Mastectomy: What Can I Expect?

If your healthcare team has discovered a lump or cancer, you may be scheduled for a mastectomy. A mastectomy may also be performed if you have a high risk of developing breast cancer, referred to as a risk-reducing or prophylactic mastectomy. Learn more, including what to expect during a mastectomy procedure.

If you have any questions or concerns, contact the Breast Health Nurse Navigator.

What is a Mastectomy?

Mastectomy is a surgery to remove the entire breast, unlike a lumpectomy, which removes a breast mass. There are different types of mastectomy:

Simple or total mastectomy: Removes the entire breast, including the nipple, skin, areola, and breast tissue
Modified radical mastectomy: Removes the entire breast and some lymph nodes
Nipple- or skin-sparing mastectomy: Removes breast tissue but preserves the nipple.

The type of mastectomy procedure you have may be based on your general health, stage of cancer, tumor grade, and if breast reconstruction will immediately follow mastectomy.

During Surgery

A mastectomy procedure lasts 2-3 hours, longer if breast reconstruction is immediately performed. First, an incision is made. The surgeon will then remove the breast tissue and lymph nodes, if that part is part of the surgical plan. If performing reconstruction, that will be done next. Finally, the surgeon will place a surgical drain(s) to remove fluid that builds up where the tumor was. It is placed under the arm on the side of surgery.

After Mastectomy

Will I stay overnight?

Most people stay overnight. Your stay will be longer if you have breast reconstruction.

Side Effects

After surgery, you may experience these side effects:

Pain and/or sensitivity along the chest or reconstructed breast.
Swelling
Limited arm and shoulder movement
Numbness along the chest or reconstructed breast. This numbness puts you at risk for a serious burn. Do not use heating pads or hot packs on this area. If you have concerns, please discuss this with your healthcare team.
After the drain is removed, a seroma could develop. A seroma is a collection of fluid under the arm or chest wall. It is not worrisome but can be uncomfortable. Most go away naturally over time. In some cases, they need to be drained in the office with a needle.

What is recovery like?

Your provider will talk to you about specific recovery issues. In general, you will be up and moving the day after surgery. Your team should review exercises to help avoid stiffness and improve range of motion in your arm and shoulder. Your doctor will also talk about how to care for your incision site and how to empty your surgical drains at home.

The drain will stay in your body for about 7-10 days. It is removed in the provider’s office and is usually quick, and often painless. You will be given instructions on how to take care of the drain at home.

After surgery, you may have:

Pain and/or sensitivity along the chest or reconstructed breast.
Numbness along the chest or reconstructed breast. This numbness puts you at risk for a serious burn. Do not use heating pads or hot packs on this area. If you have concerns, please discuss this with your healthcare team.
After the drain is removed, a seroma could develop. A seroma is a collection of fluid under the arm or chest wall. It is not worrisome, but can be uncomfortable. Most go away naturally over time. In some cases, they need to be drained in the office with a needle.

Infection is possible, but there are some things you can do to help prevent an infection:

Take a shower the night before surgery and wash your body with soap and water.
On the second day after surgery, make sure to shower or at least clean the incision with soap and water. Pat dry, do not rub the incision. Do this every day, or at least every other day, to keep the incision site clean.
Do not immerse the incision site in water (soaking in a tub or swimming).
Always wash your hands before and after touching the incision or changing the dressing.

Recovering at Home

Make sure you have a support network to lean on and follow recovery directions from your physician. You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your care team tells you that you can return to your normal activity.

Supplies to Have at Home

Gauze pads (4x4) to cover the drain, abdominal pads (also called surgi-pads) to place across your chest or reconstructed breast for padding/comfort, and 1-inch paper tape. These can all be found at your supermarket or pharmacy.
A specimen cup to measure fluid from the drain. This should be given to you by your healthcare team before going home.
Clean, supportive pillow(s) to put under your arm while sitting or to help with positioning at night.
Safety pins or a drain lanyard to help drains stay out of water when showering
Over-the-counter medications and fluids to help ease constipation
Pain medications: Have a loved one fill your prescription before you leave the hospital

Care for the Surgical Incision after Mastectomy

If you have a post-surgical bandage, remove per your provider’s instructions (often within 48 hours). Once the bandage is removed, you may shower, but do not scrub the incision. To dry, carefully pat the incision with a clean towel. Avoid lotions, powders or deodorant on or near the incision during the first 1-2 weeks until it is fully closed.

Most surgeons use dissolvable sutures inside your body, which will go away on their own. On the outside, your surgeon may use surgical glue, paper tape called "steri-strips" or nothing at all. Both glue and steri-strips can get wet in the shower.

Caring For Yourself After Surgery

Rest and sleep when you need to, as it is an important part of recovery. When you feel up to it, start walking but avoid any strenuous activity until your doctor says it is okay.

Be sure to take your prescribed medications as directed to prevent pain, infection and/or constipation, which is common after mastectomy.

Other ways to manage constipation include changing your diet, drinking more fluids, and taking over-the-counter medications. Talk with your care team before taking any medications for constipation.

Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.

This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.

Cancer resources and support

Breast Cancer Treatment at Beebe

Every patient and diagnosis is different. Your Beebe Healthcare oncology team will develop an individualized treatment plan that is best for you, which could include surgery, radiation therapy, chemotherapy, and other treatment options.

Learn more about breast cancer services at Beebe Healthcare.

References and Sources:

American Cancer Society. (2019). Mastectomy.

National Institutes of Health: US National Library of Medicine. (2016). Mastectomy.