Preparing for Your Operation

Preparing for your breast surgery will take time. Before your operation you may have:

• History and physical
• Blood work
• Mammography
• A clip, wire, and/or localization device placed. This will help to identify the tumor site
• Urine test
• Electrocardiogram (ECG) if over age 50 or otherwise high-risk
• Health history, including:
  • History of sleep apnea
  • History of problems with anesthesia
  • Allergies
  • Heart health. Do you have a pacemaker? Do you have an implantable cardioverter-defibrillator (ICD)? Tell your doctor about these and other heart devices.

Those over age 75 may have additional screening done before surgery. This may include tests on your activity level and nutrition. It may also include testing your memory and recall.⁶⁰

You should bring a list of all medications including:

• Prescriptions
• Over-the-counter drugs (no prescription needed)
• Vitamins
• Herbs, minerals, or other supplements

Ask which of these need to be stopped or changed before surgery. Examples of what may need to be stopped up to 7 days before surgery include:

• Non-Steroidal Anti-Inflammatory Medications (NSAIDs) like aspirin or Advil^®/Motrin^® (ibuprofen)
• Anticoagulants (blood thinners)
• Fish oil
• Vitamin E
• Herbs like garlic, ginseng, gingko biloba, and St. John's Wort (they can cause bleeding)

See the ACS Medication and Surgery information.

Smoking can increase your risk of problems with breathing and wound healing.^83,84 This may affect the type of surgery you will have. Quitting at least 4 weeks before your operation and staying smoke free can decrease these risks.⁸⁴ There are medications and therapies that can help. Your surgeon will talk to you about your smoking status and your plan to quit before surgery.

See the ACS Quit Smoking brochure to make your Action Plan.

Talk with your surgeon about how to control your pain. Your pain plan will be based on your:

• Operation
• Pain history
• Current medications

Regional or local anesthesia may be an option. This is medication placed with a needle near the surgery site. It decreases pain and can last for several days. It can reduce the need for strong pain medication like opioids. Ask your surgeon if this is an option for you.

See Safe and Effective Pain Control After Surgery. It can teach you about the best way for you to safely manage your pain.

Certain behaviors will enhance your recovery from surgery. These include eating healthy foods, exercising, and not drinking alcohol.⁵⁵ You may be screened for malnutrition and may need to meet with a dietitian. Visit the American Cancer Society Risk Prevention webpage for more information about healthy food choices. 

Good blood glucose control promotes healing. It also reduces the risk of surgical site infection. If you are diabetic, your team will tell you how to adjust your medications before and after surgery. One-third of patients having surgery have diabetes and do not know. Your blood glucose will be checked so it can be controlled before surgery.

Talk to your doctor about your exercise plan. Exercising before surgery (such as swimming, walking, or yoga) may help your recovery.⁶⁹ Your care team may recommend exercise therapies during your surgical care/treatment. Exercise can also improve your arm movement and decrease the risk of postoperative complications. Learning and practicing arm exercises before surgery helps you prepare. Ask your doctor when you should start arm exercises after surgery. See the Exercise resources.

Keeping You Informed

You may be monitored for swelling (lymphedema) after your treatment. Early swelling may be hard to notice. So, your provider may measure your arm before and after surgery. This may be done using:

• Measuring tape
• 3D surface volume scan
• Bioimpedance spectroscopy (BIS)

These are examples of non-invasive tests that measure the amount of water in your arm/hand. For more information on lymphedema see Postsurgical Arm Care page.