BREAST SURGERY USUALLY FALLS INTO TWO BROAD CATEGORIES
- Breast lesion surgery ( where a breast lump is being removed or in the case of cancer sometimes the breast is removed such as in a mastectomy). Sometimes these surgeries may include operating on the lymph nodes in the armpit as well.
- Reconstructive surgery where surgery is performed to alter the shape and size of the breast. See the page on reconstructive surgery for more information
BEFORE YOU GO TO SLEEP
If you haven’t already met your anaesthetist you will meet them either on the ward or in the anaesthetic bay on the day of your surgery. At this stage if you have any concerns or worries about your operation or anaesthetic please let them know.
Once in the anaesthetic bay you will have an intravenous drip placed and often you will be given a sedative “relaxing medication” just before going into the operating theatre. You often will not remember much after being given the sedative. Once inside the operating theatre you will have several monitors placed (these monitor things like your blood pressure, heart rate and breathing patterns). Once these are placed you will be given an oxygen mask and then receive another injection through the drip. This injection will put you “to sleep”.The next thing you will remember is waking up either in the recovery room or in the operating theatre.
During the operation your anaesthetist will remain with you monitoring your operation, anaesthetic and all your vital physiological functions. They stay with you until you reach the recovery room where your care will continued by the recovery staff. While you are in recovery if you have any discomfort or feel nauseous or sick it is important that you let the recovery staff know. They can administer pain killers or anti nausea drugs if they are required. Generally speaking, if we get you comfortable by the time you leave recovery you will then have good on going pain control
YOUR STAY IN HOSPITAL
Depending on the extent of your surgery you may be able to go home on the same day as your surgery.The operations where you can commonly go home on the same day as surgery are
- Breast lesion excision (lumpectomy).
- Breast lesion excision (lumpectomy) and sentinel lymph node excision.
More extensive surgery such as mastectomy or axillary dissections will general require admission to hospital and the duration of your stay will depend on the extent of your surgery.
For breast lesion surgery, we can often fill the area operated on with local anaesthetic that will give you good pain relief for up to 24 hours. Once this wears off many of the patients I speak to describe the pain as being like the pain you get with a bad bruise or muscular pain rather than sharp pain. You will be placed on regular paracetamol for several days as well as having stronger pain killers available to you, that you can take on top of the paracetamol should you require it.
Similarly for operations in the axilla we can often fill the area with local anaesthetic which will help greatly with any pain you may have. Your pain management will be similar to that for breast lesion surgery with regular paracetamol and stronger pain killers if needed.
For patients having a mastectomy significant postoperative pain is uncommon, this probably partially due to the fact that many of the nerves that would normally cause pain are disconnected or “denervated” at the time of the operation. Your pain management will generally be the same as for breast lesion surgery mentioned above. It is important if you do have any issues with your pain management you talk to your anaesthetist and surgeon as there is a very small percentage of patients who can have significant pain issues and there are several things we can do to improve your outcome.
General speaking most of our patients go home very comfortable, occasionally you may go home with a drain in, which is managed by your specialist surgeon and home nursing care. From a pain point of view you will generally go home taking regular paracetamol and a prescription for some stronger pain medication if it is required. In most cases it is not. If you have any issues wit your pain control or anything else please do not hesitate to contact your anaesthetist.