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Managing Your Medical Care: Breast Cancer: Once A Treatment Decision Is Made

If You Are Going To Have Surgery

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The Surgeon

Decide who will be the surgeon if you haven't already. Ideally, the surgeon should:

  • Be a board certified surgical oncologist (a surgeon who specializes in cancer), with a great deal of recent experience in the type of operation you have agreed to.
  • Operate in a first quality hospital with a low infection rate and back-up in other specialties in case anything goes wrong.
  • Satisfy whatever additional requirements you have. For additional factors to consider when choosing a surgeon, see our article: How To Choose A Surgeon.

Prepare for meetings with the surgeon as you would with any specialist: 

The Hospital Or Other Facility

If the surgery will be performed on an outpatient basis:

  • Learn about the facility’s emergency procedures. Be sure doctors qualified in other specialties are available in case something goes wrong and they are needed.

If you will stay in the hospital, at least overnight:

  • Learn what you need to know about how to maximize your time in a hospital and to minimize risk of infection. Hospital related infections can be dangerous. (See Hospitals: How To Avoid Infection & Medical Error
  • One of the things that you will learn from our articles about hospitals is that it is preferable to have a family member or friend stay with you as much as possible to act as a patient advocate.

Set A Date That Works For You As Well As The Surgeon

In hospital surgeries should be scheduled for early in the morning, early in the week - not just before a holiday or weekend.  

  • Doctors are more fresh when they start their day, and schedules are less likely to be backed up. . As a side benefit, if you have to stop eating the night before, you don’t have to be hungry in the morning for longer than necessary.
  • Hospitals tend to have limited staffing on weekends and holidays. If surgery takes place early in the week, you have the rest of the week at full staffing if needed.

Elective surgery should not be scheduled for the end of June or beginning of July when residents just start practicing medicine.

If you work:

  • Consider planning surgery for vacation time or during business slow times. 
  • If you schedule outpatient procedures for Friday afternoons, you have the weekend to recover with minimal loss of work. 
  • Schedule doctor appointments for your convenience.
    • An appointment early in the day or at the beginning of that part of the day when the doctor sees patients generally gets you in and out quickly. Doctors' schedules tend to back up as the day progresses.
    • If you have appointments with different doctors and/or tests coming up, consider scheduling them for the same day or only setting doctor appointments for the same day every week.

Preparation For Surgery

Find out what medical preparation to expect before breast surgery and what you should or should not do to maximize chances of success. For example:

  • There may be medications, supplements, herbs and/or vitamins you take that the doctor will want you to discontinue for a period prior to surgery. For example, aspirin or blood thinners.
  • If you use recreational drugs, let your doctor know. They may affect surgery.
  • If you smoke, the doctor may want you to stop for a number of days before surgery. Stopping can help improve the body’s response to treatment, and lessen complications and side effects. If you quit permanently, stopping can decrease the risk of recurrence and enhance survival.

If a lymph node will be removed, learn how to help prevent and control lymphedema after the operation.

Schedule a dental exam. Prior to surgery is a good time to take care of any oral problems. Mounting evidence indicates that poor oral care can worsen serious medical problems. Infections can impact surgical outcomes.

Discuss pain medication for after surgery with your surgeon or ask him or her if you can speak with a pain specialist.

  • Proper pain medication helps speed recovery and shortens the amount of time patients have to spend in the hospital.
  • Pain medication used as prescribed for pain is not addictive.
  • Fill pain prescriptions now so there won't be unnecessary pain after the surgery until the prescription is filled. 

Put together items that you can take to the hospital that will make your stay in the hospital more comfortable. For instance:

  • Family photos
  • Earplugs and a sleeping mask so you’re rest is not disturbed by hospital noise,  light,  or noisy roommates.
  • A favorite pillow that is marked so it not confused with hospital pillows.
  • A pad with which to make notes about services provided (so you can later check against your bill. A large percentage of hospital bills are wrong. It is advisable to check them – even if an insurance company pays.  (To learn how to check hospital bills, click here.) 
  • Loose clothes to wear home.

Think about who will drive you home, particularly if a procedure will be performed on an out patient basis.

Think about what you will need once you get home. For instance:

  • Minimize the need for shopping and cooking by stocking your freezer with ready-to-heat foods.
  • Put a family member or friend in charge of setting a schedule for family and friends to help, at least for the first few days after getting home – or arrange for home health care. 
  • Do all the predictable chores before going into the hospital – for instance paying bills. Credit is important after a diagnosis and you should do everything you can to protect it – and even improve it. (See Credit: Score, Getting, Fixing)

When you are ready, learn what to expect after surgery. If you are going to have a mastectomy and you haven't already considered it, this is the time to think about reconstruction. Basic reconstruction can be started at the same time as the mastectomy. For information about reconstruction, see the American Cancer Society's web site: offsite link

NOTE: If you have children, and haven’t told them about your condition and/or treatment, now is the time to do so in an age appropriate manner. For more information, click here.

A few post-surgery comfort tips

  • Pain: There is no reason to be in pain. Ask your doctor ahead of time for pain medications. That way you won’t have to take time to fill the prescription after the surgery. Many doctors under treat pain. Patient advocates suggest that you stay ahead of the pain by taking medications as prescribed rather than waiting to feel the pain. (Also consider medications or stool softeners to counteract the constricting side effect of pain medications).  It is a myth to think that you will become if you take pain medications as directed for pain. (Abusing pain medications may indeed result in addiction). For more information about pain, see Pain 101
  • Coughing: When you cough, you may feel that your incision is going to break apart. A time tested tip is to use a pillow for support when you cough. 
    • If your incision is in the front, hold the pillow against your chest. Fold your arms across the pillow. Then cough.
    • If your incision is on your side, hold the pillow under your arm. Press the pillow against your side. Cough.
  • The Incision
    • If you are feeling more than discomfort in or near your incision, let your doctor know. There may be an infection or you may not be receiving enough pain medication. (For information about pain, see the Survivorship A to Z document about pain which includes information about medications).
    • Once the bandage is removed, consider applying a cream that will keep the incision site moist and help reduce the size of the scar. Speak with your local pharmacist.
    • Wear soft, loose clothing over the incision.
    • if your incision is irritated by your bra, speak with an expert who works with bras for women with mastectomies. Many department stores and some pharmacies provide this service free of charge.
  • For more information about medical care:

Paying For Surgery

If you have health insurance, check your coverage:

If you are not insured, you may be able to obtain surgery for low cost. See How To Obtain Surgery Without Health Insurance. Also see Uninsured

For additional information, see: Preparation For Breast Surgery

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