Mastectomy: What to Expect at Home

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Your Recovery

Right after the surgery you will probably feel weak, and you may feel sore for 2 to 3 days. You may have a pulling or stretching sensation near or under your arm. You may also have itching, tingling, and throbbing in the area. This will get better in a few days.

You will probably have a plastic or rubber tube, called a drain, to collect fluid from under the affected arm on the side of the surgery. Your doctor will remove this when the fluid buildup slows. This can be in a few days or even several weeks.

You should 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 other treatment you may need.

When you find out that you have cancer, you may feel many emotions and may need some help coping. This is common. 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. After any activity, rest and raise your affected arm for a period of time equal to your activity time.
  • 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. Avoid repeated motions with your affected arm, such as weed pulling, window cleaning, or vacuuming, for 6 months.
  • Avoid lifting anything over 5 to 7 kilograms for 4 to 6 weeks. This may include a child, grocery bags, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
  • 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. This depends on the type of work you do and any further treatment.
  • Wait to take a shower until your drain is removed. Your doctor may also ask you to wait to take a shower until your staples or stitches have been removed. This is usually in about 1 week. Do not take a bath for about 2 weeks, or until the wound has healed.

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.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • You may notice that your bowels are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. Take a fibre supplement such as Benefibre or Metamucil every day. If you have not had a bowel movement after a couple of days, take a mild laxative like Milk of Magnesia or a stool softener like Colace.

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.
  • 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

  • You will have a dressing over the cut (incision). A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.
  • You may be wearing a special bra (surgi-bra) that holds your dressing in place after the surgery. Your doctor will tell you when you can stop wearing the bra.

Exercise

  • If you had any lymph nodes removed from under your arm, your doctor will advise you to do arm exercises. Do not do the exercises until your doctor says it is okay.

Ice and elevation

  • Do not use ice for swelling or pain.
  • Prop up your arm on a pillow when you sit or lie down. Try to keep your arm above the level of your heart. This will help reduce swelling.

Other instructions

  • You may have one or more drains in your surgery site. Your doctor will tell you how to take care of them.
  • If you had a mastectomy, take precautions to prevent 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.
    • Avoid insect bites.
    • Wear medical alert jewellery that says you can develop lymphedema.

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.
  • Fluid collects under the skin of the surgery site.
  • 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.
  • You have sudden swelling of your arm, hands, or fingers.
  • You have pain that does not go away when you take your pain medicine.
  • You have loose stitches, your incision comes open, or the skin around the incision turns dark, purple or black.
  • Bright red blood has soaked through your bandage.
  • 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.

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

  • You feel any changes in your other breast during breast self-examinations. This includes lumps, skin changes, or nipple drainage.
  • Your rings, watches, or bracelets feel tight, but you have not gained weight.
  • You feel anxious or depressed, or have trouble sleeping.
  • You do not have a bowel movement after taking a laxative.

Where can you learn more?

Go to http://www.healthwise.net/ed

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