Breast Resources & Support

Before your surgery, it is important to educate yourself about as many options as possible. It is a great idea to have an active support team of friends or family who can help sort out the wealth of information available courtesy of the internet, media and your medical team. The doctor or surgeon is the source of information valued by the majority of patients as the most authoritive. After learning as much as you can about the various treatments, you are much better prepared to ask your doctor specific questions. Here is a list of good questions:

• What kind of surgery are you recommending for me?
• How much of my breast will be removed?
• What are the risks of this surgery?
• What are the risks if I decide not to have the surgery?
• Why do I need this particular procedure?
• What kind of incision am I going to have?
• Will I have a lymph node dissection? If so, how many lymph nodes do you anticipate will be removed?
• What are my options for anesthesia?
• Will you come to see me following surgery?
• How long can I expect to stay in the hospital?
• What kind of follow-up care will I need?
• How will I feel after surgery? Will I need pain medication?
• How long will my recovery take?
• Are there symptoms I should be aware of that would alert me to contact you immediately?
• How often will I see you for follow-up care?
• If I have a mastectomy, am I a candidate for reconstruction? What options do I have?
• If I decide on reconstruction, what type of reconstruction would you recommend?
• Do you have photos of other surgeries you have performed that I can see?
• How long will an implant last? What happens if I gain or lose weight?
• How much pain or discomfort can I expect after reconstructive surgery?
• Will I need more than one surgery? Will they all require general anesthesia?
• When will you have the results of my pathology tests? Will I come in to discuss them or will you phone me?
• Will my medical insurance cover all charges from you and the hospital?
• What restrictions, if any, will I have on my normal activities while recovering?
• How much help will I need at home to care for the drains and surgery site?
• Will you be recommending physical therapy for me as part of my recovery?
• Should I expect swelling in my arm? What steps can I take to help prevent the onset of lymphedema?

Although it can feel overwhelming for you to make decisions about your treatment, doctors and others in the medical field have found that the happiest and most satisfied patients are the ones who are active participants in their treatment process. Allow yourself plenty of time to think things over. Consider getting a second opinion if you feel uneasy or feel your questions have not been adequately answered.

Be prepared with a checklist of tasks to complete and items to have on hand prior to surgery. Tasks such as the logistics of transportations, planning for child or pet care, along with other jobs that you would normally be in charge of are best handled prior to surgery or, better yet, handled by a family member or close friend.

Items to have on hand prior to surgery are your insurance card, identification, a list of medications you are currently taking, a list of any drug and food allergies or sensitivities you have.

While in the hospital recovering from your surgery, you may want to go over your list of questions once again to that you will know if you need additional information about caring for yourself or what to expect after being released from the hospital. The hospital staff is a good source for a list of support groups for breast cancer survivors. Support from others who are going through the same treatments or who have had similar experiences in the past can be a wonderful source of relief and companionship.

Follow up with your doctor or the American Cancer Society for rehabilitation exercises. It's important to exercise as side effects of your surgery may be lessened. Starting slowly to rebuild your strength and mobility can be a real confidence builder and lead to optimism and a better quality of life.

excerpted from the American Cancer Society - Exercises After Breast Surgery

It is important to talk with your doctor prior to starting the exercises so that you can decide on a program that is right for you.

The week after surgery:

During breast cancer treatment, the most important nutritional goal is to maintain a caloric balance. You may find small, frequent meals are better tolerated than three large meals.

Following treatment, eating well helps the body recover more efficiently and quickly. Consult with your doctor about any dietary restrictions, and then aim to select a variety of foods from all food groups. In addition to five colorful fruits and vegetables daily, eat high fiber foods, and stick with low fat milk or dairy products. For help with a well balanced and well-tolerated diet plan, visit the American Cancer Society web site, and look for Nutritional Guidelines for Cancer Survivors.

As you recover, be patient with yourself and ease back into regular meals. Prepare simple meals, visit the grocery store's salad bar and prepared foods sections, and don't hesitate to ask family or friends for assistance with shopping and cooking.

Following surgery, you will likely be fitted with special bras or camisoles that are soft and have features to accommodate any post-surgical drains, etc. Some forms of reconstruction will require binding or compression to help support the new surgery while healing.

The bras will probably be front closure or allow you to step into them so that you do not have to lift your arms while recovering.

American Breast Care features the 110 leisure bra. This bra has a front closure and is made of soft cotton to prevent any irritation. The bra has pockets to accommodate a post-surgical breast puff, if necessary.

The ABC 110 bra is also available as the 914 post-surgical kit with a puff and drain pouches.

If you are in need of something to recapture symmetry, there are several products available to help.

Ideally, prior to surgery, you will have a chance to see some of the products available for after surgery. At this time, the certified fitter can go over some of the options for breast forms, partial forms and shells, and the bras available.

After your surgical site has healed, (approximately 4 to 6 weeks) you can make an appointment to be fitted by a certified fitter of breast forms and bras. She will measure you for the correct bra size, and evaluate your needs. You will be fitted with various styles of bras to meet your requirements, and will try some breast forms to help recreate symmetry. There are many styles of bras available from ABC. Our most popular style is the seamless molded cup pocketed bra. This bra provides a fashion-forward look with the practicality of a mastectomy bra. This bra is available with or without an underwire. ABC bras come in various styles from soft and lacy to M-frame which provides needed support for larger breasts.

Upon receiving your form and bras, you will probably find that you wear time will be modified. You may experience discomfort or sensitivity of the chest wall. You may feel fatigue in your neck or shoulders. You will want to build up to wearing your prosthesis full time. Start with a few hours each day, gradually increasing your wear time until it is a daily routine.

Along with these changes, you can expect that your surgical site will also physically change. These changes can go on for as long as six months and include swelling, skin changes, and settling of tissue. This is all part of the healing process.

There are various styles of pocketed bras available through American Breast Care. The bra style that fits you best will depend on your body and breast typ0e. In addition to a bra to wear under clothing, you will find leisure bras and camisoles with integrated bras available as accessories to complete your wardrobe.

Breast forms are available for various body and breast types as well. Most breast forms are made of silicone, which mimics the feel and weight of the breast tissue very well. Your fitter will show you styles that best suit your needs.

The breast forms are available in various weight silicones. The light weight silicone is widely available, since it's a bit lighter than the standard silicone, thus relieving some of the weight on your neck and shoulders. The standard silicone sill has its advocates, and some women prefer the full weight of the standard silicone because it feels the best to them as a breast replacement. A newer lighter weight form, the American Breast Care Ultralight, is the most popular ABC breast form. This form is good for women who have some physical limitations or experience sensitivity making it difficult to wear a form against their bodies. Of course, there are women with no complications who just want the lightest form available because they feel like there's nothing there and it tends to feel cooler to them.

There are also partial breast forms, shapers, or shells, available for women who have had breast conserving surgeries and need a little shaping to fill out their bra cups. Shapers are also useful for women who are going through the reconstruction process. The various shapers help to fill out the bra cups while in the midst of using expanders or as the stages of reconstruction occur.

Lymphedema is a condition seen following breast surgeries in 12% to 25% of breast cancer surgery cases, particularly in those who experience auxiliary lymphadenectomy followed by radiation therapy.

With lymph nodes damaged or removed, the lymphatic fluid may build up in skin tissue rather than being transported to the capillaries for distribution and removal. The build up of fluid leads to swelling in the arm or surgical area that can affect the way clothing fits. In some cases, if left untreated, lymphedema can cause extreme swelling leading to skin infection and oozing.

There are lymphedema therapists available to help redirect the flow of the lymph fluid manually and with pumps. The patient with lymphedema can be taught some techniques for self-massage to help with any swelling between therapy sessions. Special compression garment help to minimize the swelling and direct the lymph fluid flow. Additionally, the patient will be taught ways to minimize lymphedema occurrence through prevention methods such as avoiding bug bites and sun exposure, protecting against wounds to that extremity, and overuse of the extremity.

As women, we often feel the need to nurture: to put others' needs before our own.

While recovering from breast cancer surgery and treatment, don't forget to take care of yourself. You are the most important person in the picture.

Your body is recuperating from a traumatic experience. Respect this, and only do as much as you feel able to do. Take the time to rest when you need to. No need to feel guilty. By taking care of yourself, and paying attention to what your body needs, you can recover more quickly.

Support groups are available nationwide, and are always welcoming new members. Check with your hospital or doctor for contacts for support groups. Some women find great comfort in sharing with others who have been through similar experiences. Other women find they do better on their own, making their own way.