Discharge Instructions for Mastectomy or Breast Lumpectomy

You've had surgery to remove breast cancer or maybe a change in breast tissue that could become cancer over time. This may have been done with a lumpectomy to remove the changed tissue. Or it may have been done with a mastectomy where all of the breast tissue was removed. Lymph nodes in your armpit may also have been removed. Now you need to rest and recover. Give yourself time and try to be patient with your body as it heals.

Your health care team will teach you what to do at home. You'll learn how to take care of your surgical site and what kind of problems you should watch for. Here are some of the things you need to know:

• Be sure you understand what you can and can't do as you recover from surgery.
• Rest when you're tired. Don't worry if you're extremely tired (fatigued). Fatigue and weakness are normal for a few weeks. This will get better over time.
• Ask for help with chores and errands while you recover.
• Don't lift anything that weighs more than 5 pounds until your doctor says it's okay.
• Don't do any strenuous activities, such as mowing the lawn, using a vacuum cleaner, working out, or playing sports. Listen to your body. If an activity causes pain, stop.
• Limit your activity to short walks. Slowly increase your pace and distance as you feel able.
• Don't drive until you're free of pain and no longer taking prescription pain medicine. This may take a few weeks.
• Do the range-of-motion exercises that you learned in the hospital.
• Don't have blood drawn from the arm where lymph nodes have been removed. Also don't get an I.V. or a shot in that arm. Not all doctors agree with this recommendation. Ask your doctor what they recommend for your situation.

Here are suggestions for taking care of yourself at home:

• Take your pain medicine as directed. Ask about side effects it could cause and what you can do to manage them.
• Your surgeon may leave a bandage on your cuts (incisions) when you go home that will be removed at your follow-up appointment. Keep the bandage clean and dry.
• If your bandage has been removed, keep your cuts clean and dry.
• Check your incisions daily for signs of infection. These include redness, swelling, and drainage. Also watch the edges of the incision to be sure it's not opening up.
• If your doctor says it's okay, wash your incisions gently in the shower. Use mild soap and warm water. Pat dry.
• You may have a drainage tube left in your skin to carry excess fluid to a soft plastic bulb. You will be shown how and when to empty the bulb. You may be told to record the amount of fluid. The amount will decrease over time.
• Don't soak in a tub, hot tub, or pool until your doctor says it's okay.
• Eat normal meals as soon as you feel able. Stick to a healthy, well-balanced diet.
• Try to prevent constipation: Eat fruits, vegetables, and whole grains. Drink 6 to 8 glasses of water a day, unless directed otherwise. Use a laxative or a mild stool softener if your doctor says it's okay.

Make a follow-up appointment as directed by your doctor. If you had a mastectomy, you may want to learn more about your choices for reconstructive breast surgery or a prosthesis. Ask to talk with someone who can tell you more about your choices.

Talk to your doctor about problems you should watch for. Call them right away if you have any of the following:

• Fever of 100.4°F ( 38°C) or higher or as directed by your doctor
• Chills
• Signs of infection around the incision, such as redness, drainage, warmth, and pain
• Incision opens up or the edges pull apart
• Pain in or around your incisions gets worse
• The drainage tube falls out of your skin
• Rapid, irregular heartbeat or new chest pain
• Swelling in your hand, arm, or chest that gets worse or isn't getting better a week or two after surgery
• Shortness of breath or trouble breathing
• Trouble passing urine or changes in how your urine looks or smells
• Pain, redness, swelling, or warmth in an arm or leg

Know what problems to watch for and when you need to contact your doctor. Also know what number to call after office hours and on weekends and holidays.