What should you know about mastectomy and lymph node removal?

A surgeon may remove the breast, nipple and areola, and sometimes the lining over the chest muscle. The chest muscle is usually preserved. Sentinel node surgery uses the first draining nodes for laboratory examination; an axillary dissection removes more nodes when the team needs broader information or treatment.

You may discuss whether reconstruction will happen at the same operation, later, or not at all. A [Mastectomy](/treatments/surgical-oncology/mastectomy/) differs from a [Lumpectomy](/treatments/surgical-oncology/lumpectomy/), which removes the tumour with a surrounding margin while leaving much of the breast. Some people receive [Chemotherapy Before Surgery](/treatments/systemic-therapy/neoadjuvant-chemotherapy/) to change the surgical plan.

Before surgery, review medicines, allergies, smoking, arm movement, and the plan for drains. Arrange help with washing, dressing, meals, and lifting while the wound heals. Gentle shoulder exercises are introduced at the time advised by your team; forcing movement early can strain the incision.

Keep the wound and drain sites as instructed, and record drain output if you are asked to do so. Swelling, tightness, altered sensation, and tiredness can occur. After node removal, ask whether [Lymphoedema Therapy](/treatments/survivorship-and-rehabilitation/lymphoedema-therapy/) could help with persistent arm or chest swelling.

Contact the surgical team promptly for fever, increasing redness or warmth, pus, worsening pain, sudden swelling, wound separation, or a drain that stops working or fills rapidly. Seek urgent help for breathing difficulty, chest pain, fainting, or heavy bleeding. These signs need assessment rather than watchful waiting.

Ask which breast tissue and nodes will be removed, whether the nipple can remain, how pathology will affect the next treatment, when drains and dressings are expected to come out, and which arm exercises are appropriate. You can also ask about [Breast Reconstruction](/treatments/surgical-oncology/breast-reconstruction/) and the effect of surgery on sensation.