Post-surgical recovery for breast cancer expectations, challenges and advances in care are important to consider whether you are having a lumpectomy, mastectomy, reconstruction or other breast surgery. By learning what to expect, what happens during the healing process and your recovery options, you can feel more confident in the process.
Preparing your home and loved ones
“The best way to get a good outcome after surgery is to be prepared before the surgery,” said Nirav Savalia, M.D., director of oncoplastic and aesthetic breast surgery at Hoag and a plastic surgeon specializing in breast reconstruction. Recovery is both physical and emotional. It’s important to ask questions before surgery including what supplies you might need, how long you may need help at home and what activities should be avoided.
It helps to set up a recovery space ahead of time – with easy access to water, medications, snacks, lots of pillows, chargers and entertainment or whatever you think you will need to make yourself as comfortable as possible. When it comes to pillows, breast cancer survivor Lynne Brewer, who has undergone three breast surgeries, offered practical advice with some humor: Avoid lying flat. “Once you get flat, you’re like a little polar bear trying to roll over and get up,” she said. “Wedges, inclines – the best thing you can ever do.” Wedges are a type of ramp-shaped pillow that helps you sit up slightly while resting.
Also, be sure to arrange help with rides, meals, children, pets and other household tasks. Consider asking loved ones beforehand. Friends and family members often want to help but don’t know how. This is a great way for them to get involved. It’s okay to ask for help!
Komen’s Patient Care Center can also help connect you with information, emotional support, financial assistance and resources to help you access care and support. Recovery after surgery can come with discomfort and uncertainty, but you do not have to navigate it alone.
What happens in the body after surgery during healing
Tissue is removed during breast cancer-related surgeries. This can leave open space under the skin where that tissue used to be. The body recognizes the injury and immediately starts the healing process with increased blood flow. Immune cells are sent to the area and the body starts repairing itself.
Inflammation is a key part of this early stage of healing, which is why things get swollen, tender or sore the days after surgery. Bruising is also common. Fluid can shift around or, at times, be blocked if the lymphatic system is affected, and that’s where you can get swelling. Fluid tends to collect in the empty spaces like a blister. Dr. Savalia explained that “the body just doesn’t like empty spaces, so it tries to fill it up with fluid.” This fluid collection is called a seroma. Some fluid is expected, but too much can cause discomfort and, in some cases, increase risk of complications. “You don’t want to leave a seroma in place intentionally,” Dr. Savalia continued. “That’s why we use drainage tubes to help evacuate that seroma.”
Fluid shifts are part of recovery
For some people, surgical drains are placed in the breast area during surgery to help remove extra fluid from the area, and the drains may go home with you. “A drainage tube is like a sump pump, so you put a pump in to pull out all that fluid that’s collecting there, and it gives your body time to heal that area so that no fluid is no longer being built up there, and the tissues can all scar together,” explained Dr. Savalia. You may then be asked to empty them routinely, tracking the amount and color of the drained fluids.
This can feel daunting, but your care team will show you what to do before you leave for home. Post-operational drain management is also evolving. “Drain management technology has improved,” Dr. Savalia said, further describing options that are becoming “available that help evacuate the fluid much more effectively from the body, and it allows the freedom for the patient to be very independent with it.”
Some newer options may reduce manual steps, such as milking the tubing, squeezing drain bulbs or frequently handling drainage, which may help make recovery feel cleaner, simpler and less disruptive to daily life. For some patients, newer systems may also support mobility and comfort during the recovery process. Ask your care team what drain management options may be available for your surgery and recovery plan and learn more in the video above.
Scar tissue, tightness and firmness can change over time
Healing doesn’t stop when the incision closes. As your body repairs itself, it builds new tissue, leading to tightness, firmness, numbness or tenderness. Scar tissue can feel different over time – starting tight but later softening with continued healing. You may notice more tightness when you’re active, like when stretching or getting dressed and lifting your arms.
Your care team may recommend gentle exercises or physical therapy depending on your situation, but it is important not to start stretching, lifting, massaging or exercising until your care team says it is safe.
Healing isn’t linear
Some days of recovery will feel easier than others, and a harder day does not always mean something is wrong.
“Healing is not linear. There are going to be days where you feel great, and there can be days where things maybe take a little step back. Not every day is going to be amazing, but on the whole, things are going upwards,” Dr. Savalia said. “Everybody’s body is different. [The rate of healing] depends on your age, your other medical conditions, your weight, what surgery you had…all these things have an impact on your healing timeline, but no two people are the same.”
As Dr. Savalia said, recovery is personal and it depends on the type of surgery you have – if lymph nodes were removed, whether you had reconstruction and your overall health. Fatigue or soreness may last longer than you expected, but everyone has their own process. However, do be sure to report any new, worsening or concerning symptoms to your care team. Be sure to get the number for who to call if it is after hours and you aren’t sure if something is urgent.
Ask questions and discuss what is normal for your body with your care team to better understand and monitor how it heals. “Don’t be afraid to ask your care team, your doctor, ‘what can we do to make my recovery smoother, easier, better?’” Lynne said, “This journey is different…it’s different for everyone, it’s difficult, but the bottom line is, it’s your journey and you need to ask, speak up and let your care team know your fears and your desires.”
Recovery after surgery may not always feel predictable, but patients today may have more recovery support options than ever before. Many tools and technologies are designed to help improve comfort, support healing and make recovery more manageable. Ask questions, track changes, get support and keep your care team informed. Your healing is your own and you have a voice in every step of it.
Content covered in the Know More Educational Series may be an emerging area in research or technology. Talk with your doctor about what is right for you.
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Explore more resources:
Personalizing Breast Cancer Surgery to Achieve Your Treatment Goals
4 Surprising Side Effects of Breast Surgery – And How to Prepare for Them
“Choosing the Right Breast Surgery” Serena’s personal story
Renee’s Story: Complications During Breast Cancer Treatment & Reconstruction
Emerging Areas in Breast Cancer Surgery
Breast Cancer Surgery Fact Sheet PDF
Watch and hear more:
Real Pink Podcast: “Promising Advancements in Nipple-Sparing Mastectomies”
Lumpectomy Surgery: Tumor & Lymph Node Removal Explained
