Possible problems after mastectomy

Blood clots

After surgery, you're at risk of blood clots developing in your legs. There is also a small risk of a blood clot in your lungs.

To prevent blood clots, your nurses get you up as soon as possible after your operation. They encourage you to move around or do your leg exercises.

To help reduce the risk of blood clots you may have injections to thin the blood (anticoagulants) before, during and after your surgery. Your surgeon will talk to you about this beforehand if you need to have this.

Also, during and after your operation, you wear special stockings (called anti embolism stockings or TEDS).

Most people feel weak and lack strength for some time after surgery. How long this lasts varies between people.

Tell your doctor or nurse if the weakness continues for more than a few weeks. They can suggest things to help, such as physiotherapy.

Wound infection

Infection is a risk after any surgery. If you develop an infection you will need to take antibiotics. Usually, this clears up the infection. You might need to stay in hospital longer or go back into hospital if you need antibiotics through a drip.

Tell your doctor, nurse or contact your 24 hour advice line if you have symptoms of an infection. Symptoms can include:

• a temperature of above 37.5ºC or above

• a temperature below 36ºC

• redness or a change in the normal colour of your breast

• your breast feels warm

• a painful or swollen breast

• fluid seeping from the wound (discharge)

• feeling cold and shivery

• feeing generally unwell

Find out more about symptoms of infection

Fluid collecting around the operation site (seroma)

Sometimes fluid collects near the wound and around the armpit. This might happen after your nurse removes the wound drain if you have one.

It can cause:

• swelling

• pain

• an increased risk of infection

The fluid normally goes away on its own within a few weeks.

Your nurse or doctor can drain the fluid with a needle and syringe if the seroma is painful. Sometimes the fluid can build up again after being drained.

Tell your doctor or nurse if you think a seroma is developing.

Blood collecting around the operation site (haematoma)

Occasionally blood collects in the tissues around the wound. This can cause pain and swelling, and the area might feel hard.

The haematoma normally goes away on its own, but it can take a few months. Your doctor or nurse can drain the swelling if needed.

Tell your doctor or nurse if you have any swelling around the wound.

Nerve pain

You might have numbness, tingling or a shooting pain in your armpit, upper arm, shoulder or chest wall. This is due to damage to the nerves during surgery. The nerves usually repair themselves, but it can take many weeks or months.

Your doctor or nurse can give you medicines to help with nerve pain.

Shoulder stiffness

Your shoulder might become stiff and painful after breast surgery or removal of the lymph nodes. Your nurse or a physiotherapist will show you exercises to do after your operation to help improve movement in the shoulder.

A swollen arm or hand

You might have some slight swelling in your arm or hand after your operation. This should settle soon after your surgery.

Tell your doctor or nurse as soon as possible if the swelling does not settle or if you have pain or tenderness in your arm or hand.

You are at risk of long term swelling (lymphoedema) in your hand and arm after surgery to remove the lymph nodes in your armpit. This is swelling caused by lymph fluid that can't drain away. It can happen any time after surgery.

Once you have lymphoedema it can’t be cured but early treatment can help to control it. Your nurse will talk to you about ways of preventing lymphoedema.

Some women develop scar tissue in the armpit after lymph node removal. The connective tissues in the armpit get inflamed, which forms one or more tight bands. This usually happens within the first few weeks or months after the operation.

The scar tissue is called cording, banding or axillary web syndrome. It can feel something like a guitar string. It can extend down the arm past the elbow, possibly as far as the wrist or thumb.

Cording is harmless but can be painful and may limit your arm movement. Massaging the area regularly can help. Tell your breast care nurse if you develop cording. They can refer you to a physiotherapist. They can show you how to massage the area and teach you stretching exercises. It usually gets better within a few months. Taking anti inflammatory painkillers may also help. Speak to your nurse or doctor about taking these.