"Because nobody goes through life without a scar."
- Carol Burnett
Lumpectomy, or partial mastectomy, involves only taking out the tumor and some surrounding tissue. I had a lumpectomy so I can speak with first-hand knowledge of that, while I have information that I have gathered from women with a mastectomy. There are pros and cons to both.
Lumpectomy Pro
Save sensation to nipple and breast
Natural feeling
Shorter surgery
Shorter recovery time
Lumpectomy Con
Breast could be a different size than its mate
Radiation is often required
Mammograms are still required
There is “worry” about recurrence
Occasionally I have heard of women who had both breasts removed (cancer was located in only one) and cancer has been found in the “good breast”. It isn’t common, but cancer is a sneaky bitch.
It is a tough position. Some women just “want the damn things off me.” Other women, like me, want to start small and go bigger if I need to down the road. Yes, it could lead to more surgeries, but that was what drove my decision.
I put together a quick look at what surgery day and the days that follow will look like. These are all things that helped me. Some might help you, or have no bearing, or you might have different helpful tips.
Anxiety – This will be through the roof. What if they don’t get it all? What if they find more? What if there’s too much and they take my breasts completely off? Is that even an option (ask this one to make yourself feel better). The what-ifs will drive you crazy. Take a deep breath. Keep yourself busy. Pray. Yoga. Meditate. Walk the dog. Clean the house. Write it down. Go to What-If Land for a while, but make sure you’ve booked a return ticket.
Plan the home return – But I haven’t even had the surgery. Yeah, duh. I know. I am Polly Plan-Ahead, and it has served me well. Know what you are going to eat for the next three days. Make it ready if possible. Have people bring it. Clean the house, vacuum the floor, run and unload the dishwasher (this one I learned the hard way, but had it done for the second surgery), do all the laundry, change the sheets, make sure the couch has clean, comfy, heated blankets at the ready. Make sure you have a ton of liquids on hand in all sorts of flavors (flush out the anesthesia). This surgery shouldn’t knock you on your keester, but it does disrupt your normal day.
Pre-Surgical Procedures – Prior to surgery you will have a procedure or two so the surgeon can find the tumor. After all, you don't want them cutting you open and then fishing around. They do things ahead of time to take the least amount out of you while getting the tumor. These procedures could include a lymph node injection where they inject dye into your breast to locate the lymph nodes. It could also include a wire localization procedure. This is where wires are inserted around the tumor. I go into these procedures a lot more on on other pages.
Surgery – You will be weighed, changed into a gown, asked your birthday a million times and soon be wheeled in.
After surgery – You will come out of the anesthesia slowly. Because you couldn’t eat for several hours, ask for water and food. Eat/drink slowly, but do so to counteract the anesthesia. You will be released soon after waking up. Have someone else listen to (and write down!) whatever the surgeon and nurses say because after-care instructions can sometimes be confusing.
Nausea – brought on by the anesthesia. You can take Zofran or other anti-nausea pill. Drink water slowly, but regularly. Also, there is a pressure point on your wrist that helps (think how a sea band works).
Pain – Take the paid medications as prescribed. Stay ahead of the pain. Once you decide you can’t “tough it out” it’s really hard to reel the pain back in. You will feel very tender and be scared to move your arms. I found, after I was bored with that, I could move them around and it didn’t really hurt. (First surgery took three days of pain pills, second surgery took two ibuprofen.) The exception was the node surgery site. That one is in the fleshy part of the armpit and was held together with two pieces of tape. It seemed I couldn’t make that one not hurt.
Sore throat – This sometimes happens because of the tube down your throat. Honey and tea and pain pills can take care of this.
Ice – Small flexible ice packs shoved into a front closing bra was bliss. I could sit on the couch or go for walks with them. Keep a spare in the freezer and rotate in and out. Again, try to stay on top of it. I did mine for two or three days (especially the second time, to keep swelling down).
Showering – They will give you instructions, but you probably can’t shower for two days. After that you can normally.
Bruising – No one told me the bruising would be at the bottom of the breast. That was where everything seemed to pool and it scared the tar out of me. It was normal (the surgeon told the frantic patient).
Tape – The bane of my cancer chapter. They put the tape directly over the incision. Not around it, right on it. There will be a thick plasticy tape (with gauze underneath to make it oddly thick and scary). This I got off by sitting on the floor of the tub, under the hot shower, after taking a pain pill. Yes, I was that much of a wimp that it took a narcotic for me to take the tape off. And that was the outer layer. Under it is a clear (trans-something), thin layer. I could either take it off prior to the 10 day follow up, or leave it for the surgeon to do. I learned the hard way to not let the surgeon do it as people in the waiting room could hear my screamed cuss words from the surgeon’s office. Coconut oil rubbed on, shower hot water, pain pill, thirty minutes, and it came off. I wear my tape-wimp badge proudly.
Visual changes – I couldn’t really tell they took a “chunk” out. One headlight pointed a little more to the left (that was the one I had surgery on), but that was all. Whatever they look like after surgery, they are going to look still different after radiation. I do have a good size scar, but even that changes with radiation.
Exercises – I started right out of the gate with these. Walking the fingers up the wall was a little, stupid, highly effective one. So were some easy yoga moves. Ask your doctor (they all are different) but you want mobility as soon as you can. Walks were also a no-brainier. They kept me sane (and gave me an excuse to nap afterwards).
Rest – Do it as much as your body wants. No prizes for making it through the day without a nap when your body is screaming for one.
Lifting – I had a hard time lifting dishes out of the dishwasher. It ended up being one at a time, taking all day with naps between the silverware and cereal bowls. Pulling wet laundry from the washing machine was a one-at-a-time venture as well. Vacuuming was not going to happen.
Lymphedema – Doctors are not really on board with this one, but it is real and it is irreversible. Once you have had nodes removed, you are not supposed to get blood pressure checks or blood draws from that arm. They’ve laxed the stance a bit and say, don’t let a surgery cuff go on it that goes off all the time. Still. Lymphedema is when the lymps can’t drain and it swells up your arm. Like, scary swells and your whole arm balloons. And it can’t be undone. A lymphatic drainage massage therapy is my absolute in this game. Yes, I needed an oncologist and radiologist, but I needed a lymphatic drainage massage therapist just as much. They can teach you how to do the massage yourself, and will also give you great exercises to do that will help with mobility.
Re-excision – There is a 20% chance they will not “clear the margins”. This means the cancer was too close to the “glob” edge they took out, and more could be in your body. You will be scheduled for another surgery called a re-excision. It’s the same thing, only without anything to do with nodes or tumor finders (wire localizations or SAVI). A second surgery is no big deal; it just messes with the schedule a bit, and pushes it further out.
Follow up Appointment – Usually 10-14 days after the surgery. Just a quick check to see how things are (or to rip off your tape). Anytime you have questions, call them. For anything. I was over-paranoid, called about and went in about everything, and they still like me.
