This operation involves the removal of the breast tissue, some overlying skin, the nipple and the underarm lymph glands on the affected side.

Is there an alternative?
There are circumstances when mastectomy will be recommended instead of breast conserving surgery. The most usual reasons are when the cancer involves a significant proportion of the breast tissue; or when the cancer cells appear to have more than one focus. Sometimes chemotherapy given before surgery can have a shrinking effect on a large cancer and so less radical surgery may then be possible. The surgeon will discuss your individual situation with you.

How is this done?
This operation is carried out under a general anaesthetic. A cut is made horizontally across the skin of the breast and then the nipple, surrounding skin and breast tissue are excised. The remaining overlying skin is then sewn together with a continuous stitch and then covered with a transparent film dressing.

Appearance after simple Mastectomy

After the operation.
You will have 'a drip' to give fluids, but once you are recovered from the effects of the anaesthetic, and are able to drink normally, the drip fluids and tubing will be disconnected. A short fine tube called a cannula maybe left in the vein so that drugs such as pain killers or antibiotics can be given.

The drainage tubes from the wound will be attached to two bottles and the nurses will monitor the amount of fluid collecting in them.

You may feel some soreness or discomfort around the wound area but we would aim to control this with painkillers.

You may also experience some altered sensation or numbness in the underarm and inner arm on the affected side. This is because there are two or three nerves situated in the area of the lymph glands which may be disturbed during surgery. This should improve within a few weeks but may take some months to settle.

The day after your operation you will be able to get out of bed and the physiotherapist will visit to advise on arm movements. The arm exercises are important to help prevent the shoulder joint from becoming stiff and will also aid the flow of fluid in the tissues. Active movement is also important in the general sense to help blood circulation, breathing and muscle tone.

What about going home?
You will usually be allowed home when the fluid draining from the wound lessens and the drainage tubes are removed. This is usually about 5 - 7 days after the operation.

Before you go home you will be given a soft padded temporary breast form to wear in your bra, as, at this stage the reconstructed breast will only have a very slight mound. You will be given an appointment to return to the Breast Clinic to have any stitches removed (usually 10 - 14 days from the date of operation) and to discuss the results from your operation. You will then be given an appointment with Dr. Lowdell, the oncologist (cancer specialist) to discuss any further treatments.

Self care at home.
The wound dressing should remain in place until you return to clinic. You can wash as normal as the dressing should protect the wound from water. We advise that you don't use deodorant under the affected arm until the wound is completely healed.

Sometimes tissue fluids will accumulate under the skin around the wound or armpit area causing the skin to feel tense and uncomfortable. If you become aware of this then ring the breast unit and we will arrange for the Doctor to see you. The fluid will usually be drained with a needle and syringe.

If you feel feverish or notice any signs of inflammation such as: a hot feeling around the wound, redness, tenderness, swelling or a discharge, it is important to contact the breast unit. This may represent infection which will need to be treated promptly. If an infection persists it may be necessary to remove the implant.

Sometimes scar tissue around the implant can become tight. Once the skin has healed, massaging the reconstructed breast can be helpful in preventing this. Over time further surgery may need to be considered.

You are likely to feel tired and need to rest more for the first couple of weeks at home. This can vary from person to person but usually after about six weeks you will feel more able to cope with your usual level of activity. You should refrain from any lifting, driving or strenuous housework such as window cleaning, hoovering etc. for about a month. Try to increase your level of activity steadily, but slowly and continue with your arm exercises.

Use your arm as normally as possible, but, if you have had your lymph glands removed it is important to be aware that your natural response to infection or injury affecting that arm is not quite as efficient as it was. It is wise to take extra care in certain situations to lessen the chance of injury to the arm. You will be given a separate booklet discussing this in more detail.

Some swelling of the arm may occur within the first few days your operation and will usually then settle down. Resting your arm on a pillow, preferably with your elbow at a higher level than your shoulder, can help.

Return to work will depend on your individual circumstances, the doctor or nurses will discuss this with you.

You may also find that you feel many strong emotions at this time as you are trying to come to terms with what has happened. The support of an understanding partner or friend can be invaluable. Some people also find that talking to someone who has been in similar circumstances can be helpful. Breast Cancer Care have a volunteer network and can be contacted on 020 7384 2344 or on Nationwide Freeline 0500 245 345. Please remember that the breast care nurses are also available to discuss your concerns and to offer support and advice.

If you are concerned about your progress in any way let us know.

If you require further advice or information please contact the
Macmillan Breast Care Nurses, Hazel Ricard and Hilary Rickwood on 020 8565 5885