Surgery: What to Expect

The hospital stay

If you are having a lumpectomy with no lymph node dissection, it's likely that your surgery will be done on an outpatient basis. This means that you can go home on the same day you have your surgery. Mastectomy and lumpectomy with lymph node dissection are more invasive surgeries and require general anesthesia and a hospital stay.

Donating blood

Some doctors recommend that you donate a pint or two of your own blood for the bigger operations, such as mastectomy and reconstruction. This is just to make sure that some is on hand if it is needed. It rarely is, but having it there may make you feel more comfortable.

Your medical history

Your medical history plays an important part in keeping you safe during surgery. This is not a time to hold back any information, even if you think it's irrelevant or find it embarrassing. Tell your doctor or the hospital staff EVERYTHING. No matter what kind of operation you're having, you must inform your doctor of 1) any past bad reactions to drugs (including allergies) or procedures, and 2) any drugs you're presently taking or have just stopped taking (prescription, non-prescription, "recreational") before surgery. Your doctor will ask you to stop taking aspirin and any non-steroidal anti-inflammatory drugs (such as ibuprofen) several weeks before surgery.

Any medications you take can have serious effects on your body's ability to handle the shock of surgery and heal well afterwards. Again, no one wants any surprises during surgery.

Timing and your menstrual cycle

There is still some question about whether the timing of surgery in relation to the menstrual cycle has any effect on its success. You may want to discuss this with your doctor.

Food and drink

Your doctor will tell you not to eat or drink anything after midnight on the night before surgery with general anesthesia. This is to reduce the chance that food and stomach acids might be vomited during surgery and enter your lungs while you are under anesthesia. This is a rare but potentially very serious complication of general anesthesia, so you should take to heart the rules about food and drink after midnight.

A buddy is a good idea

If you are going to have same-day or outpatient surgery, you're required to have someone with you to help you get home. Even if you are very strong and independent, find someone to be there with you. It's nice to have someone with you no matter what kind of surgery you're having. Just the process of being admitted to the hospital can be overwhelming. Going home on the same day is challenging. Many of the medications used during the surgery will still be in your system, making it hard to get around.

If you are staying in the hospital overnight and want your friend or relative to be admitted to your room after surgery, be sure to tell your doctor or the hospital staff.

Anesthesia

You'll probably meet your anesthesiologist before your surgery to talk about your medical history, any allergies you may have, and the plan for administering anesthesia during your surgery. Since most breast cancer surgery happens outside of the body's core, on top of the ribcage, you probably won't have the deepest kind of anesthesia. For lumpectomy, most patients have only a mild sedative to help them relax and a local anesthetic to numb the area involved in surgery.

If you are going to have general anesthesia, the process usually goes something like this:

• A nurse will insert a needle connected to a long tube—usually in your arm—and tape it in place. This is the IV (intravenous infusion) line, which the surgical team will use to administer fluids and medication without having to stick you each time medication is required.
• A nurse or anesthesiologist will give you a medication through the IV line to put you to sleep. Most people find this a pleasant experience. By the time you reach the operating room, you will probably feel calm and relaxed—even if it's only due to drugs!
• Once you are asleep, the anesthesiologist will place a mask over your nose and mouth to administer an anesthetic gas such as nitrous oxide or Ethrane (enflurane). The gas will keep you asleep and pain-free during surgery. The anesthesiologist, who will watch you during the entire surgery, will continue to administer this gas for as long as it is necessary.
• The entire team, and especially the anesthesiologist, will monitor your vital signs (heart rate, blood pressure, and respiration) throughout the surgery to make sure that your body's systems are functioning normally.

Final preparations

Just before surgery, your skin will be cleaned with an antiseptic solution, and your body will be covered with a sterile drape, leaving only the area to be operated on uncovered.