How to Prepare for a Mastectomy

Experts agree that a mastectomy may be the best way to treat or prevent breast cancer in certain cases. During a mastectomy, your surgeon will remove your breast tissue and may, depending on the situation, perform a breast reconstruction.^{[1]XTrustworthy SourceAmerican Cancer SocietyNonprofit devoted to promoting cancer research, education, and supportGo to source} Choosing to have a mastectomy is courageous and could help you live longer, but it can also be a physical and emotional challenge. Research suggests that planning ahead and working closely with your doctor can help your surgery and recovery go as smoothly as possible.^{[2]XTrustworthy SourceJohns Hopkins MedicineOfficial resource database of the world-leading Johns Hopkins HospitalGo to source}

Part 1

Part 1 of 3:

Making a Plan

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1
Talk to your doctor. Find out ahead of time what you can and cannot do after your surgery. You will probably not be allowed to drive, and you may be sent home with JP drains that will need care. Share this information with the people who will be taking care of you after your surgery.^{[3]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- Ask how long you are likely to be in the hospital after your surgery. Some people go home the same day, others stay a day or longer.^{[4]XTrustworthy SourceBreastCancer.orgPatient-focused nonprofit organization providing resources for those affected by breast cancerGo to source}
2
Discuss your options with your surgeon. Ask your family doctor to recommend a surgeon, and meet with your surgeon and anesthesiologist before your surgery. Ask any questions you have. They will talk to you about your medical history and make a plan for what type of surgery you will have and when.^{[5]XTrustworthy SourceBreastCancer.orgPatient-focused nonprofit organization providing resources for those affected by breast cancerGo to source}
- They will likely set up a pre-op exam, which will take place a couple weeks before your surgery and is usually performed by a primary doctor or a doctor specializing in pre-op risk assessment. The doctor may recommend medication and behavioral changes so you have a successful surgery.
- Tell your doctors about any medications, vitamins, or supplements that you’re taking. If you take aspirin or a blood-thinner, you will have to stop taking it temporarily before your surgery.^{[6]XResearch source}
- You cannot eat or drink for 8-12 hours before your surgery; your doctors will give you specific instructions that you must follow.
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Take a robe and slippers to the hospital to keep comfortable during your stay. Bring your toothbrush and other hygiene products. Pack a book, some magazines, and other items to occupy your time during your initial hospital recovery.^{[7]XTrustworthy SourceBreastCancer.orgPatient-focused nonprofit organization providing resources for those affected by breast cancerGo to source}
4
Take medical leave from work. You will need to recover at home for a while, possibly for as long as six weeks. Talk to your head of Human Resources department at work, and your supervisor. Your doctor can give you an idea of how long you should miss work, and if necessary they can write a letter to your employer. You may need to:
- File paperwork for short-term disability
- Plan for others to take over large projects that you are working on
- Share information that others will need to take over your daily tasks
You may need help caring for yourself at first - you will have difficulty bathing, and you will not be able to drive for several weeks. Enlist friends, family, or professional staff to help you. Set up your sleeping arrangements to be near a bathroom, and avoid the use of stairs - you will likely be sent home with medications that may make you dizzy. Plan for child-care if you usually take care of the kids.^{[8]XTrustworthy SourceBreastCancer.orgPatient-focused nonprofit organization providing resources for those affected by breast cancerGo to source}
6
Do your household chores ahead of time. After your surgery, you should concentrate on recovering. You may want to do the following beforehand:
- Clean your house
- Do your laundry
- Pay your bills
- Trim your hair (short enough that someone can shampoo it in a sink for you)
There are a few things that you will want to have on hand, such as gauze bandages, bandage tape, antibiotic ointment, and over-the-counter pain relievers. The doctor may give you some of these, but it's good to have some just in case. Get supplies at your local pharmacy or drug store.^{[9]XTrustworthy SourceBreastCancer.orgPatient-focused nonprofit organization providing resources for those affected by breast cancerGo to source}
8
Stock up on healthy food. Stay away from complicated "cancer cure" diets and concentrate on eating wholesome, balanced, protein-rich foods, and a good complement of fruits and vegetables. Stock up on these items before your surgery so you have a stocked fridge when you get home.^{[10]XTrustworthy SourceUniversity of California San Francisco Health CenterResearch hospital associated with UCSF, a leading medical university, providing innovative patient care and public health resourcesGo to source}
- Consider signing up for a service that delivers meals, or purchasing frozen pre-prepared meals for a couple of weeks to make your mealtimes easier.^{[11]XTrustworthy SourceBreastCancer.orgPatient-focused nonprofit organization providing resources for those affected by breast cancerGo to source}
9
Get a hand-held shower attachment. You will not be allowed to get your incision site wet for several weeks. You can learn to sink bathe or sponge bathe, but you may prefer a hand-held shower attachment.^{[12]XResearch source}
- You may find it much easier to wash yourself in the bathtub sitting on a bath stool.
- Dry shampoo can be handy for the first couple of weeks, until you can wash your hair again.^{[13]XResearch source}
10
Rehearse doing things one-handed. A week or two before your surgery, try doing things one-handed with what will be your "good" arm. Try brushing your hair, tying it up, brushing your teeth, washing yourself, and eating. Remember that while you'll be able to move your affected arm, you won't be able to raise it above your shoulder for a week or two. You will also have little strength in the affected arm, or only have strength in certain directions.
- If you’re having a double mastectomy, be sure to have plenty of time to recover and people to help you with tasks and daily activities.

Part 2

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Improving Your Comfort During Recovery

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Get loose, comfortable clothing. You will need several changes of loose, comfortable clothes that open completely in the front. For several weeks, you will not be able to put on anything over your head, or wear anything that is close around your body or under your armpits, including a bra.^{[14]XResearch source} Acquire some comfortable items such as:
- Several nightgowns or nightshirts that button open completely in the front
- Two or three pairs of sweatpants or yoga pants with elastic waistbands
- Slippers with non-slip soles
- A loose coat or blanket to wear if it's cold
- Special mastectomy bras or bra inserts, if available^{[15]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source}
2
Set up your bedding with added support. You may not be able to lie on your side or stomach for several weeks after surgery. Try to obtain a "bed wedge" or wedged pillow, and several extra pillows. While not essential, a wedge-shaped pillow will make you much more comfortable than a stack of pillows. You will probably want some more pillows to prop you up as you sleep, and to support your affected arm.^{[16]XResearch source}
- Look for affordable wedge pillows at big box stores or your local pharmacy, or shop online.
You will likely be sent home with some medications such as pain relievers. Many of these have side effects, which often include constipation. Have some gentle laxatives available, and use them as directed by your doctor if constipation is a problem.
You will not be able to do anything strenuous or active for a while, and prescription pain relievers are likely to affect your memory and thinking, so don't plan on making any important decisions while you're using them.^{[17]XResearch source} Plan for some gentle activities that bring you pleasure. Choose activities that can be picked up and put down easily. Select reading material that isn't demanding, learn to knit, binge-watch your favorite television programs, or pick up a new hobby!

Part 3

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Coping Emotionally

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Decide who to tell. Think about how open you want to be about your upcoming surgery. Some people you really do need to tell, but generally it is up to you. There is no etiquette in cancer, and there are no social protocols for you to follow. Think carefully, and then do what's right for you.
- You do not have to go through this alone! Share your feelings and needs with those who make you feel comfortable, safe, and cared for.
2
Build a support network. You will need help after you get home from the hospital. Many health plans offer visiting nurse services to assist with changing your bandages, but they will not bathe you, cook, or do your laundry. Talk to people you are emotionally close to, and try to have someone stay with you while you recover. Share your thoughts and feelings with your partner, family, friends, therapist – people who are supportive and caring.
- Join a support group in your community or online, or consider seeing a therapist who specializes in cancer.^{[18]XTrustworthy SourceNational Cancer InstituteAn agency in the National Institutes of Health focused on cancer research and patient supportGo to source} You can find professionals in your area through the American Psychosocial Oncology Society (APOS) Helpline.^{[19]XResearch source}
3
Learn to decrease your stress. Do stress-relieving activities before your surgery like yoga, meditation, deep breathing, taking walks – anything that helps you relax. Practice these skills now and continue them after your surgery. Practice mindfulness meditation on a daily basis.^{[20]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source}
- Get clearance from your doctor before doing anything physical like walking or yoga.
Work on building up your strength and flexibility before surgery – this can help you feel stronger and more in control afterwards. For breast surgery, try to focus on your upper body and back. Feeling physically strong may help you recover better and feel emotionally strong, as well.^{[21]XResearch source}
5
Opt for or against breast reconstruction surgery. Breast reconstruction surgery can make your breast feel and look more natural following your mastectomy. This procedure can be done during your mastectomy or in a separate surgery afterwards.^{[22]XTrustworthy SourceNational Cancer InstituteAn agency in the National Institutes of Health focused on cancer research and patient supportGo to source} Breast reconstruction may not be important to you, or it may be a big part of the healing process – everyone is different. Spend some time thinking about what feels important to you, and whether further surgery may help you feel more comfortable in your body.
- Consider talking to a therapist and/or a plastic surgeon about your feelings and options.
- Every surgery has risks, including breast reconstruction; talk to your doctor for more information.
- Some organizations, such as AiRS Foundation, help women to afford breast reconstruction surgeries.

Expert Q&A

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How long until you can wear a bra? If you can't, what do you wear for other breast support?
Janice Litza, MD
Board Certified Family Medicine Physician
Dr. Litza is a Board Certified Family Medicine Physician based in Racine, Wisconsin. With over 25 years of educational and professional experience, she has extensive experience providing full-spectrum Family Medicine, including obstetrics, newborn care, and hospital medicine. She is currently the Residency Program Director for Family Medicine at Ascension. Dr. Litza received her MD from the University of Wisconsin-Madison School of Medicine and Public Health and has completed additional fellowship training in Integrative Medicine through the University of Arizona.
Janice Litza, MD
Board Certified Family Medicine Physician
Expert Answer
Initially, you will have supportive bandages around your chest. When healing has progressed, usually after a of couple weeks, you will be advanced to a soft, supportive post-surgical bra or easy fitting sports bra for support and compression.
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Tips

It takes about 3-6 weeks to fully recover from mastectomy surgery. It’s normal to have some pain, swelling, tingling, or numbness after surgery.^{[23]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source}
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Try to quit smoking well before you have surgery, because you might not be able to smoke before your procedure. Smoking also slows down your recovery.
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