Breast cancer surgery: what to expect

Breast-conserving surgery removes the cancer with a rim of surrounding tissue while leaving most of the breast. A mastectomy removes breast tissue and may be advised when the affected area is extensive, cancer is present in separate parts of the breast, or breast conservation does not suit the clinical situation.

The surgeon may remove sentinel lymph nodes, which are the first nodes likely to receive drainage from the breast. Laboratory examination of the removed breast tissue and nodes helps clarify whether the edges are clear of cancer and whether further treatment should be considered. Reconstruction can sometimes be performed during the same operation or later.

Before the operation, give the surgical team a complete list of medicines, supplements, allergies and previous reactions to anaesthesia. Follow their instructions about eating, drinking and medicines on the day of surgery. Arrange transport home and practical help for the early recovery period.

Afterwards, use pain relief as directed, protect the wound and follow specific advice about washing, arm movement and lifting. A drain may be placed temporarily to remove fluid. Attend the pathology follow-up because those results can influence decisions about radiotherapy, medicines or another procedure.

Seek prompt clinical advice for increasing redness, warmth or swelling around the wound, pus-like discharge, fever, worsening pain, sudden arm swelling, a drain that stops working unexpectedly, or wound edges that separate. Call emergency services for severe breathlessness, chest pain, fainting or sudden confusion.

Ask which operation is recommended and why, whether lymph nodes will be sampled, how pathology findings could change the plan, and whether radiotherapy is expected after breast-conserving surgery. You can also discuss reconstruction timing, likely changes in breast sensation or shape, management of drains, return to work and access to physiotherapy.