BREAST CANCER SURGERY

Preparing for Surgery

As you work with your doctor to plan your surgery, you’ll be asked about 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 procedures or medications (including allergies), 2) any drugs you’re presently taking or have just stopped taking (prescription, non-prescription, “recreational”), and 3) any vitamins and herbal supplements you’re taking.

Your doctor will ask you to stop taking aspirin and any non-steroidal anti-inflammatory medications (such as ibuprofen) several weeks before surgery. Some 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.

Preoperative testing

In the weeks or days before surgery, you’ll need to have tests to make sure your body can handle the anesthesia and the operation. Although you may not need every one of these tests, here are the most common tests: A chest X-ray and electrocardiogram (EKG) will show whether your lungs and heart are working properly. Blood tests will check your blood counts, your liver and kidney function, and your risk of bleeding or infection. A urine test can find out about your kidney function and look for infections. Sometimes other tests, such as **CAT scans**, are given to check for tumor location and size. A CAT scan can also determine whether a tumor is involved with other parts of the body. You may also be asked whether you have diabetes, high blood pressure, heart disease, or other conditions that could affect surgery.

Surgery 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.

The Day of Surgery

Food and drink

Your doctor will tell you not to eat or drink anything after midnight on the night before surgery. 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. Vomiting into the lungs 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.

Informed consent

When you are admitted to the hospital before surgery, you’ll probably be asked to sign a form called “informed consent.” This means that you are agreeing to the surgery, fully understanding what’s going to happen and what risks you are accepting in the process. Be sure to ask for the form before you receive any anesthesia that may make you feel groggy, and long enough before surgery that you have time to read and understand it.

Informed consent forms are designed to make sure that: Your doctor has told you exactly what he or she is planning to do. You are aware of alternative treatment options. You understand the plan for surgery and its associated risks. No matter how highly you regard your doctor, read over the form carefully.

Be sure to sign a consent form only for the procedure you and your doctor have discussed and agreed upon in advance.

What Happens in the Operating Room

If you’ve never been in an operating room before, all the equipment and hustle and bustle can be disconcerting. You’ll probably see a lot of people you’ve never seen before. There may be a lot of noise as the surgical team talks to one another and puts equipment in place. Many surgeons will come in while you’re still awake to say hello and give you last-minute reassurance.

You may feel cold. Don’t be shy about asking for a blanket!

Much of the equipment you see is designed to help your surgical team watch you very carefully during surgery: A blood pressure cuff will be placed on your arm. An electrocardiograph machine will monitor your heart rate. A finger clip will measure your blood oxygen levels and anesthesia.

A breathing tube may be placed in your throat. For longer surgeries (over an hour) compression boots or stockings may be placed on your lower legs to prevent blood clotting. These are strange-feeling but not uncomfortable or painful.

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.