Axillary Lymph Node Dissection: What to Expect at Home

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Your Recovery

Right after the surgery you will probably feel weak, and your shoulder area will feel sore and stiff for a few days. It may be hard to move your arm and shoulder in all directions. Your doctor or physiotherapist will teach you some arm exercises. You now have a higher chance of swelling in the affected arm. This is called lymphedema. From now on, you will have to be careful when using your arm.

You will have a scar under your arm that will fade over time. You may also notice a hollow area in your armpit. It may also feel like you have a lump in your armpit. You may lose some feeling under your arm, or the arm may have a tingling or burning feeling. The loss of feeling may last only a little while, or it may last the rest of your life.

You will probably be able to go back to work or your normal routine in 3 to 6 weeks. This depends on the type of work you do and any further treatment. If cancer was found in the lymph nodes, you will probably need more treatment.

An axillary node dissection may be done at the same time as other breast cancer surgeries. If this is the case, your recovery may be different.

When you find out that you have cancer, you may feel many emotions and may need some help coping. Seek out family, friends, and counsellors for support. You also can do things at home to make yourself feel better while you go through treatment. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid strenuous activities, such as biking, jogging, weightlifting, or aerobic exercise, until your doctor says it is okay. This includes housework, especially if you have to use your affected arm. You will probably be able to do your normal activities in 3 to 6 weeks. But for the next 3 to 6 months, be careful when you do tasks that use the same motions over and over, such as vacuuming, weed pulling, or window cleaning.
  • For 4 to 6 weeks, avoid lifting anything that weighs more than 4.5 to 7 kilograms or that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
  • Ask your doctor when you can drive again.
  • You will probably be able to go back to work or your normal routine in 3 to 6 weeks. It will also depend on the type of work you do and any further treatment.
  • You may be able to take showers (unless you have a drain in your incision) 24 to 48 hours after surgery. Pat the cut (incision) dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay. If you have a drain coming out of your incision, follow your doctor's instructions to empty and care for it.
  • Take precautions to prevent infection and swelling in your arm. This is called lymphedema.
    • Wear gloves when you garden, handle garbage, wash dishes, and clean house.
    • Protect your hands and arms from burns, including sunburns.
    • Do not wear tight sleeves, elastic cuffs, bracelets, wristwatches, or rings on the affected arm.
    • Do not let anyone take blood pressure, draw blood, or give shots in that arm.
    • Do not carry heavy purses, suitcases, grocery bags, and other heavy items with that arm.
    • Keep the skin of that arm well moisturized.
    • Do not cut your cuticles.
    • Use an electric shaver if you shave your armpits.
    • Protect yourself from insect bites on the arm.
    • Wear medical alert jewellery that says you can develop lymphedema.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
  • Be safe with medicines. Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.

Incision care

  • If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
  • After 24 to 48 hours, wash the area daily with warm, soapy water and pat it dry. Keep the area clean and dry.
  • You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.

Exercise

  • You will need to do arm exercises once your doctor tells you it is okay. Do the range-of-motion exercises as instructed by your doctor.

Elevation

  • Prop up your arm on a pillow anytime you sit or lie down. Try to keep it above the level of your heart. This will help reduce swelling.

Other instructions

  • You may have a drain in your armpit. Follow your doctor's instructions to empty and care for it.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have signs of lymphedema.
    • You have a feeling of tightness or swelling in or around your arm.
    • You have pain, weakness that keeps getting worse, or a tingling "pins and needles" feeling.
    • Your arm feels full or heavy.
    • You notice that your hand or wrist is becoming stiff and hard to move.
    • You notice swelling in your fingers.
  • You have increased swelling in the breast.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • Fluid is leaking around the drain, you have a sudden increase in fluid, or you have no new fluid in the drain for 24 hours.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • Your rings, watches, or bracelets feel tight, but you have not gained weight.
  • You do not have a bowel movement after taking a laxative.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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