Please note: These are general guidelines and may not be applicable to every patient. Always follow your doctor's specific instructions for care after surgery.

Drain care

You may be discharged from the hospital with an external drainage device in place. The drain will continuously remove fluid from a catheter at the surgery site into an external collection device. You will be responsible for emptying this collection device. Your health care provider will discuss how to care for your drain before you are discharged from the hospital.

The amount of fluid that is drained over a 24-hour period will gradually decrease. The color of the fluid may also change from a cherry-red, to a yellow-red and then to a straw-colored fluid. Usually the drainage system is removed within one week after surgery.

Incision care

Small pieces of tape (called steri-strips) will remain over the incision site and may be removed from 10 to 14 days after surgery. The incision should be kept clean and dry for one week after surgery. Therefore, we recommend sponge baths instead of showers. You may bathe in a bathtub if you are able to keep the area dry.

Do not go swimming until you have discussed this with your physician at your follow-up appointment.

Changing your surgical dressing

You will be wearing a special bra (surgi-bra) which holds dressings in place after the surgery. Your doctor will tell you when you are able to stop wearing the bra. You should change the dressings once a day. Your health care provider will show you how to change the dressing, but here are the steps as a reminder:

• Open the surgi-bra and remove the old dressings.
• Open the new dressing package and select the gauze with the slit, placing the slit around the drainage tube (where it comes out of your body). Take the other gauze and place it over the incision. Do not use tape. Close the surgi-bra. It is helpful to have someone help you change the dressing as you lay in bed.

Note: when you go home from the hospital, a nurse will give you the appropriate supplies you will need to change the dressing.

Pain relief

You will be given a prescription for pain relief after the procedure. You may instead take Extra Strength Tylenol if that provides sufficient relief. Do not take aspirin or products containing aspirin for the first three days after the procedure.

Skin care

The area may be black and blue right after the procedure. This will go away in a few days. You may feel numbness, tingling or discomfort on the inner part of your upper arm or in your armpit. This is normal. Try to increase your exercise routine and take a mild pain reliever such as Tylenol (see Pain Relief section above). A warm shower may also provide comfort, but remember to wait one week after surgery before taking a shower.

When shaving under the arm or applying deodorant, look in the mirror to avoid irritating the incision.

As the incision heals, it may feel thick and tough. You may massage the area with a mild lotion, vitamin E or pure lanolin. Avoid highly perfumed lotions and any product containing alcohol. After several weeks, the scar will soften.

Exercise

Exercising is important after breast surgery. To regain mobility, perform these stretching exercises several times every day, starting the day after surgery.

1. Arm lifts: While standing or sitting on the edge of a chair, lift both arms over your head, with your elbows "touching" your ears. Hold for a count of five and repeat.
2. Arm swings: While standing, swing both arms forward and back from your shoulders (like a pendulum). Try to keep your elbows straight. Increase the distance of the swing each time. Repeat 10 times.
3. Wall climbing: Stand facing a wall, with your feet close to the wall. Put your arms out in front of you with your hands on the wall. Climb the fingertips of both hands up the wall, until your arms are stretched over your head. Climb your fingers back down the wall. Repeat 10 times, trying to reach higher each time.

Driving

Most women can resume driving 10 to 14 days after surgery. Please ask your physician for specific recommendations.

Follow-up exams

Regular follow-up exams are very important after breast cancer treatment. The doctor will continue to check you closely to be sure that the cancer has not returned. Regular checkups usually include exams of the chest, underarm and neck. From time to time, you may have a complete physical exam, blood tests, mammography and a chest X-ray. The doctor sometimes orders scans and other exams as well.

Breast self-exam

A woman who has had cancer in one breast has a higher-than-average risk of developing cancer in her other breast. You should continue to practice monthly breast self-examination, checking both the treated area and your other breast. Report any changes to your doctor right away.

Blood tests/medication injections

It is preferred that you do not have blood drawn or have an injection in the affected arm (on the side where the surgery was performed) as a precautionary measure. If it is necessary that blood be drawn from this arm or medication be given in this arm, be sure to tell the health care provider that you have had breast surgery.

When to call the doctor

When you go home from the hospital after surgery, call your doctor if you have:

• Swelling in your arm or hand, near the incision or under your arm
  (A small amount of swelling is normal for about one month after surgery. Sometimes, elevating your arm on pillows will reduce some of the swelling).
• A fever over 101 degrees Fahrenheit
• Increased drainage from the surgical drain (more than 240 cc or 8 oz over one 24-hour period)
• Increased pain not controlled from the pain medication
• Other physical problems such as pain, loss of appetite or weight, changes in menstrual periods or blurred vision. (Also report dizziness, coughing or hoarseness, headaches, or digestive problems that seem unusual or that don't go away.)

© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.

Can't find the health information you’re looking for?

• Ask a Health Educator, Live!
• Know someone who could use this information?...send them this link.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/11/2008...#8326