Mastectomy: What to Expect on the Day of Surgery

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Whether you’re getting a mastectomy to treat a breast cancer diagnosis or in an effort to prevent breast cancer from developing should you have a family history or a BRCA mutation, the day scheduled for mastectomy surgery will be generally the same. The only difference will be what kind of mastectomy you and your healthcare provider have decided on. The types include simple (or total) mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, or nipple-sparing mastectomy. Each one of these procedures removes breast tissue, it just depends on how much tissue, whether or not lymph nodes should be removed with tissue, and other areas of the breast that may need to be removed in order to successfully reach the cancerous portion of the tissue.

Here’s what you need to know about the day of a mastectomy surgery, so you can be as prepared as possible.

Before the Surgery

You’ll take a number of steps to prepare well before surgery day, including making sure you’re eating a healthy diet, checking that you have the proper clothes and items packed for your recovery in the hospital, and speaking to your doctor ahead of time about what to eat, drink, and which existing medications to take (if any) on surgery day.

On the day of your procedure, you’ll arrive at the hospital a few hours before the surgery is scheduled to begin. After changing into a hospital gown you’ll wait in a preoperative room where nurses will take your vitals (including your heart rate, blood pressure, and body temperature) and do any prep they may need for the surgery.

This is also where the surgeon will come in to draw markings on your breasts indicating the area that needs to be removed during surgery. This will be a guide for them to follow once the surgery begins.

From there, you’ll be moved into an anesthesia room where a nurse will insert an intravenous (IV) line into your arm for medication. They may give you medicine to help calm your nerves before giving you general anesthesia, which will put you completely to sleep for the entirety of the surgery.

During the Surgery

Once the general anesthesia has kicked in (which happens extremely quickly) the surgeon will start the surgery. An anesthesiologist will also be present during the entire procedure to make sure your medication levels are correct and all your vitals are at a stable level while you’re under.

The surgeon will then make an incision to reach the affected breast tissue. This is typically an oval-shaped incision around the nipple and across the width of the breast. This differs if you’re having a nipple-sparing procedure, in which case a smaller incision may be made not around the nipple. The surgeon will then separate the breast tissue from the surrounding skin and muscle and remove the cancerous area. Healthy tissue close to the tumor is removed as well, to make sure they get the entire malignant area.

Once the tissue has been removed, you’ll either move on to the reconstruction portion of the procedure with a plastic surgeon (if you’ve decided to go that route), or your surgeon will begin to close the incision.

To close the incision, they will first make sure there’s no bleeding around the surgical area. Next, they will put in surgical drains (also called tubes), which will help fluid drain out of the wound as it heals. The drains will stay for about 10 days and are removed quickly and relatively painlessly in an outpatient visit.

The drains are held in place by stitches which the surgeon does as they close up the rest of the incision. Depending on the type of mastectomy, the entire surgery can take anywhere from two to three hours.

After the Surgery

Once the procedure has been completed, you’ll be moved to a recovery room where nurses will monitor your vitals as you wake up from general anesthesia. Some people experience nausea from general anesthesia, along with a sore throat, muscle aches, or itching. If you’re experiencing any of these symptoms or other signs of discomfort, make sure to tell your healthcare provider, as they can give you medicine to help ease the side effects of coming off the anesthesia.

After you’re awake you’ll be transferred to your hospital room, where you will stay for roughly average three days. Your health care team will monitor the surgery incision site to make sure no infection has occurred, help manage your pain levels, as well as teach you tools you’ll need to continue your recovery at home.

You will receive instructions on how to clean the surgical drains, care for your stitches, and dress the wound on your own. They will also discuss the warning signs of lymphedema, a type of swelling that may result as a side effect of the procedure.

You’ll be sore for a few days after surgery. You will also be numb across your chest. This decreased sensation is due to the nerve damage that happens with the removal of breast tissue during a mastectomy. Unfortunately, your breast area is likely to remain numb indefinitely.

While you recover a pathologist will examine the breast tissue removed during surgery to see if cancer cells are present in the margins, the area right outside the tumor. If the entire breast has been removed then this may not impact further treatment, but in the event of a partial mastectomy that has cancerous tumor margins, more surgery may be recommended. You’ll be in close communication with your health care team post-surgery to discuss the findings and what the next treatment steps should be.

A Word From Verywell

While your healthcare team will make sure you are provided with all the information you need to prep and recover for surgery, having a strong support system in place can make all the difference in healing. Have a family member or friend drive you to the hospital on the day of the procedure as well as be available once the surgery is done and you’ve moved into your hospital room. You’ll also need someone to drive you home and help you get set up—from meals to making sure you’re comfortable and able to move around to different rooms in your house. Beyond the physical needs you’ll need emotional support, too. There are many breast cancer community groups and resources you can tap into, both online support groups and programs that are run through your hospital. Make sure you have this information before you leave to help you cope with your mastectomy.

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Article Sources
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  1. Breastcancer.org. Mastectomy: What to expect. February 27, 2019.

  2. American Board of Cosmetic Surgery. What is it really like to undergo general anesthesia? April 11, 2017.

  3. Susan G. Komen. Mastectomy - the procedure. May 23, 2020.

  4. American Society of Anesthesiologists. Effects of anesthesia.

  5. Cleveland Clinic. What you should know about numbness after mastectomy. May 22, 2017.