Mastectomy - discharge

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

Definition

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.

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. www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer.html. Updated January 11, 2023. Accessed April 6, 2023.

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.

Schedule An Appointment

Review Date: 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.


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