There’s no shortage of information about breast cancer. You can spend many confronting hours trawling web sites or wading through books on the subject. There are excellent ‘official’ web sites, books and brochures as well as what used to be called ‘chat rooms’ (but now they seem to be ‘communities’) where people share information with each other (not all of it helpful or accurate), but there seems to be a lack of information about what to expect after breast conserving surgery.
Most of what I’ve found looks something like this:
‘Expect some bruising and swelling which should settle within the first few weeks. You may also experience odd sensations.’
I didn’t find this useful. Here’s what’s actually happened:
I woke from surgery with an arced wound on my chest about 7cm long. It looked like it had been drawn on with blue marking pen and it was covered by a large, transparent, waterproof dressing. I did not have any drains under my arm as my surgeon performed a sentinel node biopsy and took the relevant nodes out through the same incision as the one she used to remove my remaining tumour.
Here’s a photo taken the day after surgery:
When I woke from surgery I said ‘pain’ and they topped me up and put me back to sleep. By the time I woke up I was not in any significant pain, more the sort of discomfort you get with a badly pulled chest muscle; move the wrong way and you know it but take it easy and it’s just uncomfortable. I was told to take two panadol every four hours and I did. I learnt a long time ago that it’s stupid to be a martyr to pain. After four days I gradually reduced the pain medication.
The surface of my breast felt numb in some places and tender around the site of the wound. The blue colouring you can see is from the dye they inject as part of the sentinel node process. I didn’t have any noticeable bruising.
I was given physiotherapy exercises to do straight after surgery. I was able to do without any difficulty but there was mild discomfort and a pulling sensation in the breast when I moved. This was exactly what I expected. I was told not to do any yoga for the first week after surgery.
I also wore a bra all the time unless I was showering. After lots of experimentation I found a cotton singlet under an ‘Ah Bra’ (a sort of seamless, nylon crop top style of bra) was my best option for night time, and, to my surprise, my ‘going out’ underwire bra was my best day time option. The underwire bra didn’t rub across my wound the way my usual bras did. When I wasn’t wearing a bra I felt the need to support my breast with my hand to prevent a very uncomfortable dragging feeling. Having bra straps constantly rubbing my shoulders proved to be a problem and I found that tucking some padding under them helped. I used the wrist bands I wear to catch sweat at the gym.
Finding a comfortable position to sleep was difficult and I found propping my breast up with pillows helped. There’s a market for a kind of high necked cotton singlet with the sort of support they put into that underwear that straps your fat down. It needs to be absorbent and to have really wide shoulder straps. It needs to be high enough at the neckline to cover wounds like mine. Most bras cut right through the middle of this type of wound. It needs to be as long as a singlet because anything else digs in under the breasts.
A week later the waterproof plaster was removed by my surgeon. I was advised to use ‘micropore tape’ on my wound to help reduce scarring and to start massaging the scar with oil after another week. I was cleared to return to yoga but advised to take it easy.
At this point the site of my surgery still felt hard, similar to the feeling of a tightly clenched bicep muscle. I started to notice that sometimes I would get strange sensations in my breast and underarm, like a small electric current zipping about inside me. Sometimes I’d get a sudden, sharp pain like someone poking me with a finger (most often to the side of my breast, under my arm) and sometimes I would get a dull ache. These sensations have continued even though it’s now six weeks since my surgery. The surface of my skin around the scar is still numb. This may be permanent.
The hardening at the surgery site is disturbing because it feels exactly the same as the cancer felt after it had been biopsied. While I was having chemotherapy, that site became softer and smaller. Having a hardened area in the breast again is very reminiscent of the cancer. After six weeks it seems a little smaller but it’s still there. The breast care nurse tells me it’s completely normal and that it’s also the most common question they get asked. “You need to become familiar with your new breast,” was an excellent piece of advice. It’s a bit like having dental work. The new tooth feels strange for a while until you become accustomed to it. My breast is not going to return to normal. It’s going to be different.
I also noticed a ridge running down the side of my breast, from the underarm to the nipple. On massaging it I found something beneath the skin that felt like a cord about as thick as a computer cable. If I lifted the breast the indentation became more obvious. With exercise and massage this has relaxed. I can still feel it under the skin but it’s no longer having and effect on the appearance of my breast.
I found the micropore tape comfortable. Even though I knew the wound was stitched up I could feel the pull on it caused by the weight of my breast and the tape helped me to feel more securely held together. On the advice of the breast care nurse I changed it every second day and massaged with rose hip oil in between. The official advice is to use ‘Bio oil’ but that’s a petrochemical product and it’s a credit to their marketing department that doctors and nurses alike mention them by name. I’m on a mission to educate!
An important tip for the micropore tape; fold a small corner over on one end before you apply it. This makes it much easier to remove. Picking at the numb skin on my breast with my numb fingers was not a good combination.
Here’s my breast after six weeks:
Pretty impressive work by my surgeon, I’d say, and I’m not done healing. For anyone worried about the tattoos you get for radiation, this photo shows my breast after I’ve had them and two of them are in this shot. Good luck spotting them. I was relieved to discover that they are very tiny.
Perhaps my biggest post-surgical shock was the continuing impact of chemotherapy. I thought that when chemotherapy ended back in December that I’d coped well and would now be moving on. Instead I’ve had increasing peripheral neuropathy that has progressed from some numbness and tingling in my hands and feet to very painful sensations running up to my knees and elbows. When I wake up in the morning my hands are stiff with pain. I’ve been advised to take paracetamol with codeine and that’s helping.
It terms of my breast, I’m very happy with the outcome of the surgery. Without a bra you can see a bit of puckering around the cancer site but compared to losing the breast (which other surgeons would have recommended) this is a much better outcome. I continue to have strange sensations in the breast, including the electrical zipping and the finger poking sensations. Recently I’ve developed an uncomfortable pain at the site where I know one of the lymph nodes was removed from under my arm. This is new. I think it’s useful to know that the patterns of pain can change, and that you can suddenly develop a new sensation as your breast heals.
I’m able to feel a little more comfortable without a bra which is a good thing going into radiation therapy. Anything that rubs the skin, including a bra, is likely to cause problems. I think I’ll just wear singlets for the next six weeks.
If you’ve had breast surgery I hope you find all of this useful. My number one tip post-surgically is to talk to your local breast care nurse. If you don’t have these wonderful professionals where you live then talk to your doctor. So often we worry ourselves because we don’t want to bother people. It’s not bother. It’s their job. I know I’m now much better at making a phone call when I’m pretty sure the answer to my question will be ‘that’s completely normal.’
There’s a world of difference between being pretty sure and knowing. Knowing gives you peace of mind.