develop a collection of fluid called a seroma. This can occur under the arm and/or in the breast or chest wall and is usually reabsorbed by the body over time. Seromas can also occur in the abdominal area if tissue has been taken from here for reconstruction.
If the seroma causes discomfort or doesn’t reduce or go away, your specialist or breast care nurse may decide to draw off (aspirate) the fluid using a syringe and needle. Sometimes a seroma will refill after it has been aspirated so it may need to be aspirated several times 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.
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.
Your arm and shoulder on the operated side may feel stiff and sore for some weeks. Your breast care nurse or physiotherapist will give you some gentle exercises to help you get back the range of movement you had before your surgery. Our leaflet Exercises after breast cancer surgery may also help.
It’s important to have a full range of shoulder movement before starting radiotherapy. If you’ve had or are having breast reconstruction, talk to your breast surgeon or physiotherapist before you start your exercises and follow their advice.
After surgery, some people develop a tight ‘cord’ of tissue under the skin, causing pain and restricting arm movement. The cord may not be visible but can usually be felt. This cord starts in the armpit and can vary in length. It may just be in the armpit, or may travel down to the elbow or wrist. This ‘cording’ is also known as axillary web syndrome.
Stretching the cord can improve your symptoms and you may need physiotherapy to help with this. You will sometimes be advised to take pain relief before performing the stretches as they may feel uncomfortable. Cording usually gets better with physiotherapy and exercise. Some people develop cording more than once.
If you have any symptoms you are concerned about tell your specialist as soon as possible.
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, months or even years after surgery.
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. If necessary, they will be able to refer you to a lymphoedema specialist for further advice and treatment.
If you develop lymphoedema, you may find it useful to read our Living with lymphoedema after breast cancer booklet.
A wound infection can happen any time until the wound is completely healed. It usually takes about two to three weeks for the skin to heal and around six weeks for any internal stitches to dissolve. 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 (fluid) from the wound
- feeling generally unwell with a raised temperature
Contact your GP, breast care nurse or specialist straight away if you think you may have a wound infection. You may need a course of antibiotics to stop the infection and discomfort.
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 including:
- 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 reconstruction, 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.
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.
Whatever breast surgery you have will leave some type of scar. Looking at and feeling the scar for the first time can be difficult. Some people find it helpful to have someone with them when they first look at their scars, while others want to be by themselves. For many women this can take some time. Getting to know how your scars look and feel will help you notice any possible future changes.
Scar tissue is produced naturally by the body during healing. At first your scar will feel uneven to the touch and may feel tight and tender. Scars are often initially red but will fade and become less obvious over time. Your specialist team should be able to tell you when you can start moisturising your scars.
At first you may find it uncomfortable to wear a bra or anything that puts pressure on the affected area. As the scars become less sensitive you should be able to wear a comfortable bra. If you’ve had a mastectomy you’ll also be able to wear a lightweight prosthesis (artificial breast form) as soon as you feel comfortable.
For more information, see our Breast prostheses, bras and clothes after surgery booklet.
Discoloration after 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.
You may feel sick after surgery because of the anaesthetic. Some people are more likely to feel sick 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.
Recovery after surgery involves healing both physically and emotionally. The time this takes will vary from person to person.
Going home can bring mixed emotions. You may feel relief that the operation is over but concern about needing to go back for your results. You may feel vulnerable because you no longer have the immediate support of the nurses, doctors and the hospital team. You will be given a contact number for the ward and breast care nurse, in case you want to talk through any issues. You can also call Breast Cancer Care’s free Helpline on 0808 800 6000 if you want to talk through your concerns with one of our experts.
Our booklet Breast cancer and you: coping with diagnosis, treatment and the future discusses some of the emotional issues you may face during and after your treatment. You may also find our Moving Forward book useful.
Before you leave the hospital you may be given, or be told, when to expect an appointment to discuss how the operation went, your pathology report (which describes the results of any tests done on tissue removed during surgery) and any further treatment that may be recommended. For more information see our booklet Understanding your pathology results.
When you leave hospital follow any instructions you are given about caring for your wound. This will vary from hospital to hospital and depends on the kind of surgery you have.
If you’re discharged with your drains still in place, they may be regularly checked at home by a nurse or you may be asked to telephone or return to the hospital each day so that the drainage can be checked. This may sound frightening, but if your treatment team suggests it, they will give you all the information and support you need.
You can usually bathe and shower normally following surgery (if you have a waterproof dressing covering the wound), but it’s advisable not to use any soaps or deodorant products on or around the area of your wound. The nursing staff on the ward will give you specific advice on caring for your wound and any dressings. They will also make any arrangements for the removal of your stitches if they are not dissolvable.
If you have questions about caring for your wound, or what kind of follow-up care you’ll receive, contact your breast care nurse or another member of your specialist team.
Returning to normal activities
When you’re home from hospital, try to do a little more physical activity each day. Try not to set yourself big tasks and remember to get a good amount of rest. Your body needs time and energy to recover.
You'll usually be advised not to lift or carry anything heavy until your wounds have fully healed. If you take things gently at first, you should be able to return to most of your normal activities within a few weeks of your operation but this will vary from person to person and will depend on the type of surgery you’ve had.
Your breast care nurse or surgeon will be able to provide advice on practical issues such as driving, returning to work and leisure activities.
Our booklet Your operation and recovery has more information about this.