Top Insider Tips on Mastectomy
For the estimated 281,550 women who’ll be diagnosed with breast cancer this year alone, the decision to undergo a mastectomy is big. The surgery involves removing the breast tissue (and potentially nearby lymph nodes to ensure the cancer hasn’t spread) to reduce the risk of recurrence. One type of mastectomy does not fit all. There’s a total mastectomy, which involves removing the entire breast, including the breast tissue, areola, and nipple; a skin-sparing mastectomy where the breast tissue, nipple, and areola are removed but not the skin, and a nipple-sparing surgery, in which only breast tissue is removed, sparing the skin, nipple, and areola.
Some of the reasons doctors recommend a mastectomy include having two or more tumors in separate areas of the breast, widespread malignant calcium deposits, or if you’re a carrier for a gene mutation that puts you at a high risk for developing a second cancer in your breast. Undoubtedly, you’ll have many feelings, and rightfully so. Going into it can be scary—mostly for fear of the unknown. But that’s where we come in, to give you all the intel, from doctors in the know, about what to expect before, during, and after the procedure so that you’re prepped and ready both physically and emotionally.
Share Your Meds
“Bring a list of all prescription and over-the-counter medications you are taking, and note your allergies to medication as well,” says Miami-based nurse practitioner Dorothy Dulko, Ph.D., a faculty member of Walden University’s Master of Science Nursing program. Studies have shown some medications, like aspirin, ibuprofen (Advil, Motrin IB), as well as blood-thinning medications like warfarin (Coumadin, Jantoven) can increase your chance of major bleeding during and after the surgery. Your doctor will likely have you stop taking these meds at least a week before surgery.
Load Up on Healthy Fats
To set you up for a speedier recovery, make foods with monounsaturated and omega-3 fats a major part of your diet. A 2014 review in Advances in Wound Care reports omega-3 polyunsaturated fatty acids, and particularly those found in in fish oil, have been shown to prevent wound infections and can improve early wound healing. Though, after several days, they may decrease collagen production, this may also prevent extensive scarring. “They are good choices for healing, as they have been shown to improve immune function, decrease inflammation in the body, and improve heart health,” Dr. Dulko says.
Pack Portable Self-Care Products
Because you might be in the hospital a few nights post-surgery, and showering may be a no-go for days, stock up on products to help you feel so fresh and so clean. While the hospital provides standard-issue items like soaps and towels, you may want to bring your own, Dr. Dulko says. Also consider packing things like baby wipes for quick washing without water or dry shampoo to keep your hair feeling fresh.
Have a Pillow on Hand
When you leave the hospital, you’ll likely have a surgical bra to cover your incision and drains attached to your bra. “These help to drain fluid from your incision and prevent swelling,” Dr. Dulko says. Make sure whoever drives you home has a couple of small pillows on hand to place under the seatbelt, including both the strap that goes across your chest and over your lap. Padding these very sensitive areas in between your drains and incisions and the seatbelt can provide some extra comfort on the ride home, Dr. Dulko says.
Embrace the Blues
“If you’ve had a sentinel lymph node biopsy (to determine if the cancer has spread), your surgeon will likely have injected a small amount of blue dye underneath your nipple or near the tumor,” Dr. Dulko says. This dye travels through your lymphatic fluid to the sentinel lymph node(s), staining them blue. Which is harmless, but it also tends to turn your skin, stool, and urine blue, too for a few days after your surgery. So, don’t be alarmed if you (and the toilet bowl water) change color.
Downsize Your Purse
Doctors recommend avoiding picking up objects over five pounds (we’re looking at you, half-ton tote) for up to eight weeks after a mastectomy and reconstructive surgery. That’s because heavy lifting may cause tearing of small vessels, which can lead to bleeding or a hematoma. In fact, you shouldn’t lift your arms above shoulder level at all for about two weeks post op. “While you may feel pretty normal as soon as two to four weeks after surgery, especially if you have no reconstruction, it takes six to eight weeks for full wound healing to occur, so take it easy after surgery,” says Constance M. Chen, M.D., a board-certified plastic surgeon and clinical assistant professor of plastic surgery at Weill Cornell Medical College in New York City.
Real talk: You’ll be living with surgical drains for a while after surgery, as well as potentially leaky wounds. Opt for dark colors to mask stains and front zippers that are super easy to get in and out of, Dr. Chen says. “Many surgeons will place a post-surgical bra that has attachments for the drains, so it may not be necessary to buy special clothing to carry the drains. However, there are post-surgical clothes, scarves, and belts that have special pockets if your surgeon does not use a post-surgical bra that holds the drains,” she says.
Improve Your Snooze
While a restless night’s sleep can wreak havoc on your level of functioning the next day, it can also increase sensitivity to pain and impede your recovery, according to a 2018 study in Current Opinion in Anesthesiology. Because your doc will recommend that you sleep on your back for six to eight weeks post-op to help with healing and symmetry if you have reconstruction, it can take some getting used to for stomach or side sleepers, Dr. Chen says. Well ahead of surgery, practice sleeping on your back to help train your body, so you’ll sleep more soundly afterward.
Effects of Aspirin On Surgical Procedures: The New England Journal of Medicine. (2014). “Aspirin in Patients Undergoing Noncardiac Surgery”. nejm.org/doi/full/10.1056/nejmoa1401105
Benefits of Omega-3 Fatty Acids on Wound Healing: Advances in Wound Care. (2014). “Role of Arginine and Omega-3 Fatty Acids in Wound Healing and Infection”. ncbi.nlm.nih.gov/pmc/articles/PMC4217020/
Sleep and Post-Surgery Recovery: Current Opinion in Anesthesiology. (2018). “Improve postoperative sleep: what can we do?” ncbi.nlm.nih.gov/pmc/articles/PMC5768217/