A mastectomy is one of the most common operations for breast cancer. It means removing the whole breast. The time it takes to recover from a mastectomy will depend on a lot of different factors. Read on to learn about how long it takes to recover after a mastectomy and what you can do to heal faster.
Why do I need a mastectomy?
If there is too much cancer in the breast to be treated by a lumpectomy (wide local excision) alone you need a mastectomy. This might be because the size of the cancer or DCIS (pre-cancer change) is large. Also, it might be because there are a number of different tumours in the breast and they can’t be taken out separately. Although surgeons try to avoid a mastectomy where possible, it is still a common procedure in women of all ages. Ladies who want to reduce their risk of breast cancer usually have a double (both sides) mastectomy.
What happens when I am admitted for a mastectomy?
The doctors will give you a general anaesthetic (you are asleep). Most people come in to hospital on the day of surgery, having had tests done beforehand to check you are fit for the operation. You will sign a consent to treatment form (if you haven’t already) and have a chance to ask any last minute questions. Hopefully you will have met the surgeon and been able to have a good discussion with him or her already.
You will be asked to change into a hospital gown and given special stockings to wear. These reduce the risk of a clot in the legs (DVT). You will then be taken through to the anaesthetic room where the doctor and assistants will gently put you off to sleep. You are then wheeled into the operating theatre.
How is a mastectomy operation performed?
The top part of your gown will be removed to expose your chest, breast and shoulders. Your arm will be placed on an arm board at 90 degrees to your body and secured in place so that it doesn’t move. The anaesthetist monitors you the whole time to make sure that you are comfortably asleep.
The surgeon will prepare the skin using an antiseptic solution and then place sterile drapes around the area. The surgeon removes a crescent or ellipse of skin, including the nipple. The breast tissue below this is all removed down to the chest muscle (pectoral muscle). If the glands under the arm are being removed then this will be done next. Local anaesthetic is injected to give pain relief after surgery. A rubber drain tube is placed through the skin below the scar. The skin is then closed using a dissolving suture. Glue, paper stitches and a dressing are placed over the wound.
If you are having a reconstruction at the same time as the mastectomy, the procedure will be slightly different and may involve preserving the skin over the breast and the nipple.
What happens when I wake up?
You will wake up slowly and probably feel sleepy. Most patients do not feel sick nowadays due to the modern drugs used for anaesthesia. There will be a drain coming out of your chest and dressings over your wound. You will feel that your chest is flat. It is normal to take some time before you feel able to look at and touch the area. For the first few hours the nurses will closely monitor you for any signs of bleeding or other problems. We usually remove the drain the day after surgery.
What can go wrong after a mastectomy?
Most people who have a mastectomy recover well afterwards. There are a few important complications to be aware of:
- Bleeding- occasionally you have to go back to the operating theatre or receive a blood transfusion to control bleeding
- Pain- this is usually well-controlled with painkillers. Occasionally it can last longer and require specialist help.
- Scar- you will have a scar and there is no guarantee as to how each individual’s body will react to stitches or dressings
- Infection- the surgical team will inject antibiotics when you are asleep to reduce the risk of an infection but we can never eliminate any chance that this might occur later. If you get an infection you would need more antibiotics.
- Seroma- this is a collection of fluid and can become large and uncomfortable. It is best to avoid draining the fluid as your body will absorb it itself. If you need to it can be drained with a needle.
- Need for further treatment- depending on what the pathologist sees when he examines the mastectomy specimen under the microscope, you might need more treatments. This might mean another operation (for instance to remove all of the glands under the arm). It might mean radiotherapy to the chest wall or chemotherapy. The information from the pathologist will help make these decisions.
- Complications of surgery- everyone who has an operation is at risk of clots in the leg or lung (DVT/PE) or chest or heart problems. These are rare but would require further treatment in hospital.
How long will I take to recover from a mastectomy?
Most patients are able to go home the day after surgery. Some hospitals send patients home the same day as surgery if they feel up to it. You will feel sore and stiff for a few days. But it is important to keep doing your exercises to keep your shoulders moving. You shouldn’t do any heavy lifting or vigorous exercise for 2 weeks. Keep the dressings dry for 48 hours and after that you can shower and dab them dry. After 2 weeks you can gently increase the amount of activity you are doing. Most patients are back to normal activities after 6 weeks.
What can I do to help my recovery?
- Don’t over-do it too early with physical activity
- Listen to the advice of your surgeon and breast care nurses
- Get in touch with the team if you are worried something is wrong (e.g. swelling or discharge)
- Eat healthy, nutritious food including fruit and vegetables
- Stay well hydrated with clear liquids
- Avoid excess alcohol
- Stay away from friends or relatives who may have an infection
- Be active, go for a walk
- Keep in touch with friends and family, consider joining a support group, make contact with people going through the same experience