Mastectomy - discharge
Breast removal surgery - discharge; Nipple-sparing mastectomy - discharge; Total mastectomy - discharge; Simple mastectomy - discharge; Modified radical mastectomy - discharge; Breast cancer - mastectomy -discharge
You had a mastectomy. This is surgery that removes the entire breast. The surgery was done to treat or prevent breast cancer.
Now that you're going home, be sure to follow the surgeon's instructions on how to care for yourself at home.
Of all the different types of cancers, breast cancer is one of the most talked about, and with good reason. One out of every eight women will develop breast cancer sometime in their life. That's why every woman should be thinking about how to protect herself from this disease. Breast cancer is cancer that forms in the breast. Usually, it begins in the tubes that transport milk from the breast to the nipple. If the cancer spreads to other parts of the breast or body, it's called invasive breast cancer. Some breast cancers are more aggressive, growing more quickly than others. Although women are 100 times more likely to develop breast cancer, men can also get the disease because they do have breast tissue. You're more likely to get breast cancer if you're over 50, you started your periods before age 12, or you have a close family member with the disease. Drinking more than a couple of glasses of alcohol a day and using hormone replacement therapy for several years also may increase your risk. The telltale sign of breast cancer is a lump in your breast or armpit. You may also notice a change in the shape, size, or texture of your breast, or have fluid coming from your nipple when you're not breastfeeding. If you notice any changes in your breasts, call your doctor. You'll probably need to have an imaging scan, such as a mammogram, MRI, or ultrasound. A piece of tissue may be removed from your breast, called a biopsy. With these tests, your doctor can tell whether you have breast cancer, and if so, determine whether or not it has spread. So, how do we treat breast cancer? That really depends on the type of cancer, and how quickly it's spreading. Your doctor may recommend that you have the cancer removed with surgery. Sometimes it's enough just to remove the lump. That's called a lumpectomy. In other cases, the doctor will need to remove the entire breast to get rid of all the cancer or prevent it from coming back. That's called a mastectomy. Other treatments for breast cancer include chemotherapy, medicines that kill cancer cells, and radiation therapy, which uses energy to destroy cancer. Women whose cancer is fueled by the hormone estrogen may receive hormone therapy to block the effects of estrogen on their cancer. Today's breast cancer treatments are better than ever. Many women who have breast cancer go on to live long, healthy lives. The outlook really depends on how fast the tumor is growing, and how far it has spread. That's why it's so important to report any changes in your breasts to your doctor as soon as you notice them. Women who are at an especially high risk for breast cancer because of their family history can talk to their doctor about taking medicine or even having surgery to reduce their risk.
When You're in the Hospital
Your surgery was one of these:
- For a nipple-sparing mastectomy, the surgeon removed the entire breast and left the nipple and areola (the pigmented circle around the nipple) in place. The surgeon may have done a biopsy of nearby lymph nodes to see if the cancer spread.
- For a skin-sparing mastectomy, the surgeon removed the entire breast along with the nipple and areola, but removed very little skin. The surgeon may have done a biopsy of nearby lymph nodes to see if the cancer spread.
- For a total or simple mastectomy, the surgeon removed the entire breast along with the nipple and areola. The surgeon may have done a biopsy of nearby lymph nodes to see if the cancer spread.
- For a modified radical mastectomy, the surgeon removed the entire breast and the lower level lymph nodes under your arm.
You may have also had breast reconstruction surgery with a tissue expander. This is a temporary implant to be replaced later with a breast implant or natural tissue.
What to Expect at Home
Full recovery may take 4 to 8 weeks. You may have shoulder, chest, and arm stiffness. This stiffness gets better over time and can be helped with physical therapy.
You may have swelling in the arm on the side of your surgery. This swelling is called lymphedema. The swelling usually occurs much later and it can be a problem that lasts. It can also be treated with physical therapy.
You may go home with drains in your chest to remove extra fluid. Your surgeon will decide when to remove these drains, usually in a week or two.
You are likely to need time to adjust to losing your breast. Talking to other women who have had mastectomies can help you deal with these feelings. Ask your health care provider about local support groups. Counseling can help as well.
Activity
You can do whatever activity you want as long as it does not cause pain or discomfort. You should be able to resume your usual activities in a few weeks.
It is OK to use your arm on the side of your surgery.
- Your provider or physical therapist can show you some simple exercises to relieve tightness. Do only the exercises they show you.
- You may drive only if you are not taking pain medicines and you can easily turn the steering wheel without pain.
Ask your surgeon when you can return to work. When and what you can do depends on your type of work and whether you also had a lymph node biopsy.
Ask your surgeon or nurse about using post-mastectomy products, such as a mastectomy bra or a camisole with drain pockets. These can be bought in specialty stores, the lingerie section of major department stores, and on the internet.
Wound Care
You may still have drains in your chest when you go home from the hospital. Follow instructions on how to empty and measure how much fluid drains from them.
Stitches are often placed under the skin and dissolve on their own. If your surgeon used clips, you will go back to the doctor to have them removed. This usually takes place 7 to 10 days after surgery.
Care for your wound as instructed. Instructions may include:
- If you have a dressing, change it as directed by your surgeon.
- Wash the wound area with mild soap and water if your surgeon says it is OK.
- You may shower but do not scrub the strips of surgical tape or surgical glue. Let them fall off on their own.
- Do not sit in a bathtub, pool, or hot tub until your surgeon tells you it is OK.
- You may shower after all of your dressings have been removed if your surgeon says it is OK.
Managing Your Pain
Your surgeon will give you a prescription for pain medicines. Get it filled right away so you have it available when you go home. Remember to take your pain medicine before your pain gets severe. Ask your surgeon about taking acetaminophen (Tylenol) or ibuprofen for pain instead of narcotic pain medicine.
Try using an ice pack on your chest and armpit if you have pain or swelling. Do this only if your surgeon says it is OK. Wrap the ice pack in a towel before applying it. This prevents cold injury to your skin. Do not use the ice pack for more than 15 minutes at a time.
Follow-up
Your surgeon will tell you when you need to have your next visit. You may also need appointments to talk about more treatment, such as chemotherapy, radiation, or hormonal therapy.
When to Call the Doctor
Call if:
- Your temperature is 101.5°F (38.6°C), or higher.
- You have swelling of the arm on the side you had surgery (lymphedema).
- Your surgical wounds are bleeding, are red or warm to the touch, or have a thick, yellow, green, or pus-like drainage.
- You have pain that is not helped with your pain medicines.
- It is hard to breathe.
- You have a cough that does not go away.
- You cannot drink or eat.
References
American Cancer Society website. Surgery for breast cancer.
Elson L. Post-mastectomy pain syndrome. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 110.
Klimberg VS, Hunt KK. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 35.
Version Info
Last reviewed on: 3/11/2023
Reviewed by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
