The physical healing process after early breast cancer surgery is a significant part of recovery, requiring careful attention. This involves understanding the wound, managing its care at home, recognizing normal healing signs, and adapting to the long-term presence of a scar.
Understanding the Surgical Wound
The appearance and size of a surgical wound after early breast cancer treatment vary by procedure. A lumpectomy, also known as breast-conserving surgery, removes the tumor and surrounding healthy tissue, leaving most of the breast intact with a smaller incision. A mastectomy removes the entire breast, resulting in a longer chest incision. Lymph nodes in the armpit may also be removed, creating an additional incision.
Immediately after surgery, the wound is covered with a dressing, which may be waterproof. Surgical drains, thin tubes connected to a collection bulb, may be placed to remove excess fluid from the surgical site. These drains help prevent fluid buildup, known as a seroma, which can cause discomfort and delay healing. Drains typically remain for several days to a few weeks, depending on the amount of fluid collected.
Caring for the Wound at Home
After surgery, a dressing covers the wound, and specific instructions will be provided on when and how to change it. Some waterproof dressings can remain in place for up to a week or until the first follow-up, allowing for showering. When showering, use mild soap and water, gently wash the incision area, and pat it dry. Bathing is not recommended until the wound has fully healed.
Patients are advised to avoid heavy lifting, strenuous physical activity, and activities that strain chest muscles for several weeks. This includes refraining from high-impact exercises that can jostle the surgical site. Gentle arm exercises are encouraged to maintain range of motion, but specific guidance should be followed, especially if drains are still present.
Identifying Normal Healing and Potential Concerns
The wound healing process involves several stages, and it is normal to observe certain changes. Initially, the surgical site may appear red, swollen, and tender, with some bruising. This is part of the inflammatory phase, where the body works to clean the wound and begin repair. Over the following weeks, the wound edges will close, and new tissue will form, which may appear pink or reddish and can feel firm. Mild itching around the incision is also a common part of the healing process.
However, certain signs indicate a potential complication or infection, requiring prompt medical attention. These include increased pain, spreading redness or warmth around the wound, excessive swelling, or a fever above 37.5°C (99.5°F). Any thick, cloudy, or foul-smelling discharge from the wound, or if the incision separates, are also concerning symptoms. While minor drainage is expected initially, persistent or excessive discharge suggests a problem. Contacting a healthcare provider immediately for any of these signs is important to ensure proper management and prevent further issues.
Living with the Wound and Scar
The surgical wound eventually matures into a scar, a natural part of the body’s healing. Scars initially appear red, raised, and firm as collagen is produced to strengthen the area. Over several months to a year or more, the scar gradually flattens, softens, and its color fades, becoming less noticeable. Complete scar maturation can take up to two years.
Scar management techniques can help improve the scar’s appearance and flexibility. Once the incision is fully healed, typically around two weeks post-surgery, gentle massage with an unperfumed moisturizing cream or oil can be beneficial. This helps keep the skin supple and prevents the scar from sticking to underlying tissues.
Silicone gels or sheets may also be recommended by a surgeon to help reduce scar size and redness. Protecting the scar from sun exposure with sunscreen is also important, as new scars are sensitive to ultraviolet rays. Living with a surgical scar after breast cancer is a personal journey, and support from healthcare teams can address any concerns about its appearance or sensation.