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Caring for Yourself

   Before and After Breast Surgery

Table of Contents

  • Prior to Surgery
  • Being Prepared
  • Caring for Yourself
  • Nutrition During & After Treatment

 

  • Exercising
  • Lymphedema
  • Options after Surgery
  • Understanding the Fitting Experience

 

  • Choosing What’s Right for You
  • Adjusting to Your Prosthesis
  • Quality of Life
  • Resources

Prior to Surgery

Before your surgery, it is important to educate yourself about options available to you.  It is a great idea to have an active support team of friends and family who can help you sort the wealth of information available from the internet, media and your medical team.   Doctors are a source of information valued by the majority of patients as the most authoritative.  After learning as much as you can about the various treatments, you are much better prepared to ask your doctor specific questions such as these.

 

  •  What kind of surgery do you recommend for me?
  • How much of my breast will be removed?
  • What are the risks of this surgery?
  • What are the risks if I decide not to have the surgery?
  • Why do I need this particular procedure?
  • What kind of incision am I going to have?
  • Will I have a lymph node dissection? If so, how many lymph nodes do you anticipate removing?
  • What are my options for anesthesia?
  • Will you visit me following my surgery?
  • How long can I expect to stay in the hospital?
  • What kind of follow-up care will I need?

 

  • How will I feel after surgery?  Will I need pain medication?
  • How long will my recovery take?
  • Are there symptoms I should be aware of that would alert me to contact you immediately?
  • How often will I see you for follow-up care?
  • If I have a mastectomy, am I a candidate for reconstruction?  What options do I have?
  • If I decide on reconstruction, what type of reconstruction would you recommend?
  • Do you  have photos of other surgeries you have performed?
  • How long will an implant last?  What happens if I gain or loose weight?
  • How much pain or discomfort can I expect after reconstructive surgery?
  • Will I need more than one surgery?  Will they require general anesthesia?
  • When will you have the results of the pathology tests? Will I come in to discuss them or will you phone me?
  • Will my medical insurance cover all charges from you and the hospital?
  • What restrictions will I have on my normal activities while recovering?
  • How much help will I need at home to care for the drains and surgery site?
  • Is physical therapy recommended as part of my recovery?
  • Should I expect swelling in my arm?  What steps can I take to help prevent the onset of lymphedema?

Being Prepared

Although it can feel overwhelming for you to make decisions about your treatment, doctors and others in the medical field have found that the happiest and most satisfied patients are the ones who are active participants in their treatment process.  Allow yourself plenty of time to think things over.  Consider getting a second opinion if you feel uneasy or feel your questions have not been adequately answered.

A checklist of tasks to complete and items to have on hand prior to surgery is a great way to prepare for surgery.  Tasks such as the logistics of transportation, planning for child or pet care, along with other jobs that you would normally be in charge of are best handled prior to surgery.

Items to have on hand prior to surgery are your insurance card, identification, a list of medications you are currently taking, and a list of any drug and food allergies or sensitivities you have.

While recovering from your surgery, go over your list of questions again to gain additional information about caring for yourself and what to expect after release from the hospital.  The hospital staff is a good source for survivor support groups who are going through similar treatments and experiences.

Caring for Yourself

Following surgery, you will likely be fitted with special bras or camisoles that are soft and have features to accommodate any post-surgical accessories.  Some forms of reconstruction will require binding or compression to help support the new surgery while healing. 

The bras will most likely be front closure or allow you to step into them so that you do not have to lift your arms while recovering.

American Breast Care offers the Leisure Bra.  This bra has a front closure and is made of incredibly soft cotton to prevent irritation.  It also has pockets to accommodate a post-surgical breast puff.

The Leisure Bra is also available in ABC’s Post-surgical Kit.  This kit comes with a puff, two drain pouches and informational brochures. 

Nutrition During & After Treatment

During breast cancer treatment, the most important nutritional goal is to maintain a calorie balance.  You may find small, frequent meals are better tolerated than three large meals.

Eating well helps the body recover more efficiently and quickly.  Consult with your doctor about any dietary restrictions and aim to select a variety of foods from all food groups.  In addition to five colorful fruits and vegetables daily, eat high-fiber foods and stick with low-fat milk or dairy products.

For help with a well-balanced and well-tolerated diet plan, visit the American Cancer Society website and look for Nutrition Guidelines for Cancer Survivors.

Be patient with yourself and ease back into regular meals as you recover.  Prepare simple meals, visit the grocery store’s salad bar and prepared foods sections, and don’t hesitate to ask family or friends for assistance with shopping and cooking.

Exercises for Reconditioning

Exercising after your surgery can help reduce instances of side effects that may occur.  Talk with your doctor prior to starting exercises so that you can decide on a program that is right for you.  Begin exercising after doctor’s permission.

The Week After Surgery

*Excerpted from American Cancer Society Exercises After Breast Surgery, 2012

  • Use your affected arm as normally as possible.
  • Raise your affected arm above heart level for 45 minutes two or three times a day while reclined.
  • Exercise your affected arm while it is elevated above the level of your heart by opening and closing your hand 15 to 25 times, then bend and straighten your elbow.  Repeat three or four times a day to help reduce swelling by pumping lymph fluid out of your arm.
  • Practice deep breathing exercises (using your diaphragm) at least 6 times each day.
  • Exercise to help reduce tightness in your chest and armpit.
  • Do exercise until you feel a slow stretch and hold stretch for a count of five.  Do not bounce. You should experience no pain.
  • Exercises should be done twice daily until you regain normal flexibility and strength.

Lymphedema

Lymphedema is a condition seen following breast surgeries in 50% to 65% of breast cancer surgery cases, particularly in those who experience axillary lymphadenectomy or who undergo radiation therapy. 

With lymph nodes damaged or removed, the lymphatic fluid may build up in skin tissue rater than being transported to the capillaries for distribution and removal.  The build up of fluid leads to swelling in the arm or surgical area that can affect the way clothing fits.  In some cases, if left untreated, lymphedema can cause extreme swelling leading to skin infection and oozing.

There are lymphedema therapists available to help redirect the flow of the lymph fluid manually and with pumps.  Patients with lymphedema can be taught some techniques for self-massage to help with any swelling between therapy sessions.  Special compression garments help to minimize the swelling and direct the lymph fluid flow.  Additionally, patients will be taught ways to minimize lymphedema occurrence through prevention methods such as avoiding bug bites and sun exposure, protecting against wounds to that extremity, and overuse of the extremity. 

Options after Surgery

The various styles of post-mastectomy products available through American Breast Care help restore confidence and appearance after your breast surgery.  The bra style that fits you best will depend on your body and breast type.  Options include bras to wear under clothing, leisure bras, and camisoles with integrated bras to complete your wardrobe.

Breast forms are available for various body and breast types as well.  Most breast forms are made of silicone that mimics the feel and weight of breast tissue.  Lightweight silicone is lighter than the standard silicone and relieves some of the weight on your neck and shoulders.  American Breast Care’s exclusive Ultra Light silicone are good for women who have some physical limitations or experience sensitivity when wearing a form against their bodies.  Ultralight silicone is also a great option for women with no complications who want the lightest form available. 

There are also partial breast forms, shapers, or shells, available for women who have had breast conserving surgeries and need slight shaping to fill out their bra cups.  Shapers are also useful for women who are going through the reconstruction process. 

Understanding the Fitting Experience

Ideally, prior to surgery, you will have a chance to see available post-surgery products.  At this time, a certified fitter can go over options for breast forms, partial breast forms, and bras available for your post-surgery needs. 

Approximately four to six weeks following surgery after being released from doctor’s care, you can make an appointment with a certified fitter to select products that best suit your needs.  She will measure you for the correct bra size, and evaluate your needs.  You will be fitted with various styles of bras to meet your requirements and will try some breast forms to help recreate symmetry.  There are many styles of bras available from ABC.  ABC bras come in various styles from seamless molded cups for a smooth rounded look to M-frame designs that provide the needed support for larger breasts.

Choosing What’s Right For you

If you are in need of something to recapture symmetry, there are several products available to help.  Sometimes, for a lumpectomy or reconstruction, a well-fitted and supportive bra may be the only thing needed for symmetry.  For lumpectomies or other breast conserving surgeries that require a bit more than a well-fitting bra, there are partial breast forms or shapers.  These can be worn in special pocketed bras or against your skin in a fashion bra.  For reconstruction, the shapers can also help fill in any deficits in the bra cup.  Additionally, there are akin-friendly adhesive nipples that can be worn with or without a bra.

Adjusting to Your Prosthesis

Upon receiving your breast form and bras, you  may find that your wear time will be modified.  You may experience discomfort or sensitivity of the chest wall.  You may feel fatigue in your neck or shoulders.  It is important that you build up to wearing your prosthesis full time.  Start with a few hours each day, gradually increasing your wear time until it is a daily routine.  Along with these changes, expect that your surgical site will also physically change.  These changes can go on for as long as six months and could include swelling, skin changes, and settling of tissue.  This is part of the healing process.

Quality of Life

As women, we often feel the need to nurture and put others’ needs before our own.  While recovering from breast cancer surgery and treatment don’t forget to take care of yourself.  You are the most important person in the picture.

Your body is recovering from a traumatic experience.  Only do as much as you are able to do.  Take the time to rest when you need to. No need to feel guilty.  By taking care of yourself and paying attention to what your body needs, you can recover more quickly.

Support groups are available nationwide, and are always welcoming new members.  Check with your hospital or doctor for support groups in your area.  Some women find great comfort in sharing with others who have been through similar experiences.  Other women find they do better on their own.

Whatever your decision, start living a fuller life today.  If you don’t know where to start, start with ABC.

American Cancer Society

800.ACS.2345

www.Cancer.org

BreastCancer.Org

www.breastcancer.org

National Breast Cancer Coalition

www.breastcancerdeadline2020.org

National Women’s Health Information Center

800.994.WOMAN (9662)

www.womenshealth.gov

Sister’s Network, Inc

866.781.1808

www.sisternetworkinc.org

National Lymphedema Network

800.541.3259

www.lymphnet.org

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