What to expect

Some people with breast cancer are advised to have a mastectomy as part of their treatment. A mastectomy is the removal of the entire breast tissue, along with cancer and can be done in different ways depending on the size and location of the tumour. For many, it may also involve the removal of the nipple and areola area as well. Your surgeon will advise you as to which type of mastectomy is best for you, but it will always involve having a general anaesthetic and an incision or cut across your breast, either diagonally or horizontally to remove the breast tissue. For most, the procedure is well tolerated and involves only an overnight stay.

Sometimes breast reconstruction follows mastectomy in the same surgery and may include partial or complete restoration of breast tissues using tissues from other parts of the body or implants. Your doctor will discuss this option with you and go through details of the procedure.

Mastectomy has both physical and psychological impacts. On the physiological side of things, you may experience pain, symptoms of scar formation and lymphoedema. Psychologically, you might suffer from lack of confidence as a result of changes to your body and how it looks. This can be difficult to deal with, and you may need some support to help you feel more like yourself again.

This guide will cover:

  • Pain
  • Lack of confidence
  • Scars
  • Comfort
  • Bathing
  • Lymphoedema

Why does this happen?

  • Pain appears because of scar and damage to your nerves during surgery - studies show that up to 68% of patients may experience it for some time. If you had breast reconstruction, you may also feel increased sensitivity and altered sensation or tenderness in the rib area.
  • Lack of confidence: It's totally understandable to feel self-conscious or anxious about having a mastectomy. Sudden changes in your physical appearance can be hard to accept, but there are lots of things you can do to make the process a bit easier and help you feel more comfortable with the new look and feel of your body.
  • Scars: While you are healing post-surgery, the incision area may sometimes feel stiff, numb, lumpy or even painful. And even a while after surgery, you might feel like you want to change or reduce the appearance of your scars. 
  • Comfort: Following surgery, you may need some downtime to recover. It's important to get as comfortable as possible while resting in bed so you can recuperate.
  • Bathing: Having a shower or bath after surgery could be slightly more complicated. You might need to protect healing scars, or the mobility of your arm on the side of the surgery might be restricted. 
  • Lymphoedema is caused by excessive lymph that collects in the arm, hand, or chest. This happens because some of the lymph nodes are removed during the surgery, and fluid is still collecting in remaining pathways. The swelling can be uncomfortable or painful, but there are some things you can do to relieve it.

What can you do about it?

Restoring confidence

Restoring confidence

Breast forms: If you haven’t had breast reconstruction, you may find breast forms very helpful in restoring the look and feel of your breast; they can either be attached to the skin, or put in a special pocket of a mastectomy bra. 

Mastectomy bras: There are many flattering designs out there for post-surgery bras. Most of them are soft and non-wired, so you can cover up your post-surgical scars if you want to, without the discomfort of a normal bra. They're also available in front-fastening designs, in case your surgery has made it hard to reach round to your back.

Mindfulness books: If your anxieties and thoughts about your changing body are really dragging you down, a few mindfulness exercises might help you to clear your head slightly and get some relief. There are a lot of books out there that can help you manage negative thoughts through mindfuness, by training your mind to think and feel more positively. 

Aromatherapy oils:  These come in many different forms and can help to reduce stress and anxiety. If you're feeling down, anxious or having trouble relaxing or falling asleep, the smell of your favourite essential oils can help you to feel grounded, more alert or help you doze off. Just like the smell of a good cup of coffee in the morning, or the scent of a cosy fireside, aromatherapy can have a subtle but positive effect on your emotions and state of mind.

Meditation:  The art of meditation has been practiced for centuries, and if you can get into the habit of it, it's proven to reduce stress and anxiety. Of course, meditation won't change the fact you've had a mastectomy, but it might give you the mental space to find your own ways of coping with the surgery.

Even five minutes a day can help you to feel calmer and more ready for the day - and there are loads of apps, books and videos that can help you get started.

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Being comfortable after surgery

Being comfortable after surgery

Overbed table & cushioned lap trays: If you need to spend a lot of time in bed recovering from surgery, an overbed table will make it easier for you to do things like reading, using your laptop or eating meals. Cushion trays have a beanbag or cushion attached underneath making it more comfortable to rest them on your lap.

Back-rest: If you're finding it difficult to sit up in bed after surgery or are fed up of re-arranging pillows to keep yourself propped up, you could try using an adjustable backrest to help you find and maintain a more comfortable position.

Support cushions: Use support pillows to help you find a position that's most comfortable in bed, including specifically designed V-shaped cushions for back support, knee cushions to relieve pressure on the knees and hips, as well as leg raising cushions to help ease fluid build up and the discomfort from swollen legs

Post-surgery bras: Compression bras are designed specifically to put pressure on your chest after surgery to aid healing. If you had breast reconstruction, you might need a belt for additional pressure.

Bamboo clothing: Wearing loose, breathable clothing that absorbs moisture will make a big difference to feeling comfortable while you rest.

Bamboo is a perfect material for tender or sensitive skin - it's super soft, stretchy, and 41% more breathable than cotton. Bamboo headwear, pyjamas and even bedsheets are all good options to try if you're struggling to get comfortable.

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Dealing with scars and pain

Dealing with scars and pain

Scar gels, creams & oils: Scars are a really personal issue - some people are proud of their "battle scars", as a symbol of their strength and resilience. But many people also feel understandably self-conscious about scars, and would rather conceal them or reduce their appearance.

If you would like to try reducing them, there are a few trusted scar remedies prevent or soften and smoothen scars. They also help to reduce discolouration, redness, itching, pain and discomfort of scar areas. Lotions, gels and creams may also sometimes stimulate production of normal cells to replace your scar tissue.

Anti-itching creams & oils: Although itching is a positive sign that scars are healing, it can get maddeningly uncomfortable - especially if your skin was already sensitive before surgery! Luckily there are now some specially formulated creams and oils that can reduce the sensation of itching, and can also reduce dryness and tautness around your scar area. 

Cooling gels: These handy creams reduce pain by distracting the nerve endings with a cold sensation, blocking them from detecting the pain sensation. They have also been shown to reduce swelling, inflammation and muscle spasms from nerve damage. You can also try using cold packs or cooling pillows for a similar effect.

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Lymphoedema

Lymphoedema

Compression: Keeping the area compressed is one of the main ways to reduce swelling caused by collecting lymph. Depending on the area, you might benefit from a compression sleeve, compression bra or compression socks. 

Keep moving: Certain kinds of gentle exercise, such as yoga or pilates, can help to stimulate healthy lymph circulation. Keep an eye out for exercise books, videos or online tutorials that are specifically designed for people who've had a mastectomy - finding that one stretch or exercise that provides relief could be really worth it!

Skin care: If lymphoedema is causing swelling, your skin may feel tight and sore. It's really important to keep your skin moisturised and clean if it's swollen, preventing the skin from breaking and causing infections. Finding a good lotion or gel that works for your skin is worth the research, and it could not only protect your skin but also relieve some of the tenderness and itching you're experiencing. 

Bathing

Bathing

Bathing aids: If you really think about it, cleaning yourself in the bath or shower actually involves some pretty flexible movements. This may be something you only realise once your mobility is restricted by surgery and the need to keep your healing scars comfortable. Simple bathroom helpers like back cleaners and sponges with a handle can be just the thing to help you to shower when your arm flexibility is restricted, and it's hard to make certain movements.

Waterproof dressings: There are plenty of inventive solutions you could try to keep your surgery area dry in the shower. In general though, it's best to go with the more hygienic solution rather than getting creative with a bin bag. Waterproof dressings are usually sterilised and easy to wrap over an existing bandage or healing scar without causing too much irritation. 

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Last but not least...

Last but not least...

Whether you're scheduled to have a mastectomy soon, or recovering at home, we hope you find a way to get comfortable with the physical and psychological effects of the operation. 

If you have any of your own tips and tricks for dealing with a mastectomy, we'd love to hear them. 

You can share them with us and our whole community on our Facebook or Twitter pages, or by emailing us at theteam@livebetterwith.com.