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Mastectomy - discharge

Alternative Names

Breast removal surgery - discharge; Nipple-sparing mastectomy - discharge; Total mastectomy - discharge; Simple mastectomy - discharge; Modified radical mastectomy - discharge; Breast cancer - mastectomy -discharge

When You Were in the Hospital

You had a mastectomy. This is surgery that removes the entire breast. The surgery was done to treat or prevent breast cancer. Your procedure 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 implants 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 may 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 about 2 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 drug stores and on the internet.

Wound Care

You may still have drains in your chest when you go home from the hospital. You will need 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 uses 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 every day until your doctor says you do not need to.
  • Wash the wound area with mild soap and water.
  • DO NOT wash or 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 doctor tells you it is ok.
  • You may shower after all of your dressings have been removed.

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.

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 of 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 Surgeon

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 milky 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

Hunt KK, Green MC, Bucholz TA. Diseases of the breast. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 36.

Khatcheressian JL, Hurley P, Bantug E, et al. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:961-965. PMID 23129741 www.ncbi.nlm.nih.gov/pubmed/23129741.

Riutta J. Post-mastectomy pain syndrome. In: Frontera, WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 109.


Review Date: 3/13/2015
Reviewed By: Debra G. Wechter, MD, FACS, General Surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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