• Reference Number: HEY-001/2023
• Departments: Breast Services
• Last Updated: 27 April 2023

Introduction

This leaflet has been produced to give you general discharge information following your Breast Surgery.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with the nurse caring for you on the ward or your Breast Care Nurse.

Can there be any complications or risks?

our doctor will have explained the possible complications following your breast surgery; however we would like to provide the following information that has been highlighted by our patients’ previous experiences.

It is normal to experience altered sensations around the area of your operation and especially in the armpit and upper part of your arm, if you have had axillary surgery (removal of lymph nodes from under your arm pits). Please do your arm and shoulder exercises from the leaflet given to you at your pre-assessment appointment if appropriate and as advised by the physiotherapist.

Please continue to wear your white stockings (anti-embolic stockings – full length or knee length to prevent blood clots) for two weeks after your operation, unless otherwise instructed. You can take your stockings off, in order to hand wash them but they need to be put back on soon as possible.

Pain Relief

You may experience some discomfort following your operation but the pain relief medication that you would normally take should provide you with adequate relief (paracetamol or ibuprofen). However, please do not hesitate to contact your doctor if you feel that you need stronger pain relief medication. If you continue to experience discomfort, or if you have any additional concerns, please ring Ward 16 or the Breast Care Nurses on the telephone numbers at the end of this leaflet.

Drains

Depending on the type of surgery you have you may need be discharged with a drain in situ. This is nothing to worry about and you will be given instructions on the ward on how to look after it. The drain comes with its own carry bag and you need to ensure that you carry it around where ever you go. You can still go out of the house with a drain in but cannot drive. The ward will show you how to measure and mark or mark the bottle and you will need to contact the breast care unit on 01482 622679 when the drainage is less then 50mls to arrange to have it removed. If this is over weekend or a bank holiday then contact ward 16 on 01482 468616.

What symptoms should I look out for?

Swelling in the wound area is a common symptom following surgery and may affect your breast area or armpit. Sometimes a fluid collection called a Seroma may develop after the drain has been removed. This is normal and nothing to worry about; however you will need to contact the breast care unit if you develop any of the following or have any concerns

• The swelling is causing you a lot of discomfort.
• The area looks red or feels hot to touch.
• You have a sensation of fluid moving behind your wound.
• There is a lot of leakage through the dressing.
• Some patients are sensitive to the dressing and this may cause skin irritation (the skin may itch and feel sore). In this case the dressing may need to be replaced.

What happens afterwards?

Recuperation period

Listen to your body and be kind to yourself. Having an operation means that you need time to recover. Light housework such as dusting or washing up can be good exercise but we do advise avoiding heavy housework for a good 2 weeks.  Try to do a little extra each day but be sure to rest between tasks if you feel tired. It is normal to feel as though your energy levels are low, especially in the days following your general anaesthetic. You are able to get out and about but avoid carrying any heavy bags including handbags for a good 2 weeks.

You can use a deodorant if you do not have a dressing in your armpit. A ‘roll on’ is better, as you can direct this easier than a spray.

You will have a shower proof dressing in place, you can wash / shower but it is important to keep the dressing dry until it is removed. You can remove your dressing between 7 to 10 days after your operation if you wish, or alternatively you can contact your GP surgery for the practice nurse to remove it. You may need to come back to the breast care unit for your dressing to be removed especially if it is a bigger surgery. You should receive an appointment for this and is usually 10-14 days post-surgery.

We do advise you wear a soft non wire bra post-surgery; a soft sports bra is good as it gives support and is comfortable. Depending on the surgery you have you may be fitted with a bra in theatre. This is normally after the reconstruction type surgeries.

You will be given advice on how long you will need to wear this.

If you have undergone a mastectomy the ward will provide a soft temporary prosthesis (pad) called a softie to wear in your bra to go home. These can be washed and the padding can altered to fit. Don’t worry if you cannot wear a bra for long periods of time, this is normal and you will gradually be able to wear it for longer. If you require a permanent prosthesis an appointment will be made for you once your wound has healed. This is normally discussed at your next follow up appointment; usually 4-5 weeks post-surgery.

Psychological recovery

There is no right or wrong way to feel. Remember that everyone is an individual. Talk about your feelings to your family, friends or partner so they can support you. Psychological support is available from the Breast Care Nurse and the Oncology Health Centre at Castle Hill Hospital.

Exercises

It is important to continue to do your arm/shoulder exercises when you are at home, if appropriate. Try to use your arm normally but avoid lifting heavy objects.

Driving

You can start driving again once you feel alert and able to operate your car safely and you are able to do an emergency stop. You should also check with your insurance company first. Generally you are advised not to drive for the first two weeks following surgery.

Results of your breast surgery

You will be advised when to return to the clinic for your post-operative results. An appointment will be sent out to you and this is normally 4-5 weeks post-surgery.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Breast Care Nurses on Tel no: (01482) 622013.

If you have a problem with your wound please contact the Breast care Unit (01482) 622679.

Outside office hours (evenings and weekends) please contact Ward 16 at Castle Hill Hospital on (01482) 468616.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.