What should be the post-surgery breast cancer care?

1) How do I take care of my wound?

 Keep the wound clean. There is no need to dress the wound if it is healthy. You only need to touch it with an antiseptic lotion once a day (Betadiene lotion).The drain site dressing has to be changed after 4-5 days.

2) When can I take a bath?

You can take a full body bath after stitch removal i.e. after 2 weeks. Till then, you can sponge the upper half of the body and pat yourself dry. You can wash your head with assistance.

3) How do I dress my wound?

The dressing is removed on the first post-operative day and left open. Staples are usually used to close the wound. The wound is to be dabbed with Betadiene lotion and you are requested to wear clean cotton clothes.

4) How do I take care of the drain? Do I have to wash it every time I empty it?

The drain may be carried around in the bag that we provide you in the post operative kit. You have to empty it once a day on a fixed time and measure it with the measuring cylinder provided in the kit. The specialist nurse will teach you how to handle it and you can also go through the ‘Drain Care’ leaflet provided to you. You don't need to wash the drain box every time you empty it.

5) Can I wash my hair?

Yes you may, with assistance. Lie down with your head beyond the bed and your attendant can shampoo it for you and wash as well.

6) What should I do about the pain in my arm and the feeling of stretching in operation site?

If you have undergone axillary surgery especially axillary dissection, it is not uncommon to feel numbness and tingling in the inner half of the upper arm. This is much less seen after sentinel lymph node biopsy. You may even perceive touch as pain. This is because a nerve that crosses your armpit and reaches the arm is cut or stretched at the time of surgery. The intensity of these abnormal sensations reduces with time and definitely gets better with exercise. They may not go away completely.

7) Can I sleep on the side of surgery?

Yes, you may, provided you don't rest your head on the arm and don't put your weight on the drain tubes.

8) Can I do a few chores at home?

Yes, you can perform several household chores that don't tire you. This could mean dusting, laying the table, supervising in the kitchen, etc. You can slowly scale up your work to normal in 2-3 weeks.

9) When can I drive?

Once the drain is out and you are freely mobile, you can drive a car.

10) What should I eat?

You should focus on eating clean, nutritious food with your family on the dining table. You can share everything with them. Remember, cancer is not infectious. If you are a diabetic or are obese, the dietician can prescribe a diet chart to you.

11) How frequently should I exercise?

You should start exercising as early as the first post-operative day and do it more frequently to start with i.e. every hour for 3-5 minutes. You can reduce the frequency to 4-5 times a day, once the full range of movement is established.

12) When do I get to know about further treatment?

Further breast cancer treatment will be decided on the basis of your histopathology report which comes back after 7-8 days of surgery.

13) What are the possible problems that I am likely to have and how do I deal with them?

There could be pain, swelling at the operation site or fever or leakage from the side of the drain or a malfunctioning drain. All these need to be attended to. You can call our helpline or your doctor for advice.

14) When should I meet the doctor?

Usually, you will be called back to see your operating surgeon 5-7 days after surgery to have a look at the wound and the drain. The drain will be removed once the output over 24 hours is 30-40ml. This usually takes 10 days to 2 weeks. The stitches /staples will be removed 2 weeks after surgery.

15) When will my chemotherapy begin? Is it painful? Do I have to be admitted?

Chemotherapy begins in the third week after surgery. The wound should have healed well before chemotherapy is started. The optimum time to start chemotherapy is 3-6 weeks after surgery.

16) What are the likely side effects of chemotherapy?

Chemotherapy tends to attack all those cells which are rapidly dividing. While cancer cells are rapidly dividing, so are the cells lining the intestine, the hair follicles and the bone marrow. This is also the reason why one feels nauseated during chemotherapy, lose hair and also become susceptible to infections. All this contributes to fatigue as well.

These effects last about a week after chemotherapy and then the recovery begins. The good news is that there are effective medicines to counter a host of these side effects that happen during chemotherapy. Your medical oncologist will explain them to you in detail.

17) What is radiation therapy and when will it happen? How frequently do I have to come for radiation and how long does it last?

Radiation therapy is the process by which high beam X-rays are delivered to either the breast after breast conservation surgery (BCS or) to the chest wall after breast removal (mastectomy). Radiation almost always follows after completion of chemotherapy. The conventional treatment lasts 5-7 weeks and newer techniques can deliver it in 3 weeks in suitable patients. Your radiation oncologist will discuss the details of treatment with you.

18) How do I know that I am disease free? What will be my follow up protocol? And who should I meet for my follow up?

Once you have completed treatment, you will be called back for follow up. You will be assessed for symptoms and seen clinically every 3 months for the first two years, six monthly for the next three years and then annually for a further five years. An ultrasound abdomen and X-ray chest may be done six monthly while a mammogram will be done once a year.

For those undergoing breast conservation surgery, an MR mammogram may be performed a year after surgery. There is no need for intensive investigation, unless a specific symptom needs to be investigated further with CT scans or PET-CT. You should be seeing one clinician each time and if need be, he or she can refer you to the other specialties.

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