What to expect if you have a mastectomy and tips for living better
If you have been diagnosed with some form of breast cancer, you may be advised to have a type of surgery called mastectomy. In the UK, just over four in every 10 women diagnosed with breast cancer will have a mastectomy.
In this guide:
What is a mastectomy? | What are the side effects of mastectomy? | Restoring your confidence | Help with scars and pain | Getting comfortable after surgery | Help with bathing and showering | Help with lymphoedema | Specialist organisations
What is a mastectomy?
A mastectomy is surgery to remove all of your breast tissue. There are several different types of mastectomy and your surgeon will tell you which is best for you.
You have a general anaesthetic and a diagonal or horizontal incision or cut across your breast so that your surgeon can remove all the breast tissue and the cancer itself. You may have your nipple and areola (the darkish area around the nipple) removed and some or all of the lymph nodes under your arm.
Most people cope well with the surgery and only have to stay in hospital overnight.
Your surgeon may offer you breast reconstruction at the same time as your mastectomy – to restore the breast tissue you have lost – using implants or tissue from other parts of your body. The aim is to give you a breast similar in size and shape to your original breast. Your surgeon will discuss this with you and explain what is going to happen during surgery.
There is no doubt that having a mastectomy will have a physical and emotional impact on your life and that can be hard. There are various side effects and you may have some or even all of them.
The good news is that there is plenty of information, advice and support available, and products and aids to help you feel more comfortable – and more like yourself.
If you are a having a mastectomy in the UK, you will almost certainly have your own specialist breast care nurse, who can tell you what to expect, answer any questions you have, and support you at every stage, from diagnosis, during your treatment and beyond. Many other countries also have breast care nurses with similar expert knowledge.
What are the side effects of mastectomy?
- Losing your confidence. It’s quite natural to feel anxious or self-conscious about having a mastectomy, as you would about any sudden changes in your appearance. So, it is reassuring to know that there are ways of making things easier and more comfortable to help you get used to the way your body now looks and feels.
- Pain. Scarring and nerve damage during surgery can leave you in pain. Most mastectomy patients have pain at some point. Reconstruction can make your breast feel more sensitive and you might feel a unusual sensation or tenderness around your ribs.
- Scars. After surgery, the area around your incision may feel stiff, numb, lumpy or even painful. You might feel, later on, that you want to change or reduce the appearance of your scars.
- Discomfort in bed. Everyone who has had a mastectomy needs to time to rest and recover – it’s important for your physical and psychological wellbeing. A good night’s sleep will help and getting as comfortable as possible while resting in bed will help you feel better.
- Difficulty having a bath or shower. After surgery, having a bath or a shower will be more complicated. You’ll need to protect recent and healing scars and it can be harder to move your arm or shoulder on the side of your surgery.
- Lymphoedema. If you have had some lymph nodes removed during surgery – to check if the cancer has spread – you might develop lymphoedema (also known as lymphedema or lymphatic oedema). This is a type of swelling that happens when your lymphatic system struggles to remove the fluid that collects in your arm, hand or chest. The swelling can be uncomfortable or even painful but there are steps you can take to help with this.
Here are some practical tips to help you live better with the side effects of mastectomy…
Restoring your confidence
“Talk to friends and relatives you trust who are outside your situation: simply speaking about your day or your worries with someone you trust can really help with some of your anxieties.” Barbara, member of the Living Better With community.
If you haven’t had breast reconstruction, you may find breast forms will help to restore the look and feel of your breast. Just attach them to your skin or put them in a special pocket in a mastectomy bra.
These now come in flattering but comfortable styles; for example, a front-fastening design, which is much easier to manage than a back-fastening bra. They tend to be soft and non-wired, so that you can cover any scarring, without having to struggle with the discomfort of a normal bra.
Mindfulness books and CDs
Worrying about your changing body can be draining. Mindfulness exercises are a simple way to help clear your head and to feel calmer by training your mind to think more positively. There are some excellent books and CDs that will teach you how to practise mindfulness, which can help you in every area of your life.
Meditation has been used around the world for centuries and there is a growing body of scientific evidence that shows how effective it can be in reducing stress or anxiety. It can give you the mental space you need to discover how best to cope with the physical and emotional effects of surgery. It is easy to learn, takes only minutes at a time, and you can meditate in a comfortable position. Just five minutes in the morning will help you to feel more ready for whatever the day may bring and, in the evening, refresh or calm you. And it’s easier than you might think to get started – with a wealth of apps, books and videos to help you.
Essential oils such as lavender, rose and sandalwood have been used for well-being for hundreds of years. They can help you in so many subtle but effective ways throughout the day and night, from making you feel more alert or calming anxious thoughts, to helping you to relax or get to sleep. Oil stimulate your sense of smell; you can use them in a diffuser to scent a room, for example, or with a rollerball to apply to your forehead or wrists. Live Better With have selected aromatherapy products here.
Help with scars and pain
“Put scraps of silk cloth on friction areas where clothing hurts your skin . . .” Hilary, member of the Living Better With community.
Scar gels, creams and oils
Some people feel self-conscious about scars and wish to reduce or hide them. There are several proven scar remedies that are very good at with preventing, softening or smoothing scars. They can also help reduce discoloration, redness, itching, pain and discomfort in any scar areas. And there are lotions, gels and creams that can encourage normal cells to grow – to replace your scar tissue.
Anti-itching creams and oils
Itchy scars can drive you mad, especially if you have always had sensitive skin – even though they are a sign that you are healing. But there are special creams and oils that can reduce itching, dryness and that taut feeling around your scar areas.
These creams can reduce pain by distrcacting nerve endings with a cold sensation, which stops them from detecting pain. They can also reduce swelling, inflammation, and muscle spasms from nerve damage. Cold packs and cooling pillows have a similar effect.
Getting comfortable after surgery
“This pillow gives me the relief and comfort I have craved recently as I can be as elevated as I need to be, especially when trying to rest and sleep. I use it whilst sleeping or just sitting when resting. It is very much worth every penny.” Eloise, Living Better With customer.
Overbed tables and cushioned lap trays
If you have to spend a lot of time in bed after surgery, an overbed table will make things like reading using your laptop and eating meals much easier. Cushion trays that rest on your lap have a beanbag or cushion underneath them for extra comfort.
You may find it difficult to sit up in bed after surgery and have to keep rearranging your pillows to stay propped up. Try using an adjustable back-rest, which will help you find and stay in a comfortable position.
Support cushions and pillows
Support pillows, including specially designed V-shaped pillows that support your back, can help you find a comfortable position in bed. Knee cushions will relieve pressure on your knees and hips and, if your legs are swollen, leg-raising cushions can help to ease fluid build-up and discomfort.
Compression bras safely help to put the pressure you need on your chest to help you heal. A belt will give you extra pressure, if you need it after breast reconstruction.
Bamboo clothing and sheets
Wearing loose comfortable clothing and sleeping between bamboo sheets that absorb moisture can make you feel much more comfortable. Bamboo is a perfect material for tender or sensitive skin – it’s very soft, stretchy, and much more breathable than cotton. If you are struggling to get comfortable, bamboo products can make a big difference.
Help with bathing and showering
You need to be pretty flexible to get yourself properly clean in the bath or shower, although you may not realise just how flexible until you have had surgery! You’ll find that your movement is restricted, and you’ll need to keep your healing scars comfortable. But there are simple bathroom helpers like back cleaners and sponges with handles to help you shower, when your arm is less flexible than normal.
People come up with all sorts of solutions to keep healing wounds dry after surgery. But it’s best to stick to a hygienic approach rather than getting creative with a bin bag! Sterile waterproof dressings are easy to wrap over a bandage or healing scar and won’t cause too much irritation.
Help with lymphoedema
“When I was on holiday I found the hot weather made my lymphoedema much worse so I used to avoid the midday sun and stayed cool wearing long, loose fitting clothes.” Shirin, member of the Live Better With community.
When lymph builds up in your body after a mastectomy, it can lead to swelling in areas such as your arm. Keeping these areas compressed is one of the best ways to reduce that swelling. Compression sleeves, bras or socks can help, depending on which part of your body is affected.
Gentle but effective exercise such as yoga or Pilates can help to stimulate healthy lymph production. An experienced, qualified teacher should be able to tell you which exercises and postures will help best. Look out too for books, DVDs, or online tutorials designed specially for anyone who has had a mastectomy.
Before starting any exercise, it’s vital to check with your GP or breast care nurse to make sure that the type of exercise is right for you. Your GP can also refer you to a physiotherapist, who will give you expert advice and a tailor-made exercise programme that can make you feel much more comfortable.
Lymphoedema can cause swelling, which could make your skin feel tight and sore. Keep your skin clean and moisturised if it’s swollen, as this will stop it from breaking and reduce the risk of infection. It’s worth taking the time to find a lotion or gel that works well for your skin, as this will protect it and relieve some of the tenderness and itching. A selection of Live Better With skin care products can be found here.
Breast cancer and lymphoedema organisations
There are several organisations dedicated to helping people with all aspects of breast cancer and lymphoedema. Some offer expert information and advice; others provide practical help and support at local centres. There are campaigning organisations and others that fund research. They include:
Share your mastectomy tips
Have you had a mastectomy? Are you about to have one or are you just recovering from one? We hope that you have found your own ways to get as comfortable as possible and to cope with the physical and psychological effects.
If so, we’d love to hear about your tips, as they could help other people like you. Share your tips with the Live Better With cancer community here.