Life after breast cancer surgery

After completing treatment for breast cancer, you will continue to be monitored and remain under the care of your cancer team for at least five years. 

At a minimum, you will receive annual follow-ups, which will include clinical examinations and routine tests, such as a mammogram and ultrasound scan, and in some cases, an MRI scan or CT scan to check that the cancer hasn’t recurred. Your doctor will also ask you about any new symptoms or concerns. 

Here we’ll take a closer look at what life after breast cancer surgery involves, beyond attending your regular follow-up appointments. 

Managing pain and discomfort

Your recovery from breast cancer surgery will depend on the type of surgery you had, for example, a lumpectomy, mastectomy, mastectomy with reconstruction or delayed reconstruction. 

In general, the initial recovery from a lumpectomy or mastectomy takes two to three weeks, during which time your wound will heal. However, your chest and arm area may feel swollen and stiff for several months. In most cases, over-the-counter painkillers are enough to manage any pain or discomfort during these first few weeks and months. Recovery from reconstruction surgery, which is a longer and more complex operation, takes longer. 

Some individuals may develop chronic (long-term) pain due to scarring as a result of surgery or due to the effects of radiotherapy. A combination of physiotherapy and over-the-counter painkillers can help relieve this pain, although a minority of individuals may develop severe chronic pain. If you develop severe chronic pain, you will be referred to a specialist pain clinic.

Body changes after breast cancer surgery

Breast cancer surgery will physically change your body but can also change how you feel about your body image. It’s important to talk to your care team about any concerns you may have both before and after surgery regarding the cosmetic effects of surgery and how this may affect your confidence and self-esteem. Talking to your family can also help you better cope with the changes. 

Lumpectomy

If you have a lumpectomy, you may have a scar over your breast, asymmetry in the size of your breasts and/or chronic pain over your scar. Asymmetry in your breast size may improve over time, but if not, you may decide to have surgery to restore greater symmetry. 

Lymph node removal

If you have surgery to remove your lymph nodes as part of your breast cancer treatment, you may develop swelling in your arm (lymphoedema) as fluid accumulates here. 

Although lymphoedema can’t be cured, there are effective strategies to manage it, including wearing special elasticated sleeves, vests and arm bandages, performing exercises that improve fluid drainage and having a special massage called manual lymphatic drainage (MLD) which also helps improve fluid drainage. 

Mastectomy without reconstruction

Without reconstruction surgery, a mastectomy will cause flatness of your chest wall on the side of your body where your breast was removed. You may, therefore, decide to wear a prosthesis so that your chest appears symmetrical when wearing clothes.

As with any type of surgery, you may also develop chronic pain over your scar. 

Mastectomy with reconstruction

This operation is longer and more complicated than a mastectomy alone, but it produces more positive cosmetic outcomes and greater symmetry between your breasts. However, you may need further surgery to improve the level of symmetry achieved with your initial reconstruction surgery. 

Lifestyle changes after breast cancer surgery

Getting back to your usual routine as soon as is safe and feasible is an important part of your physical, mental and emotional recovery. 

However, depending on your lifestyle before your cancer diagnosis, you may need to make a few changes. 

It is important to exercise regularly for your physical and mental health. Practising relaxation techniques can improve your emotional wellbeing; this may involve yoga, meditation, mindfulness or taking part in a hobby that helps you destress or focuses your mind on something you enjoy. 

It is also important to reduce any risk factors that increase your risk of the cancer returning, such as quitting smoking, cutting back on alcohol and losing any excess weight.

A significant part of adapting to life after breast cancer surgery is learning to accept and feel confident in your body. If you are using a prosthesis after a mastectomy, you will need to adjust to getting changed with a prosthesis, which may include changing in public spaces, such as swimming pools. 

If you have had a mastectomy with a reconstruction, you will need time to adapt to your new breast as it will look and feel different to your old breast. While there are several surgical techniques to achieve good symmetry between your breasts, it is difficult to achieve the same natural symmetry that you had before. 

Supporting your recovery

Your multidisciplinary care team is not only there to care for your physical wellbeing but also your mental health and emotional wellbeing as breast cancer surgery can have a major impact on how you see yourself, your identity and your sexuality. 

In addition to the medical treatment you receive, as well as supportive treatment such as physiotherapy, your care team can provide you with information on complementary therapies that can help you during your treatment and recovery. 

It is important to note that complementary therapies are different from alternative therapies. Complementary therapies are used alongside conventional medical treatment to help you feel better, while alternative therapies are used instead of conventional medical treatment and often claim to treat cancer without any scientific evidence to support this. 

Complementary therapies may include acupuncture, acupressure, aromatherapy, hypnotherapy, massage, meditation, mindfulness, reflexology, shiatsu, tai chi, qi gong and yoga. 

Managing menopausal symptoms

Several breast cancer treatments, including hormone therapies, ovarian suppression and chemotherapy, can cause menopausal symptoms. For some individuals, after cancer treatment stops, periods return and menopausal symptoms go away. However, for others, periods never return and menopausal symptoms persist. 

If you have had breast cancer, systemic hormone replacement therapy (HRT) — that is, HRT tablets — is not generally recommended as a treatment for menopausal symptoms as it may increase the risk of your breast cancer returning. 

This risk depends, in part, on whether your breast cancer was hormone receptor positive and how long you take HRT for. If you have severe menopause symptoms, your doctor can discuss the risks and benefits of taking HRT with you in more detail so you can make an informed decision. 

If you do not take HRT, there are non-hormone menopause treatments available that your doctor can prescribe to target specific symptoms. They can also refer you to a menopause specialist for further support.