Having an operation for breast cancer

Before your operation for breast cancer, you may go to a pre-operative assessment clinic. At the clinic, you may have tests to check your general health. These can include:

• blood tests
• a chest x-ray
• a recording of your heart (ECG).

Your surgeon or breast care nurse will talk to you about how your breast or chest will look after your surgery. They may show you photographs of other people have had surgery for breast cancer. They may also put you in contact with someone who has had the same operation. You could also contact a local support group or Breast Cancer Now, or visit our breast cancer forum to talk with people who have been affected by breast cancer, share your experience, and ask an expert your questions.

You will usually go into hospital on the day of your operation. You will meet the doctor who gives you the anaesthetic. They are called an anaesthetist. The nurses may give you elastic stockings to wear during and after the operation. These are called TED stockings. They help prevent blood clots.

We have more information about preparing for surgery.

Signs of infection can include:

• warmth around the wound
• redness around the wound
• swelling around the wound or discharge coming from it
• feeling unwell with a fever

Tell your breast care nurse, cancer doctor or GP if you get any of these symptoms, even after you go home.

A seroma is a soft bulge or swelling around the wound or very close to it. It is caused by a build-up of fluid. It usually goes away within a few weeks. Talk to your surgeon or breast care nurse if the swelling does not go away. They may drain the fluid with a needle and syringe. This may cause a little discomfort when it is being done. And it may need to be repeated if the fluid builds up again.

If you had a mastectomy or lymph nodes removed, your shoulder or arm may feel sore or stiff.

A physiotherapist or nurse will show you some arm exercises to do. These will help improve the movement in your shoulder and arm. They will also reduce the risk of long-term problems. You should start the exercises the day after your operation and slowly build up what you do. It is important to keep doing them until you can move your arm as well as you could before your operation.

Some people find it helps to take painkillers 1 hour before doing the exercises.

Breast Cancer Now has a leaflet about these exercises.

You may have numbness or a tingling feeling in your upper arm. This is more likely if you had all the lymph nodes in your armpit removed.

Numbness and tingling in the upper arm is caused by swelling and damage to the nerves in your breast and armpit. This can happen during or after the operation. It may slowly improve over a few months, but numbness can sometimes be permanent. Talk to your surgeon or nurse if you are worried.

If you had surgery to remove lymph nodes in the armpit, you may develop cording. This is also called axillary web syndrome. It feels like a tight cord going from your armpit down the inside of your arm. You may be able to see the cord as well as feel it. Sometimes there is more than 1 cord. It can feel tight and painful and can affect the movement in your arm and shoulder.

Cording may happen days or weeks after surgery, or sometimes months later. It is less likely to happen if you only had 1 or 2 lymph nodes removed. It is not clear exactly what causes cording. It may be caused by changes in the lymphatic vessels after surgery.

If you are worried, ask your breast care nurse for advice. Cording usually gets better on its own. But you may need to visit a physiotherapist. They can help you with exercises to stretch the cord and improve your movement.

We have more information about cording in our information on the late effects of breast cancer treatment.

You will have a clinic appointment to see your surgeon and breast care nurse. They will check that the wound is healing properly. They will also tell you about the tissue that was removed during surgery (pathology) and the stage of the cancer.

If you had breast conserving surgery, your surgeon will tell you whether the margins around the cancer are clear. If the margins are not clear, you may need another operation. Sometimes cancer cells are found very close to the margin or in it. Although this can be upsetting news, it can usually be treated successfully with a second operation.

The surgeon and nurse will also talk to you about any further treatment you may need. This may be radiotherapy, chemotherapy, targeted therapy or hormonal therapy. In some situations, your doctors may discuss having a tumour-profiling test. This can help you decide about having chemotherapy.