Making the decision to undergo breast surgery (mastectomy) as part of your breast cancer treatment plan is a courageous move in your fight to overcome breast cancer. A mastectomy is major surgery and can be a very emotional experience. It is normal to be emotional and allowing yourself the time and space to prepare mentally and emotionally is just as important as preparing for a comfortable recovery.

Being fully aware of what happens before, during and after a mastectomy will help you put your mind at ease and alleviate any worry or anxiety you may experience leading up to the surgery.

In the hospital on the day of surgery, you will change into a hospital gown and wait in the pre-operative holding area. Some hospitals will allow you to have one or two friends or family members to accompany you here. Using a felt-tip marker, your surgeon or nurse may draw markings on your breast to show where the incision is to be made. You will be taken to the anaesthesia room, where the nurse will insert a needle connecting to a long tube – an intravenous infusion (IV) line into your hand or arm. You will be given relaxing medication through the IV line and after you’re wheeled into the operating room and placed on the operation table you will be administered general anaesthesia.[1] 

A mastectomy with axillary lymph node dissection (surgery to remove lymph nodes from under the arm that contain cancer) may take up to 2-3 hours. If you have elected for reconstruction surgery immediately after your mastectomy, the surgery will take longer. 

Most mastectomy incisions are in the shape of an oval around the nipple, running across the width of the breast. If you are having a skin-sparing mastectomy, the incision will be smaller, including only the nipple, areola, and the original biopsy scar. If you're having a nipple-sparing mastectomy, a variety of incisions can be used. 

After the incision is made, the breast tissue is separated from the overlying skin and from the chest wall muscle underneath. All of the breast tissue — which lies between the collarbone and ribs, from the side of the body to the breastbone in the centre — is removed. 

In the final stages of the surgery, your breast surgeon will check the surgery areas for bleeding and insert surgical drains. Drains are long tubes that are inserted into your breast area or armpit to collect excess fluid that can accumulate in the space where the tumour was. The tubes have plastic bulbs on the ends to create suction, which helps the fluid to exit your body. After the drains are inserted, your surgeon will stitch the incision closed. The surgery site will then be covered by a bandage that wraps closely around your chest. [2]

You’ll be moved to a recovery room where medical staff can monitor your heart rate, body temperature, and blood pressure. If you are in pain or feel nauseous from the anaesthesia, let your medical team know so that you can be given medication. You will then be moved to a hospital room. You may expect to stay in hospital for 3 days or less. If you had a mastectomy and breast reconstruction at the same time, you may have to stay in the hospital for longer. [3] 

Immediately after your surgery and during your recovery period, you may feel pain, soreness, tired, or experience bloating or swelling. You may find it difficult and painful to move about or extend your arms past a certain point. Therefore, doing some of the simplest things like showering or making yourself a meal may be challenging. Understanding all this is part of the healing phase and being well prepared for it will make your recovery period easier and more comfortable.

Line up help – Arrange for a friend or family member to drive you home after the surgery as the medication you receive post-op may slow your responses. Speak to friends and family who will be able to provide assistance and support when you’re stuck at home recovering. 

Take care of personal matters – There will be a host of things which you may not be able to do immediately after your surgery, so it’s best to do it way ahead of time; like going to the dentist, getting a haircut, or making appointments for your children. Take this time to also plan for anything with a due date such as payment of bills by preparing checks or setting up auto-pay. 

Arrange your wardrobe/cupboards/pantry –Just twisting your body to reach for things may be painful or difficult. Organize your wardrobe, kitchen cupboards and pantry to ensure necessities are easily accessible with your limited reach. 

Spring clean your home – You may not want to be doing any housework during your recovery period. Spring clean and declutter your home for a comfortable recovering environment. You may also want to look into securing cleaning services for this period. 

Stock up on food stuff /houseware – Do all your grocery shopping before your surgery to limit your having to move about or go out during the healing phase, which you may not feel like you want to. 

Prepare your meal plan – If you don’t have anyone cooking for you, opt-in on food delivery services to have healthy meals delivered to your doorstep.

Shop for comfortable clothing – Buy post-mastectomy garments that are designed to hold drains and are easy to get in and out of. The drains may also add extra bulk so be sure to buy clothing which are a little bigger than your usual size.

Shop for recovery support aids – There are specially designed post-surgical bras or mastectomy brassieres which help reduce the risk of edema (the abnormal accumulation of fluid in certain tissues within the body). The Can-Care Post-Op Kit which consist of a Post-Op Bra, Post-Op Molded Breast Form, and squeeze ball for hand exercises to reduce stiffness in your arm and shoulder is a great basic post-op kit to have on hand immediately following your mastectomy. Can-Care Post-Op Bra is designed for supporting the breast and scar areas while keeping wound irritation to a minimum. The Can-Care Post-Op Molded Breast Form is a non-silicone, feather light molded form designed as a temporary shape replacement. 

Download music for relaxation – Music is a powerful aid to have pre-op for relaxation and motivation before you’re wheeled into the operating room and an effective relaxing aid post-op. Download music onto your phone or tablet,

Get books/magazines/movies to keep you company – Everyone’s bodies heal differently. The recovering period after a mastectomy can be anything from 2 weeks to 4 weeks. It’s a long wait, and you may get restless and irritable. Create your must-read list or must-watch movie list to keep yourself occupied during your recovery. 

Practice helpful fitness moves and exercises – Following your mastectomy, you may have limited use of your upper body. Climbing out of bed, getting up from chairs or even using the bathroom can be challenging. Speak to your doctor or post-care specialist on moves and exercises that will help you post-op like learning how to carefully roll in and out of bed. 

Speak to your doctor – Get a clear picture of what will be happening before and after your mastectomy and have all your medical questions answered by speaking with your surgeon and oncologist (medical specialist in cancer).

Follow your doctors pre-op and post-op instructions – Your surgeon and oncologist may have a list of to-do or not to-do items in preparation for surgery like to stop smoking if you’re a smoker or to stop specific medication. It is important that you follow your doctor’s instructions for a smooth operation and recovery.

Speak to friends and family – Don’t keep everything to yourself. Share your fears and concerns with your nearest and dearest.  

Speak to a post-care specialist – Obtain non-medical advice and recovery support from a post-care specialist. Can-Care provides education and counselling services to assist patients in alleviating any anxiety or worries they may experience before and after breast surgery.

Allow yourself time to grieve for your breasts – Parting with your breasts is a big deal not only physically but also emotionally. It’s perfectly all right to grieve for the loss of a body part and understand that this grieving period doesn’t necessarily have an end date.

Take pictures of your original breasts – Some women keep a journal of their recovery journey and some just want a memento of their breasts. Some women find this helpful with the grieving process. On a practical note, having pictures of your original breasts would also come in handy if you later choose to have breast/nipple tattoos or breast reconstruction to help with picking out the best positioning and colour of your nipples.

Go for a massage – You will not be able to lie on your front following your mastectomy and having a relaxing massage would be a great way to relieve all that pre-surgery anxiety.

You may have to stay in hospital for up to 3 days following your mastectomy. Here is a list of essential items to pack for your hospital stay: 

1. Medical & Personal Documents such as personal ID and insurance 
2. Comfortable Clothing & Underwear
3. Items for Personal Comfort 
   

• Toothpaste & toothbrush
• Dry Shampoo
• Face wipes
• Lip balm for dry lips
• Hairbrush
• Comfort pillow
• Headbands to keep hair out of your face
• Slip-on Shoes
• Books and music 
  

Don’t bring any valuables like jewellery to the hospital. 

Most importantly, remember that everyone manages stress and anxiety in different ways. Find your own personal way to relieve any anxiety you might have and allow yourself to open up and seek professional advice or just a comforting chat with a friend or family member.