Your guide to breast surgery at St Andrew's War Memorial Hospital
Your care and treatment will alter according to how you recover as they type of surgery and responses to treatment can vary from person to person. As a result this information will act as a guide for you on the care you will receive while at St Andrew's War Memorial Hospital.
During your admission you can invite a support person to accompany you during consultations with members of your healthcare team.
Whether you are having breast conserving surgery or a mastectomy as part of your breast cancer treatment plan, you are likely to require a short stay in hospital (usually one to three days).
This information will give you an idea of what to expect after your operation.
If you have any questions or concerns regarding your physical or emotional health, or any special requests for your hospital stay please talk to your nurse. This enables the healthcare team to tailor individual assistance to meet your needs.
The breast care nurse is there to help co-ordinate your care between departments, answer your questions and provide support. If you are scheduled for surgery late in the day, every attempt will be made to provide you with a ward bed while you wait for your surgery.
Your healthcare team
There are a number of people who will care for you during your stay.
- Breast Surgeon - will usually visit you daily to check on your progress.
- Plastic Surgeon - will usually visit you daily to check your progress if you have also undergone breast reconstruction.
- Specialist Breast Care Nurse - will guide you on your day of surgery and will usually visit you daily and provide a range of information and resources. She may have had contact with you pre-admission and will help co-ordinate your care.
- Physiotherapist - will visit during your stay to show and assist you with arm and shoulder exercises, provide advice regarding posture and positioning of your arm and assist with your physical recovery.
- Clinical Nurse Manager - is in charge of the ward. She will try to see you daily and assist with any enquiries you may have regarding your care.
- Nurse - will be assigned to care for you and several other patients each shift.
- Chaplains - are members of the healing team and are available for patients and their families.
Day Surgery Procedure
If you are having a day procedure, once you are awake and comfortable you will be taken to the day recovery lounges. This is where you will have something to eat and drink while waiting for your support person to take you home. You will be given information from the day surgery nurse regarding your recovery at home.
Inpatient after surgery
After surgery you will wake up in the recovery room. The recovery nurse will monitor your vital signs (temperature, pulse, blood pressure and your wound). Once you are awake and comfortable you will be taken to the ward by the recovery nurse.
Your ward nurse will continue to monitor your vital signs and your wound regularly.
You might have:
- An intravenous (IV) cannula ('drip') in your arm for fluid and IV medication.
- A drain to remove excess blood and fluids from your wound. Your surgeon will request your wound drain tube be removed when the drainage is minimal.
- A dressing over the wound.
- You will be required to wear compression stockings to prevent blood clots. Your nurse will assist with fitting these before you go into surgery. Your surgeon may request that you wear an additional compression device over the stockings. If this is required your nurse will also assist with fitting this.
- Oral tablets
- Patient Controlled Analgesia (PCA pump)
- Regularly encourage you to take deep breaths and to move your feet and ankles while in bed.
Give you ice or sips of water within one to two hours after your surgery and a light meal (as tolerated) about four hours after surgery, when you are fully awake.
- Remain with you when you get up for the first time, to assist you to the bathroom so that you can wash and go to the toilet.
- Ask if you have passed urine after your surgery.
- Monitor your recovery (and keep your team informed of your progress).
Day one after surgery
Today your nurse will help you with your recovery after surgery. You can eat and drink normally. When you are able to, your nurse will remove your IV fluids as advised by your surgeon.
Your nurse will help you to shower or sponge, depending on your wound dressings and your surgeon's preference. If you wish you can change into your own nightwear, a loose t-shirt or pyjama top (one with buttons at the front) is best.
The nurse will also monitor your vital signs and wound. You will be encouraged to walk around the ward as much as possible.
Visits from the healthcare team may include:
- Breast Surgeon
- Plastic Surgeon
- Breast Care Nurse
- Nurse Unit Manager
A breast care nurse will visit you in the ward and provide a supportive breast pillow, post surgical bra and a drain carry bag (if required). With your permission, she may also order you a My Journey Kit and a My Care Kit.
The physiotherapist will visit and show you how to do arm exercises that will help your recovery after surgery. You should perform the exercises as instructed and not overuse the arm.
You may have some wound dressings removed today (depending on your surgeon's preference).
When seeing your wound for the first time you may feel nervous, emotional or concerned.
You may have some swelling or bruising around the wound on your breast or chest. Please advise your nurse if you would like your support person present. Your nurse or breast care nurse will be able to provide support and answer your questions.
If you have a wound drain/s your surgeon will decide if it can be removed. Your nurse will attend to this. If you go home with your drain/s your breast care nurse or ward nurse will provide you with education, a booklet on drain care and extra drain bags.
Day two after surgery
As you continue to recover from your surgery you will be encouraged by your nurse to walk around the ward and perform exercises given to you by the physiotherapist.
If your wound dressings were not removed yesterday, they may be removed today or replaced, depending on your surgeon's preference.
Today, you may have further visits from your healthcare team including; the surgeon, breast care nurse, physiotherapist, nurse unit manager and chaplain. Most patients will go home either today or tomorrow. If you have had a breast reconstruction you may benefit from staying longer.
Day of Discharge
Discharge from the hospital is usually around 10am.
When you are being discharged, you will receive care instructions to take home with you.
Prior to going home you may be seen by your surgeon, breast care nurse and pharmacist.
Please ask your surgeon or nurse any questions you may have about your care.
You will be advised by your surgeon when to make a follow-up appointment.
After You Go Home
Take analgesia (pain relief) as advised by your surgeon, when required. You should be fairly comfortable by the time you leave hospital. If your pain increases contact your surgeon.
You will be able to shower normally when you go home unless advised otherwise by your surgeon. Wash your wound or around your wound in the shower and pat dry with a clean towel. If your wound becomes more red, leads fluid or feels hot or tight please ring your surgeon or breast care nurse for advice. If you are unable to contact your surgeon or breast care nurse, ring your GP or the hospital ward you were admitted to following surgery.
The amount of drainage from your wound should decrease over the next few days. You need to record the amount at the same time each day. The amount of drainage may decrease then increase again before it settles to a regular daily amount. This is not unusual, particularly if you are overusing your arm. If you experience increased swelling and pain in your armpit and no drainage please contact your surgeon or breast care nurse. Ring your surgeon or breast care nurse if you are concerned about the amount of drainage.
Aiding Your Recovery
- Maintain a healthy, well balanced diet.
- Perform your exercises as instructed by your surgeon and physiotherapist. The exercises become easier and you should experience less discomfort as you recover.
- Gradually resume normal activities.
- Initially avoid heavy lifting and vigorous sport and activities, as advised by your surgeon. Your surgeon will advise you about returning to work, participating in sport and commencing driving.
Importantly, be kind to yourself and do what makes you feel comfortable and helps you recover.
You will be advised when to make an appointment with your surgeon(s). It may be within a week of discharge if you still have drains in, otherwise up to four weeks after discharge.
Your breast care nurse will ring you at home one to two weeks after your discharge and can be contacted by telephone for any issues or concerns you may have. If you live in a regional area, contact with a breast care nurse in your local area can be arranged by the St Andrew's breast care nurse.
A follow up telephone call is also available to you from someone who has personally experienced breast cancer. This type of support is valuable because of your shared cancer experience. You can connect with this support at anytime after discharge through:
Choices Program on 3377 9871 or the Cancer Council QLD Helpline on 13 11 20, Monday to Friday.
Breast Care Nurse
The breast care nurse at St Andrew's War Memorial Hospital is a registered nurse who has specialised experience in breast care nursing. She is there to offer you and your family emotional and practical support throughout your entire breast cancer journey.
Breast care nurses are part of the multidisciplinary team caring for women with breast cancer. They work in close collaboration with other specialists including surgeons, oncologists, physiotherapists, dieticians and other specialised nurses.
Role of the Breast Care Nurse
- Give support and information to women with breast cancer, their family and those who care for them.
- Ensure high standards of treatment in breast care nursing.
- Make women living with breast cancer more aware of the support services available in the hospital and community.
- Care for men with breast cancer.
The St Andrew's Breast Care Nurse is available to:
- Answer your questions.
- Explain your treatment.
- Provide information on treatment for breast cancer.
- Provide support on your day of surgery.
- Explain what happens during your stay in hospital.
- Visit you during your hospital stay.
- Give you emotional support.
- Provide information on breast prostheses and breast reconstruction.
- Refer you to other services if needed and ensure you are aware of what is available to you when you leave hospital.
How to contact our Breast Care Nurse
Natasha our specialist breast care nurse welcomes your direct contact via phone, email or by pre-arranged appointments.
Natasha can be emailed at firstname.lastname@example.org