Ductal Carcinoma in Situ (DCIS)

Mastectomy: the operation

Most women had surgery shortly after being diagnosed and found this reassuring because they wanted treatment as soon as possible. Some, though, said they would have liked more time to think about or come to terms with it and felt that things moved a bit too quickly from diagnosis to surgery. One woman, who had a mastectomy a few days after diagnosis, said she felt ‘pushed’ into having it so quickly. A younger woman with DCIS said she had to rush around organising childcare as well as come to terms with the diagnosis because the surgery was booked so soon after diagnosis.
Many women talked about their feelings the day before surgery and on the day itself. For most, it was their first time to have surgery and some said they found it hard to sleep the night before. Several were worried about having a general anaesthetic. On the day itself, many women said they felt anxious or apprehensive. Some were very upset, and one said she found it ‘surreal’ because she was being treated in the same hospital in which she worked.
At the hospital
 
Some women said that, at the hospital, they waited several hours ‘doing nothing’ before they were taken to theatre. They’d been allowed no food or drink and ‘waiting around’ just made them more anxious. A few said they had expected and would have liked to talk to their breast care nurse at this time for reassurance and support.
 
Most women said they were surprised that they felt no pain when they came round and, though they were attached to a tube to drain fluid from the wound, they felt well. Several said they felt very relaxed because of the drugs they’d been given, though others felt tired and groggy because of the anaesthetic. A few had reacted badly to the drugs and felt sick or were shivering. Many of the women who had immediate breast reconstruction remembered having frequent checks by nurses, some saying it was difficult to rest or sleep but they knew these needed to be done.
Women said nurses encouraged them to get out of bed and start moving around as soon as possible after their operation. Some found it uncomfortable to move their arms very much at first, though many were eager to be mobile again as soon as possible. Although most women were happy with the nursing care they received, a few said the pain control was poor or the nursing care disappointing and this made their experience on the ward very difficult.
Some women were on a ward with other breast cancer patients, while others were in a mixed ward with patients who’d had various kinds of surgery. A few women found the ward noisy and were pleased to be discharged so they could get the rest they needed at home. One woman said she went to see the ward before going into hospital and chose to have a private room because she was worried about not getting the sleep she would need. Some women said they liked having the company of other patients around them, though a few said they would have liked more privacy.
The drainage tube is usually taken out by the nurses on the ward within a few days of the operation. Many women said that, shortly after their drains had been removed, they were allowed to go home. Women who have had a mastectomy usually stay in hospital for 3–5 days after their operation. Those who have breast reconstruction at the same time as the initial surgery could be in hospital for up to a week, depending on the type of reconstruction.
 
Women who chose not to have immediate breast reconstruction were given a lightweight foam prosthesis (false breast), which they could put inside their bra. This is sometimes called a cumfie or softie. It is designed to be worn immediately after the operation when the area feels tender. When the wound has fully healed, women can choose a permanent prosthesis (see Prostheses).
 
DCIS does not generally spread to the lymph nodes in the armpit (axilla), but sometimes, if the area of DCIS is large or widespread, a few lymph nodes may be removed during the surgery and checked for cancer cells. This is because, for some women, there may be an area of invasive cancer cells within the DCIS which could spread into the lymph nodes. Before surgery, the doctor discusses whether it is necessary to remove any lymph nodes. A few women said they had a sentinel node biopsy before or after surgery.

Last reviewed October 2013.

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