What to Expect for Breast Cancer Surgery and Recovery

By Anne Denk, RN, BSN

One of the most common treatments for breast cancer is surgery. The two standard forms of breast cancer surgery are a lumpectomy or a full mastectomy. If the cancer has spread to the lymph nodes, your surgeon will also discuss options for lymph node removal. Some people choose to pursue breast reconstruction surgery following the removal of cancer from the breast. Regardless of the type, you will need time to recover from your surgery. 

Before Surgery

Prior to receiving surgery, you might need to be cleared by your other doctors. This clearance typically includes lab work and a visit with your primary care doctor. Clearance from specialty doctors, such as a cardiologist, pulmonologist, or hematologist, might be needed if you have pre-existing conditions such as cardiac disease, lung disease, or blood disorders. Once you have been cleared by your primary care doctor and/or specialty doctors, you will be scheduled for surgery. You will have a “pre-op” visit with your surgeon one week before your surgery. During this pre-op visit, your surgeon will discuss what to expect for surgery. They will provide additional details, such as when to stop eating and drinking prior to surgery and when to check in for the surgery.

Surgery and Hospital Stay

You will check in with the surgical admitting department when you arrive at the hospital for surgery. The surgical admitting department will have you fill out additional paperwork. You will be taken back to the “pre-op” area, where you will change into a hospital gown. A nurse will place an IV in your arm for IV medications that you will be receiving. The nurse will also review additional information with you, including what to expect after surgery. You will meet with the anesthesiologist prior to surgery.

Following surgery, you will wake up in the Post Anesthesia Care Unit, also called the “PACU.” The PACU team will ensure that you are awake and alert and that your vital signs are stable before discharging or transferring you. If you are not able to go home on the same day of surgery, you will be transferred to an inpatient unit in the hospital. Once transferred, you will be placed in a patient room. You will have a nurse, and probably a medical assistant or patient care assistant, assigned to you. Your medical team will monitor your vital signs — temperature, blood pressure, heart rate, and oxygen levels — regularly. They will also monitor the output of your surgical drain.

Recovery at Home

You will be expected to have a family member or friend drive you home from the surgery center or hospital. While at home, you must empty and measure the output from the drains in your chest daily. The goal is to see a decrease in the output from your drains over the next few days. You and your caregiver will also be expected to monitor your surgical incision site. Call your doctor if you notice increased redness, pain, or swelling at the incision site. Also, call if you develop a temperature of greater than 101 degrees fahrenheit. 

You will have a follow-up appointment with your surgeon approximately one week after your surgery. Your surgeon will examine your incision to ensure it is free of infection or any other complications. Your surgeon will also assess your arm’s range of motion and strength. Surgery to your breast or chest will temporarily cause pain and swelling in the affected area, which can impact the strength and range of motion in your chest, shoulder, and arm. Once medically cleared by your surgeon, you can start exercises to regain this range of motion and strength. 

Your surgeon might refer you to a physical therapist to practice the recommended exercises, or they might provide you with a list of home exercises. These exercises help improve your range of motion and strength in various ways.

• The “wand exercise” helps to regain your ability to move your shoulder forward

• “Elbow winging” assists in regaining the mobility of your chest and shoulder

• “Side bends” help to regain the movement of your torso

Your surgeon will inform you which exercises are safe to start and when.

Continued Screenings

Depending on what type of surgery you received, you will continue to follow up with your surgeon every 3 to 6 months in the first year. If you received breast-conserving surgery, you will require a mammogram about six months after your surgery. If you received a mastectomy, follow-up imagery is not necessary unless there is a new abnormality. Once your surgeon clears you, you will continue to receive a physical exam once a year. 

Conclusion

The road to recovery after breast cancer surgery is different from other breast cancer treatments. After surgery, you might go home, or you might be admitted to a unit in the hospital for monitoring. While at home, you will record the output of your surgical drains and monitor your surgical incision site. Once approved by your surgeon, you will practice home exercises to regain mobility and strength in your chest, shoulder, and arm. If you have any questions or concerns throughout this journey, you can always reach out to your surgeon’s office for answers and additional support.

References

American Cancer Society. (2019, October 2). Getting Ready for and Recovering from Cancer Surgery. https://www.cancer.org/cancer/managing-cancer/treatment-types/surgery/recovering-from-cancer-surgery.html

American Cancer Society. (2021, October 27). Exercises After Breast Cancer Surgery. https://www.cancer.org/cancer/types/breast-cancer/treatment/surgery-for-breast-cancer/exercises-after-breast-cancer-surgery.html

American Cancer Society. (2023, January 11). Surgery for Breast Cancer. https://www.cancer.org/cancer/types/breast-cancer/treatment/surgery-for-breast-cancer.html

American College of Surgeons. (2023). Your Surgical Drain. Retrieved January 10, 2024, from https://www.facs.org/for-patients/home-skills-for-patients/breast-cancer-surgery/after-your-operation/surgical-drain-care/ 

Carson, C. (2022, July 15). Breast cancer surgery recovery and follow-up screening. The University of Texas MD Anderson Cancer Center. https://www.mdanderson.org/cancerwise/breast-cancer-surgery-recovery-and-follow-up-screening.h00-159541323.html

University of Utah. (n.d.). Breast Surgery Drains Care & Management. Retrieved January 10, 2024, from https://healthcare.utah.edu/plastic-surgery/breast/surgery-drains

Assessed and Endorsed by the MedReport Medical Review Board