How long will I stay in the hospital after breast cancer surgery?
The length of stay in the hospital depends on the type of surgery and reconstruction that is performed. Generally, lumpectomies are done on an outpatient basis, and the patient recovers in a 23-hour, short-stay observation unit after the procedure.
Mastectomies with lymph node removal usually require a one- to two-night stay in the hospital; with tissue flap breast reconstruction, the stay may be 4-7 days.
Most women can resume driving 10 to 14 days after surgery. Please ask your surgeon for specific recommendations.
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 nurse or 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 at your follow-up visit.
Small pieces of tape (called steri-strips) will remain over the incision site and may be removed 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 the first week. You may bathe in a bathtub if you are able to keep the area dry. Look for redness and swelling, which may be signs of infection.
Do not go swimming until you have discussed this with your surgeon at your follow-up appointment.
Changing your surgical dressing
You will be wearing a special bra (surgi-bra) that holds the dressings in place after the surgery. Your health care provider will tell you when you are able to stop wearing the surgi-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 lie 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.
Before leaving the hospital, you will be given a prescription for relief of pain after the procedure. You may take Extra Strength Tylenol® instead if that provides sufficient relief. Do not take aspirin or products containing aspirin for the first three days after the procedure.
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. 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.
Exercising is important after breast surgery. To regain mobility, perform these stretching exercises several times every day, starting the day after surgery:
- 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.
- 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.
- 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.
Regular follow-up exams are very important after breast cancer treatment. You will most likely be followed by both an oncologist and your breast health care provider after surgery. You will continue to be followed 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 possibly other imaging studies.
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 health care provider right away.
Blood tests/medication injections
If you had an axillary dissection or lymph node removal, it is preferred that you do not have blood drawn or have an injection in the 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.