CANSA Tips to Help You Cope After Breast Cancer Surgery

Each person heals at their own pace after breast cancer surgery – CANSA has prepared a few helpful tips to aid recovery:

1. Prescribed Medication

• If antibiotics were prescribed, take them after meals, as directed. Do not stop taking them because you feel better.
• Do not take aspirin or anti-inflammatory medication for 2 – 3 days after surgery as this can cause bleeding. Consult your medical practitioner if you have cardio or other health concerns.
• A prescription for pain medication will follow after surgery. Take pain medication as prescribed.

2. Choice of Clothing

• Wear loose fitting clothing.
• Ensure clothing is easy to put on and take off.
• Tops and blouses that have buttons or zippers at the front are the easiest to wear.

If you had a lumpectomy / segment of the breast was removed:

• Wear a bra that has support all day and all night for 7 to 14 days.
• Do not wear a bra with an underwire.

If you had a mastectomy (the entire breast or breasts were removed), wear whatever is comfortable. You can wear:

• a camisole
• a surgical bra
• a bra (with no underwire)
• a top without a bra

CANSA sells breast prostheses, wigs and headwear at affordable prices.

3. Showering and Bathing

For the first 48 hours after surgery:

• Keep the gauze dressing dry during this time to facilitate healing of the incision (cut).
• Wash with a sponge or take a bath with a small amount of water.
• Only take a bath if you can keep your gauze dressing dry.

After the first 48 hours post-surgery:

• The gauze dressing may be removed, but leave the plaster strips in place.
• You may shower
• Use mild soap (like Dove, or baby shampoo or soap) to wash gently around the incision.
• Gently pat the area dry and do not rub.

Soaking in the bath or swimming:

• Do not soak in a bathtub or swim for at least one month after surgery.

4. Care for Surgical Incision Site (Cut)

There are two types of bandaging used:

Gauze dressing:

• Place a gauze dressing (bandage) over the incision site.
• Keep the gauze dressing clean and dry for the first 48 hours after surgery.
• Remove the gauze dressing 48 hours after surgery, when your incision has started to heal.
• Under the gauze dressing, there will be adhesive strips (skin tape) on the incision (cut).
• Keep the adhesive strips in place for 14 days after surgery, and then remove them.
• Do not apply ointment / anything else on the incision site unless you have discussed it with your surgeon.

Clear (transparent) dressing:

• If a clear dressing was used, do not remove it. Leave it in place until your next visit with the surgeon.

5. Management of Drains

2. Milking the drain 3-hourly will prevent the drain from becoming blocked.  How to milk the drainage system:

• Hold the drain firmly in one hand
• Gently push fluid downwards with other hand

3. Empty the drain twice a day or more frequently, if this is required.

4. Measure the amount of drainage each time and keep note of the time the drain was emptied.

5. Compress (squeeze) the bulb of the drain, when putting the cap back on, to start the negative suction pressure again.

6. Management of fluid on skin around the drainage site:

• Pat the fluid dry around the drainage insertion site.
• Cover the insertion site with several layers of gauze and apply adhesive material.

7. Other important information about your drain:

• The amount of fluid from your drain might vary in amount.
• It is normal for the amount to decrease over time.
• The drainage will change from reddish, to pink, to a straw colour.
• Drain removal will be considered if the drainage is less than 30 millilitres a day, for two days in a row.
• The hospital / care clinic will remove the drains.

Queries regarding points 1 to 5 may be directed to CANSA’s Clinical Nurse, Sr Vlooi Venter vventer@cansa.org.za – the service is free.

6. Nutrition Post-Surgery

Nausea and an upset tummy may be a challenge after surgery. Tips to help with this include:

• Eat light and easy to digest meals to combat nausea.
• If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yoghurt.
• Drink plenty of fluids.
• Resume your normal diet when you feel ready to do so.
• If antibiotics were prescribed, take them after meals, as directed. Do not stop taking them, because you feel better.
• For further advice regarding nausea contact CANSA’s Clinical Nurse, Sr Vlooi Venter – email: vventer@cansa.org.za

7. Pain Management

• A prescription for pain medication will follow after surgery. Take pain medication as prescribed. Unfortunately, pain medication often consists of opioids, which may lead to constipation.
• For further advice regarding pain management contact CANSA’s Clinical Nurse, Sr Vlooi Venter – email: vventer@cansa.org.za

Managing constipation:

• Increase fluid intake.
• Increase intake of food containing fibre.
• Take a stool softener if required.
• If constipation persists after using the stool softener, take a laxative such as Senokot.
• For further advice regarding constipation contact CANSA’s Clinical Nurse, Sr Vlooi Venter – email: vventer@cansa.org.za

8. Physical Activity

Minimize time spent in bed during recovery. Being active will help prevent blood clots in your legs and promote a sense of emotional well-being. Here are some guidelines for daily activities:

• Do not lift, push or pull anything more than 2 kilograms heavy, with your arm (on the surgery side), for 4 weeks after your surgery.
• Rest when you feel tired.
• Adequate sleep will help you recover.
• Slowly start to increase the movement in your arm and shoulders.
• After any activity, rest and raise your affected arm for a period of time equal to your activity time.
• Try to walk each day. Start slowly and increase the distance daily. Walking increases blood flow and prevents blood clots, pneumonia and constipation.
• Avoid strenuous activities, such as biking, jogging, weightlifting, or aerobic exercise, until your doctor gives you the go ahead. This includes housework, particularly if the affected arm is to be used.
• Avoid repetitive motions with your affected arm, such as weed pulling, window cleaning, or vacuuming, for 6 months.
• Most of your usual activities may usually be resumed in 6 weeks (always check with the surgeon first).
• Only start driving again when your surgeon gives the go ahead.

9. Arm Exercises (lymph node removal)

• If you had any lymph nodes removed from under your arm, your doctor will advise you to do arm exercises.
• Do not do the exercises until your doctor says it is okay.
• Do not use ice for swelling or pain or excessive heat.
• Prop up your arm on a pillow when you sit or lie down.
• Try to keep your arm above the level of your heart. This will help reduce swelling.

10. Psychological Support

• It is not easy to lose a part of, or an entire breast or both breasts – do some research regarding counsellors and support groups ahead of the time – if you need to talk things through, you will have someone to talk to.
• You may feel a loss of confidence after surgery – warn loved ones in advance, and make a pact with yourself not to become isolated from loved ones, friends and family.
• Make an appointment for free CANSA Tele Counselling with a trained CANSA Tele Counsellor, by submitting our online booking form. This is a confidential, professional, cancer-related telephonic counselling service for cancer patients and loved ones. Counselling is available in seven languages (English, Afrikaans, isiXhosa, isiZulu, Sepedi, Sesotho and Setswana). Or join a CANSA WhatsApp support group or a Facebook support group.

Lymphoedema

Unfortunately, lymphoedema, a side effect of cancer treatment, is a condition that can only be managed, and not cured.

During surgery for breast cancer, nearby lymph nodes, under the arm are often removed. The remaining lymph nodes may be treated through radiation therapy, which can cause scarring and blockages that increase the risk for lymphoedema.

These lymph nodes drain lymph fluid from the lymphatic vessels of the upper arms, most of the breast, the chest, neck, and underarm area.

Surgery and radiation may disrupt the flow of lymph, which may lead to a build up of lymph fluid causing swelling of the arm, hand, or neck. This is known as lymphoedema and can occur months or years after treatment.

Swelling can worsen and become severe over time and may lead to skin damage. As damaged skin is more likely to become infected, it is important to address it as soon as possible.

Leaflet: CANSA Tips to Help You Cope with Lymphoedema

Signs of Lymphoedema

• Feeling of fullness, heaviness, or tightness in the arm, chest, or armpit
• Bra, clothing, or jewellery does not fit as it did before surgery
• Aching, new pain or weakness is experienced in the arm
• Trouble bending or moving a joint, such as the fingers, wrist, elbow, or shoulder
• Swelling of the hand
• Thickening of, or changes seen in the skin

Ways to Treat the Condition

• Exercises – these help improve lymph drainage, but it is important to use the guidelines provided by trained therapists. See exercises courtesy of the Australian Cancer Council, but please make sure you only start exercises when a medical professional has given the go ahead, and they have been demonstrated to you by a trained therapist.
• Bandaging – wearing lymphoedema bandaging may help to move fluid and prevent fluid build up – the correct method must be used according to professional advice.
• Wearing a compression garment may be helpful.
• Preventing infection – protect the skin in the affected area from drying, cracking, becoming infected or the skin breaking.
• Lymphoedema Manual Massage therapy can help move fluid out of the swollen area – obtain a referral to a certified lymphoedema therapist.

More Tips 

Avoid blocking the flow of lymph through the body:

• Do not cross legs your legs when seated.
• Change your sitting position at least every 30 minutes.
• Wear only loose jewellery and clothes without tight bands or elastic.
• Do not carry handbags on the arm affected by lymphoedema.
• Avoid the use a blood pressure cuff on the arm affected by lymphoedema.
• Avoid the use of elastic bandages or stockings with tight bands.

Keep lymph from pooling in the affected limb:

• Keep the affected limb raised higher than the heart when possible – this allows allows gravity to help drain the lymph fluid.
• Do not swing the limb quickly in circles or let the limb hang down.

Avoid temperature extremes:

• Do not apply heat or cold to the limb.
• Try to avoid extremes of temperatures such as saunas or ice packs.

Healthy lifestyle:

• Try to keep your weight within the normal range for your height.

Fact Sheet

Download our CANSA Lymphoedema Fact Sheet

Treatment After Surgery

After surgery has been completed and the patient has recovered, chemotherapy or radiation therapy is sometimes indicated. Side effects as a result of this treatment may be hard to cope with. CANSA offers free advice by Sr Vlooi Venter vventer@cansa.org.za regarding how best to cope with these side effects, dietary challenges and pain management.

Patients staying far away from oncology treatment centres, may be accommodated in our CANSA Care Homes, for an affordable fee, receiving meals* and transport to treatment sessions.

*unless self-catering

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