1 - 2 days

You will have pain at the site of the scar and you may or may not have a drain in place. Be careful not to snag or pull the drain tubing on objects. When you leave hospital (normally within 1–2 days, or even the same day if you have had a day-case mastectomy) you may well still have a drain in place; this will be looked after by the district nurse.

You will also feel a lot more tired than normal; take things easy, rest often for short spells.

• Get up, get dressed, move around.
• Eat and drink as normal.
• Do the shoulder exercises you’ve been given.
• If you feel tired, rest for a while and try moving around again later.

No

3 - 7 days

There should be less pain in and around your scar. You should be able to get up and dress as usual. Try using the “softie” in your bra. You’ll get tired more quickly than you did before the operation. Although you may feel independent, shopping and housework will still be difficult so avoid these activities and get some help in the house for the first 2 weeks.

• Continue as on days 1–2; try to take short walks. If you have a dog and need to hold its lead, walking alone may be difficult if you have shoulder pain or if you have had surgery to the armpit, so consider walking with a friend.
• You may still occasionally need to take a mild painkiller at this time.
• Check you do not have swelling at your wound site.

No

8 - 13 days

You’ll probably be able to do many things as normal, most of the time. Be careful if the mastectomy side is the same side as your dominant hand (preferred hand) as you may have more pain in the scar as you begin to use your hand and arm more regularly. As well as everyday jobs, it’s very important you continue to do the shoulder exercises to regain good shoulder movement.

As your clinic date gets closer you might start to feel anxious about your results – this is normal.

• Continue to build up the amount of activity you’re doing towards your normal levels.
• Keep up your shoulder exercises; go for short walks each day.
• Some women may want to try working from home at this point. Shoulder pain and armpit surgery may make it difficult to use a computer keyboard or even hold a telephone, so don’t try to do too much at this stage.

No

14+ days

You should be feeling physically stronger each day. Initial discomfort should have settled and wearing a bra and “softie” will be more comfortable.

You should have an appointment arranged to discuss your histology (cancer results) with your surgeon and breast care nurse. At this meeting your scar will be checked and further treatment will be planned:

• If you require more surgery, you will be given a date for admission.
• If you require chemotherapy and/or radiotherapy, you will be referred to the specialist teams for discussions about your treatment.
• If you require anti-hormone treatment (tablets) only, or no further treatment, you will be given your follow-up appointment and you can discuss with your GP and employer about planning a return-to-work date.

• Talk with your doctor and occupational health team at work about plans for going back (if you haven’t already).
• Keep up your exercises.

Thinking about it; many women will be able to return to work in a management or light administrative role at this stage, starting with reduced hours while they settle in and regain fitness and confidence. Shoulder and arm symptoms may make it difficult to do some physical tasks, particularly heavy lifting or reaching. You should discuss adjustments to duties with your employer if you wish to return to work now.

6 weeks

Check your shoulder and arm movements are back to normal; if you have a stiff shoulder you will need to contact your GP, breast care nurse or surgeon. You may need to be referred to the physiotherapy team for additional help and exercises.

You can have your permanent prosthesis measured and fitted by the breast care nurse.

If you work, it’s your decision when you decide to go back, but if you’re off for too long, there’s a risk of developing problems to do with anxiety, isolation and lack of confidence. These could affect your quality of life in the long-term. Talk with your GP about how best to avoid this becoming a problem for you or have a chat with your occupational health doctor or nurse and employer about a gradual return.

Yes, although a few women may have problems with arm pain or swelling. They won't be harmed by work but may have difficulties reaching or with heavy lifting. A temporary change to lighter physical work and shorter hours can help.

It is common to feel tired towards the end of radiotherapy treatment and for a few weeks afterwards. Consider working reduced hours or fewer days for this period.