After breast cancer surgery

This information discusses your recovery after surgery for breast cancer. You may not have experienced any of the following, but if you do they can be managed effectively.

Wound infection

A wound infection can develop a few days after surgery or at any time until the wound is healed, which usually takes about two to three weeks. Any of the following symptoms could indicate a wound infection:

  • the wound feels tender, swollen or warm to touch
  • redness in the area
  • discharge from the wound
  • feeling generally unwell with fever.

If you have any of these symptoms get in touch with your breast care nurse, surgeon or GP. You may need a course of antibiotics, which should resolve the infection and discomfort.

Bruising and haematoma

Bruising is common after surgery. It can be mild or moderate but will gradually disappear.

Occasionally, blood collects within the tissues surrounding the wound, causing swelling, discomfort and hardness. This is called a haematoma. Although the blood will eventually be re-absorbed by the body, this can take a few weeks. If the haematoma causes you a lot of discomfort, your surgeon may decide to draw off the fluid using a syringe and needle.

Swelling

Swelling is a common symptom after any surgery and may affect your breast, chest wall, shoulder and arm. It is a normal part of the healing process and should lessen six to eight weeks after your surgery. If the swelling is uncomfortable and feels heavy, try wearing a supportive bra or tube top. It may help to wear it at night as well.

If the swelling persists for longer than two months after your surgery, particularly if you have had your lymph glands removed, tell your breast care/oncology nurse or cancer specialist. She or he may arrange for you to see a lymphoedema specialist who can decide whether your swelling is persistent post-operative swelling or an early sign of lymphoedema (swelling caused by a build-up of lymph fluid in the tissues). For further information ring 0800 CANCER (226 237).

Seroma

It is common for people who have had their lymph glands removed to experience fullness under the arm after the drain has been removed. People often describe it as like having a ball fixed in the armpit. This is due to a collection of fluid called a seroma. Following a mastectomy (removal of a breast) it is possible to develop seroma on the chest wall. As with a haematoma, this fluid is reabsorbed by the body over time. However, if it causes discomfort or is persistent, your specialist or breast care nurse may draw off the fluid using a small syringe and needle. In some cases, the fluid can collect again so this may need to be done more than once.

Pain

Pain in the breast after the post-operative period (around two months) can sometimes occur. If you have had your lymph glands removed you are more likely to feel pain and discomfort, particularly in the armpit and running down your arm, described by women as burning, numbing, tingling or stabbing. If you have had ongoing problems with pain, tell your specialist or breast care nurse. She or he can carry out a full pain assessment and prescribe treatment such as physiotherapy or pain relief. Exercises are important after armpit surgery and, if performed regularly, can reduce symptoms. If you find it difficult and painful to move your shoulder and are unable to continue with your exercises you may have developed a frozen shoulder. Ask your specialist or breast care nurse to refer you to a physiotherapist who can teach you specific exercises to regain your shoulder movement.

Cording

Occasionally you may develop a pain which can feel like a tight cord running from your armpit, down your upper arm through to the back of your hand. This is called ‘cording’, which is not serious but can cause restriction of movement. It is important to continue with regular exercises which will not cause damage or make the condition worse. If you have any symptoms that you are concerned about, tell your specialist as soon as possible so that she or he can sort out the best treatment.

Change in sensation

If you have had your lymph glands removed you may experience a loss or change in sensation running down the inner side of your upper arm. This happens because the nerves running through the armpit are divided or stretched during surgery. This may cause damage to the nerve, which can lead to a variety of symptoms such as:

  • loss or reduced sensation
  • numbness or coldness
  • weakness in the arm
  • sensitivity to touch or pressure
  • burning or tingling sensations.

If you have had a mastectomy, with or without reconstructive surgery, you might have similar symptoms in your breast/chest area.

These symptoms are usually temporary and improve or completely disappear about three months after surgery. This is because nerve tissue can take many months to repair. In rare cases you may be left with some permanent loss or altered sensation in your arm. If you are concerned about these symptoms, tell your specialist or breast care nurse. Although it can be difficult to relieve symptoms completely, various treatments are available.

Coming to terms with breast surgery

Breast surgery affects people in many different ways and you may experience other symptoms that have not been discussed here. If you have any problems or concerns, talk to your specialist or breast care nurse so that other appropriate support and treatments can be arranged for you.

Recovering from breast surgery emotionally can take some time. Everybody reacts differently so don’t be too worried if you feel you are not coping as well as someone else you know in a similar situation. Remember that fatigue, associated with cancer, can be a problem for some people, lasting for several months to a year, and this can bring you down emotionally.

If there are times when you are struggling or feeling isolated it is important to remember that there are people who can help you. Try to let your family/whānau and close friends know how you feel so that they can support you. It can also help to discuss your feelings with your breast care nurse or specialist. You may also find it helpful to talk to someone who has had the same experience.

This information was reviewed in December 2006 by the Cancer Society. It is reviewed every two years.

For cancer information and support phone 0800 CANCER (226 237).