Post operative problems
If you have any concerns in the few days following your surgery, we are here to help. It is much better that you contact us for advice than visit your GP or go to casualty. We know exactly what to expect and how best to treat it because we have seen it all before.
This is how to get advice (private or NHS):
- 9am – 5pm working days telephone - 01554 783395 (Peony Breast Unit)
- 5pm – 9am and weekends telephone - 01554 783365 (Breast Unit Ward 7)
There are open post-operative clinics every day of the year:
- Mon – Fri 12 MD Peony Breast Care Unit - Outpatients - No appointment required – just turn up!
Sat, Sun and Bank Holidays
Please telephone - 01554 783365 Peony Breast Care Ward before 08.30am or preferably the evening before and you will be seen as part of the daily ward round by one of our senior staff. Times vary between 8.30 and 11am.
Things to look out for:
Some degree of bruising can be expected. It usually comes out on the skin the day after the surgery and spreads out over the next few days before dispersing within 2 weeks.
Only if the area suddenly becomes very swollen, tight and painful do you need to be concerned – please contact us
Infection is uncommon but if the wound becomes red rather than bruised, uncomfortable, pussy or you start feeling feverish with a temperature - please contact us
Seroma (fluid collection):
This is common following either mastectomy or clearance of all the lymph glands from under the arm. About one in three women who have this done will need to attend for the fluid to be drained using a fine needle. It is rare to happen with wide local excision or sentinel node biopsy. Usually what you would notice is the wound slowly filling and sometimes you can see fluid moving under the skin as you move form side to side. The skin can get tight and uncomfortable. Particularly under the arm it can feel like you have a cricket ball in the armpit.
A small amount of fluid does not need to be removed and will be reabsorbed by the body itself. If the wound begins to bulge, get uncomfortable or you think the fluid might start leaking through the thinned wound, particularly in the first 2 weeks after your surgery then please come to the clinic or contact us. It is better to remove the fluid with a needle than to risk the wound opening and letting the fluid out (and, possibly, infection in).
It is usual to have a bruised type discomfort following breast surgery. Usually simple painkillers (paracetamol or co-codamol) are requires for the first few days only.
If your pain is not adequately controlled with simple painkillers at home please contact us as it may be there is a problem like seroma or infection which needs treating and even if there isn’t, it is important you be given something stronger.
Neuralgic pain can occur – from having to divide the nerves to the breast and upper inner arm. This is like a burning discomfort often made worse by lightly brushing the skin. Special painkillers are available to help this. It is best to treat such pain early because if you do not, then it can become chronic and much more difficult to treat - please contact us
We find women expect their arm to be stiff from the day after the surgery, but because it takes several days for scar tissue to be laid down in the wound, the stiffness only starts becoming a problem toward the end of the fist week and is at its worst about 2 weeks after the surgery. Scar tissue naturally shortens as a way of bringing the wound edges together even though you will have stitches to do that for you.
The Breast Care Sisters will give you advice about exercises you can do to help to settle the stiffness as soon as possible. If you require further advice please contact us
If you have had all the lymph glands removed from under the arm (axillary clearance), then some permanent numbness can be expected over the inner and back of the upper arm. This can be a bit intrusive to begin with but within a short time you will stop noticing it although it is likely to last a long time. – even permanently. If the numbness starts burning or feeling like stinging nettles, please do not just put up with it as we have good treatments, please contact us
It is very common to get slight swelling and pinkness of the breast following removal of the sentinel nodes or following complete clearance of the lymph glands. This is not important and often resolves slowly. It can be made worse by radiotherapy. However if the breast becomes suddenly more swollen, painful, red and you become feverish, then yomy have developed an infection and urgent antibiotics will be needed - please contact us
Lymphoedema of the arm is more serious but much rarer. It is very unusual to see lymphoedema of the arm after sentinel node biopsy, which is one of the main reasons why we prefer this procedure if safe.
The Breast Care Nurse and will give you advice about lymphoedema of the arm before you leave the hospital and you will be invited to attend a course about lymphoedema, its treatment and prevention by the Lymphoedema team within a few weeks of you leaving hospital. We would encourage you to attend.
If you have had an axillary clearance (all the lymph glands removed from under the arm) then you will be at risk of lymphoedema, even though most women are never troubled. Even if you have no symptoms you will be at greater risk of infection of that arm. Please be sensible and try to avoid unnecessary injury. If you are gardening, for instance, please wear gloves to avoid being cut. When cooking do your best to avoid burns and remember there are household chemicals can be strong and damage sensitive skin. We ask that drips for chemotherapy or future surgery be put in the other arm if possible.
If you do get even a simple infection affecting the skin of that arm, please contact your GP for antibiotics, but if there is a delay or at the weekend, you are welcome to please contact us
More detailed information about Lymphoedema is available here by courtesy of the American Cancer Society.