BREAST CANCER

 

Screening & Diagnosis

  • Breast cancer is usually diagnosed with imaging (ultrasound, mammography, MRI) followed by biopsy. It is important for all women over 40 to obtain screening studies. Additionally, women with family history of genetic predispositions to cancer may discuss additional options with their doctors.

 

Surgery Care

  • Options

Important when choosing a surgeon, is having a frank discussion about all options and individual goals. Bring a close friend or family member to the appointment.  The surgeon should discuss options such as lumpectomy, mastectomy, bilateral mastectomy, and reconstruction. Also included in the appointment may be discussion of advanced options such as nipple sparing procedures and immediate (single-stage) reconstruction. If you feel that you do not have satisfactory answers to all questions, or are being presented with limited options, it is advisable to seek a second opinion.

 

  • Aftercare - What to expect. When you return home soon after surgery, taking care of yourself is a full-time job. Make arrangements to receive lots of support the first couple days including help with child care, meal prep, and medication administration, etc. The effects of anesthesia usually wear off in 24 hours. Most patients find they can resume normal activities in 1-2 weeks depending on the extent of surgery. You may find it helpful to write down important information, such as drain output, questions for your doctor, or specific care instructions. Also keep contact info for the surgeon’s office on hand. Buy loose fitting garments and discuss the use of specific undergarments with your doctor. Planning ahead for these needs will ease your mind after surgery.

    • Incisions- Overlying dressings can usually be removed in 2-3 days. In some cases the incision will have Derma-bond (skin glue) or Steri-strips (white) which may be left in place for 2 weeks. You may use soap and water; then cleanse the area around the incision and pat dry.

    • Drains- Drains prevent seroma (fluid buildup) formation and infection. Output should be recorded daily. Drain tubing should be manually milked (stripped) twice daily. Drains may remain in place for 2-3 weeks, until output is minimal. Surgeons have various “cutoffs” for acceptable output prior to pulling drains, but generally 10-30 cc of drainage daily is the lower acceptable limit. It is not uncommon for a drain to have no output for 12 hours. But please notify your surgeon’s office if you have no output from a drain for several days.

    • Wraps- Your surgeon may wrap your chest and arms following surgery. Alternatively, the surgeon may recommend a sports bra or surgical bra for compression. Generally the chest compression helps prevent seroma formation. The compression wraps of the arms (which are to be re-wrapped daily) may help with lymphedema (arm swelling) following an extensive lymph node dissection.

    • Exercises- Following mastectomy, it is important to perform “range-of-motion” exercises of the upper extremity to prevent “freezing” of the shoulder joint. These exercises can be initiated on the first post-operative day. A description of all exercises can be found here: https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer/exercises-after-breast-cancer-surgery.html Our favorite is the shoulder stretch. Stand facing the wall with toes about 1 foot from the wall. Put your hand on the wall. Use your fingers to "climb the wall," reaching as high as possible (should feel a stretch). Repeat 5-7 times every hour while awake.

    • When to call: Please notify your surgeon’s office if you are experiencing fevers, copious amounts of bloody output from the drains (>1 cup of frank blood, but red tinged fluid does not count!), purulent drain output (resembling pus), if your drains fall out or are dislodged, your incision opens up, you see a large amount of skin necrosis (>25% of total surface of chest) blackening, or if you develop a fluid collection (seroma). Please visit our Post-mastectomy FAQs page for additional questions.

 

Chemo & Radiation

 

 

 

Surveillance

Following treatment, your doctor may recommend a surveillance regimen consisting of repeat imaging and/or exams every 6 months to yearly.

Support

 
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United and together.