Your Guide to Preparing for Breast Cancer Surgery and Understanding the Journey Ahead

At Premier Surgical Network, we understand how overwhelming a breast cancer diagnosis can be. As you start your treatment process, we are here as a resource to help you comprehensively understand your options. We offer a range of surgical breast cancer procedures like lumpectomy, mastectomy, and lymph node removal. Understanding the different surgical options available is an important tool to help you navigate your breast cancer diagnosis, and our doctors will work with you to develop a custom treatment plan that targets your unique situation. Entering into this journey as an informed patient will help you feel ready to tackle breast cancer.

Understanding Different Types of Breast Cancer Surgeries

The type of breast cancer, size and location of tumor, stage/grade of cancer, patient health history, and patient personal preferences are all important factors our surgical team considers when advising on the appropriate surgery for each individual breast cancer patient. Our experts will help you understand which procedure may be right for your unique diagnosis.

Lumpectomy: This surgery removes only the tumor and some surrounding healthy tissue. Lumpectomy is often recommended for smaller, early-stage cancers, to preserve as much of the breast tissue as possible.
Mastectomy: This surgery removes the entire breast, including all breast tissue and sometimes other nearby tissues. There are several types of mastectomy, ranging from simple/total mastectomy to more extensive surgeries removing muscles/lymph nodes. Mastectomies may be recommended for larger tumors, later-stage breast cancers, or patient preference.
Hidden scar approach: This is an advanced surgical option in either a mastectomy or lumpectomy procedure. With a hidden scar approach, your incision is placed in a location that is hard to see, so the scar will not be visible once healed.
Nipple-sparing mastectomy: This is an advanced surgical technique that preserves the nipple and areola along with the breast skin.
Sentinel lymph node biopsy: This surgical procedure pinpoints and removes the sentinel lymph node(s) to determine if breast cancer has spread to the lymph nodes.

Steps to Prepare for Your Breast Cancer Surgery

We recommend taking the following steps to prepare for breast cancer surgery:

Consult your surgeon to discuss details of your specific surgical procedure, associated risks, and expected recovery timeline. Ask all your questions.
Attend pre-operative appointments for any necessary physical exams, bloodwork, and medical tests to evaluate your health for surgery.
Meet ahead of time with your full care team – surgeon, oncologist, anesthesiologist, reconstructive surgeon, nurses, etc.
Schedule any recommended pre-operative imaging, biopsies, or consultations about breast reconstruction.
Stop smoking at least 2 weeks before surgery and refrain for 6+ weeks after to help proper healing.
Limit alcohol intake around the surgery timeline, as it can impact healing.
With physician approval, optimize health by improving diet, activity levels, and medication adherence.
Plan for transportation home from the hospital after being discharged. Arrange for someone to drive you.
Stock up on easy-to-prepare meals and plan for food delivery if helpful. Meal prep ahead of time if possible.
Make your at-home recovery space comfortable with everything you’ll need handy – pillows, cold packs, medications, chargers, and loose, comfortable clothing.
Ask family/friends to assist with transportation, light housework, yardwork, pet care, etc, in the few weeks following surgery so you can focus on healing.

What to Expect on the Day of Surgery

The day of your breast cancer operation will begin by arriving at the hospital a few hours before your scheduled surgery time. You will complete any necessary intake paperwork and then be prepped for the procedure. This involves changing into a hospital gown, having an IV line inserted, and meeting with your full surgical care team – surgeon, anesthesiologist, nurses, as well as a plastic surgeon if you are having reconstruction.

Your medical team will confirm the details of the surgery, mark the surgical area on your breast, go over anesthesia information, and answer any final questions you have. The anesthesiologist will administer medication that will make you fall asleep before the surgery begins. The type of anesthesia used – general or local with sedation – depends on the operation you’re having.

During the surgery, the surgeon will make cuts and use cauterizing tools to access the tumor or breast tissue intended for removal. If you’re having a lumpectomy, only the tumor and margins of healthy tissue will be taken out to preserve the breast shape. A mastectomy removes the entire breast. Lymph nodes may also be tested and removed. Incisions will then be closed with stitches or surgical glue.

The length of the operation can range from 1-3 hours for lumpectomy, up to 5+ hours for more complex surgeries involving extensive reconstruction. You will wake up post-surgery in a recovery area where nurses monitor your status. Your recovery time will partly be contingent on your health before the surgery, but you can expect to return to relative normalcy, such as your diet and bathing, within a day of your procedure. Patients usually can go home the same day as their mastectomy or breast-conserving surgery, unless reconstruction was also performed.

Post-Surgery Care and Recovery

Post-Operative Care at Home

After your breast cancer operation, you will need to carefully monitor your at-home recovery for the next several weeks. Initially, get plenty of rest while your body heals from the trauma of surgery. Have someone available to help with drainage tubes, changing bandages, assistance taking medication, and providing meals. Most patients experience post-surgical pain and discomfort that is managed with prescription pain medication. It is also common to have swelling, bruising, numbness, and tightness in the breast and underarm area.

Recovery Timeline

During the first week, follow any guidelines provided by your surgeon, such as avoiding lifting your arms over your head, strenuous activity, driving, and submerging incisions underwater. Over the next month, swelling and sensitivity will decrease allowing you to gradually return to normal routines. However, complete healing of relocated nipple tissue, breast implants, or tissue flap reconstructions takes several months. Follow all instructions on wound care, supportive bra wear, and exercises to retain mobility. Expect ongoing fatigue, so listen when your body needs extra rest.

When To Contact Your Doctor

Contact our office immediately if you experience emergency symptoms like excessive bleeding, intense pain, drains falling out, fever over 101 F, or red skin hot to the touch, as these could indicate an infection or other surgical complication needing quick evaluation. We will also schedule post-operative check-ins and follow-ups to track your progress, undergo tests to confirm cancer removal and discuss any additional cancer treatments like radiation, chemotherapy, or hormonal therapy if they are part of your treatment path. Please reach out with any questions during your recovery!

Support and Resources for Breast Cancer Patients

Navigating a breast cancer diagnosis and treatment plan can feel overwhelming. Know that you don’t have to go through this alone – there are many great organizations and support groups that provide community, resources and information to patients and caregivers.

One excellent organization is the American Cancer Society Cancer Survivors Network which connects patients with survivors and caregivers online to ask questions and get insights about all aspects of the cancer experience. Local branches hold support groups and educational meetings as well, which provide a sense of community with people who understand what you’re going through. Another option is breast cancer-specific nonprofits like Susan G. Komen and Living Beyond Breast Cancer, which offer free webinars, podcasts, newsletters, and conferences to educate at all stages – from navigating treatment options to managing long-term side effects.

Seeking out peers in the community, whether online or in person, can make the journey feel less overwhelming. Don’t hesitate to ask your nurse navigator about hospital-based support groups or programs. Know you have a whole community of fellow warriors ready to lift you up along the way with care, camaraderie, and advice.

FAQs

1. How do I know if I need a lumpectomy or a mastectomy?

Your doctors will determine if you require a lumpectomy or full mastectomy based on factors like the stage of cancer, size/location of the tumor, overall breast size, and if radiation therapy will be recommended. For smaller localized tumors, a lumpectomy to remove only the malignant tumor may suffice, but for later-stage cancers that have spread more extensively throughout the breast, a full mastectomy could be necessary to remove all cancerous tissue.

2. What kind of anesthesia will be used for breast cancer surgery?

Typically breast cancer surgeries are performed under general anesthesia, where you are put into a deep sleep during the procedure. There are circumstances such as mastectomy with reconstructions where a combination of general anesthesia and local anesthesia may be recommended. This is something your surgeon and anesthesiologist will determine.

3. How long will breast cancer surgery take?

Surgery times can vary between 1-3 hours for a simple lumpectomy, 3-5 hours for a mastectomy, and up to 7-8+ hours for complex mastectomies with reconstruction. Factors such as whether lymph nodes are being removed or additional plastic surgery is part of the procedure also impact length. Talk to your surgeon about the expected time for your specific case.

4. Where will my scars be?

The placement and number of surgical scars will depend on the type of breast surgery, the location of the tumor, and whether reconstruction is done. Incisions will usually be made where scars have the best chance of healing well and being least noticeable. But your doctor will discuss scar expectations with you so you know what to anticipate.

5. What kind of support will I have during recovery?

Your medical team will be extensively involved during initial recovery and healing, providing wound and pain management, exercise guidance, and addressing any postsurgical complications. We also have resources and referrals for physical therapy, lymphedema specialists, counseling, and other rehabilitative services to ensure you have robust support. Your nurse navigator can connect you to additional assistance you may require during the recovery period.