There are countless thoughts running through your head after a mastectomy – the entire process can be quite a daunting experience. Here are some tips that could help you navigate your post-mastectomy gauntlet.

1. Taking pain medication:

Don’t be too brave. If you need it, take it.

2. Don’t be scared to ask questions:

No question is a silly question, your Doctors, Nurses and Physiotherapists have heard them all. They are there to help, let them.

3. Caring for the dressing over your incision:

The best option is just to leave the dressing alone until your follow up with the surgeon. The same goes for your stitches and staples, leave them alone, we do not want to encourage infection. Ask for help if you are unsure.

4. Caring for a surgical drain:

Sometimes a drain will stay in until the first follow-up visit with the doctor. If you’re going home with a drain, you’ll need to empty the fluid from the detachable drain bulb a few times a day. Make sure a nurse demonstrates how to do this before you leave the hospital. Do not lift the wound drain above the incision site.

5. Recognizing signs of infection:

Is it red, hot, itchy, painful? If so, see your surgeon immediately. There is no harm in being cautious. Better safe than sorry.

6. Exercising your arm in the early days:

Rehabilitation after a mastectomy starts Day 1 after surgery.  This may seem very daunting but it is essential to prevent shoulder and arm stiffness and the formation of significant scar tissue. Your Doctor and Physiotherapist will inform you exactly what you can and can’t do depending on your individual needs. While your wound drain is still in place, you will perform only circulatory exercises which do not strain or stretch the incision site. Once the wound drain has been removed, the Doctor will advise when you may start further exercises. Walking is your friend; just remember to keep your shoulders relaxed, stand tall and try keep your back straight. Good posture is important after a mastectomy to ensure you recover full function of your arm.

7. Exercising your arm after the initial healing phases:

When you are ready your physiotherapist can progress your initial exercises and help you with pain management. Let pain be your guide. It is normal to feel a gentle stretch when you start to move your arm. Once the dressing and drain have been removed the goal is to ensure that a good scar, free of adhesions, forms. This will ensure you regain full range of motion and can get back to your activities of daily living. Your physiotherapist may use the following modalities to assist you:

  • Scar massage
  • Electrotherapy (laser / ultra sound)
  • Soft tissue release
  • Stretches
  • Home exercise programs

8. Recognizing signs of lymphedema:

Swelling is your enemy. Stop it from happening before it even starts, by keeping the arm moving as allowed. Lymphoedema is a condition which can develop after the operation, whereby the lymph fluid cannot drain effectively causing the affected limb to swell. Not everyone develops this condition.

(See the links below regarding contact details for specialist therapists who manage lymphedema.)

  • Do not hang your bag on the shoulder of your affected arm.
  • Avoid restrictive clothing / jewelry on your affected arm.
  • Avoid lifting more than one kilogram (Tip: carry drain in unaffected arm)
  • Do not have your blood pressure readings taken on the affected arm.
  • Do not tire out your affected arm – pace yourself in terms of activity and exercise.
  • Watch the condition of the skin, avoid insect bites, sunburns, cuts etc. Treat immediately if these occur.
  • Keep the skin dry and clean on the affected arm.
  • Do not let your affected arm hang down. It is important to elevate the hand of the affected by positioning a small pillow under the affected arm for support.

9. When you can start wearing a prosthesis or resume wearing a bra:

Healing is your number one priority. Once your wound is fully healed you can have a discussion with your surgeon about this and can contact your closest prosthetist.

10. Call in your favours:

Have friends and family pitch in around the house, recovery from mastectomy can take time. Ask friends and family to help with meals, laundry, shopping, transport (do not drive until your surgeon says you can) and childcare. As your body heals, don’t feel you should take on more than you can handle.

Important links

Compiled by Chanel du Piesanie and Emma Bennett