Recovery and long-term follow-up

The first days at home: comfort and immediate care

• Early mobilisation: Rest is essential, but prolonged bed rest is contraindicated. Gentle walks around the house stimulate blood circulation and reduce the risk of thromboembolic complications.
• Pain control: Post-operative discomfort is mild to moderate. Take the prescribed painkillers and anti-inflammatories according to the schedule set at discharge, without waiting for severe pain to set in.
• Sleeping position: For the first 2–3 weeks, sleep only on your back, with the trunk slightly raised on two pillows (at 30–45°). This posture reduces tension on the incisions and local swelling. Sleeping on your stomach or on the operated side is strictly forbidden at this stage.
• Hygiene: The wounds must be kept clean and dry. A full shower is allowed only with your doctor’s approval (usually after the drains and waterproof dressings have been removed). Until then, a partial sponge wash is recommended, protecting the operated area.

Caring for the drains (if you have them)

In mastectomies, reconstructions or axillary clearances, suction drains are often placed to remove lymph and residual serous fluid:

• Empty and measure the volume of fluid collected every day, noting the amount in a notebook.
• Keep the drainage container below chest level and fixed to your clothing to prevent accidental traction.
• The drain is removed in the clinic, simply and quickly, usually when the output falls below 20–30 ml/24 hours.

Recovering arm mobility and preventing lymphoedema

After operations on the breast and armpit (especially after axillary lymphadenectomy, but also in the initial phase after sentinel lymph node biopsy), the shoulder may be stiff:

• Adapted physiotherapy: Start gentle exercises for the fingers, wrist and elbow within the first 24–48 hours. Exercises for shoulder rotation and raising the arm above the head are introduced gradually, following the instructions received at discharge (usually after the drains are removed).

Preventing lymphoedema (on the operated side)

• Avoid blood draws, injections, infusions and blood pressure measurement on the arm on the side where the armpit was operated.
• Protect the arm from cuts, burns (cooking, ironing), insect stings or animal scratches.
• Do not wear jewellery or tight clothing on that arm, and avoid lifting heavy weights (over 2–3 kg in the first month).
• Report immediately any feeling of heaviness, tension or thickening of the arm or hand.

Caring for scars and tissues

Complete maturation of a scar takes between 6 and 12 months:

• Initial phase: After the stitches are removed or absorbed, the wound must be kept clean and moisturised.
• Silicone-based gels and strips: They can be applied once the incision is completely closed (no open scabs) to prevent hypertrophic scars or keloids.
• Scar massage: Gentle massage with a moisturising/silicone cream is started only on your doctor’s recommendation, helping to loosen subcutaneous adhesions.
• Strict sun protection: Protect the scar from direct sunlight for at least 1 year (using SPF 50+ cream or protective clothing) to avoid permanent hyperpigmentation.

Returning to daily activities

Medical bra

Worn continuously (day and night) for 4–6 weeks, taken off only for washing.

Driving

It can be resumed after about 2–3 weeks, when arm mobility is completely pain-free, your reflexes are reliable and you are no longer taking painkillers with a sedative effect.

Work

Returning to an office job is possible within 1–3 weeks (depending on the operation). If the work involves sustained physical effort or lifting, the rest period is extended to 4–6 weeks.

Sport

Walking outdoors is recommended from the first week. Light gymnastics, swimming or running are resumed only after 6–8 weeks, with your doctor’s approval.

The oncological follow-up protocol (surveillance)

Surgical treatment is completed by regular oncological monitoring, set in line with international guidelines (NCCN / ESMO):

• Early post-operative check (at 1–2 weeks): Assessment of the wounds, removal of stitches/drains and communication of the final histopathological result. Setting the plan in the multidisciplinary board (Tumor Board).
• In the first 2–3 years: Clinical consultation every 3–6 months, accompanied by laboratory tests as recommended by the oncologist.
• Follow-up imaging:
  • Bilateral mammography (or of the remaining breast) every year
  • Breast ultrasound at 6–12 months
  • Abdominopelvic ultrasound, chest X-ray or other advanced imaging (CT, MRI, bone scintigraphy) set case by case by the oncologist
• After year 5: Clinical and mammographic evaluation once a year, for life.

Warning signs: when to contact the surgical team

Get in touch with your doctor without delay if you notice:

• Fever (≥ 38°C), with or without chills
• Marked redness, local warmth, induration or purulent discharge at the wound
• Sudden, massive and painful swelling of the breast, chest wall or armpit
• Marked oedema (visible swelling) that appears in the arm or hand
• Acute pain that does not respond to the prescribed medication
• Opening of the edges of the incision or a drain tube coming out

For major medical emergencies, call the single emergency number 112 immediately.

Frequently asked questions