Recovery after lumpectomy (wide local excision): week by week

The figures here come from three NHS trust leaflets that do not agree on every point, for example whether to keep the wound dry for 24 hours, 48 hours, or not at all behind waterproof dressings. That is normal, since each unit has its own routine. Use your own discharge leaflet as the rule and this page as a picture of the general shape.

The first stretch is about comfort and the wound. The second is about arm and shoulder movement, particularly if the armpit nodes were also operated on. After that, the schedule is driven by results and any radiotherapy, which belongs to the treatment pathway rather than to surgical recovery. The operation itself is explained in the guide to lumpectomy.

Expect soreness for a few days. Birmingham advises taking painkillers regularly for the first few days instead of waiting for pain to build, and to tell your GP if they are not working. Oxford describes severe discomfort as uncommon.

Dissolvable stitches under the skin are usual, topped with paper strips or glue. Oxford says strips often fall off before the results call, and glue flakes off gradually. Birmingham advises a comfortable, supportive, well-fitted bra as soon as possible, because it supports the breast and prevents pulling on the wound, and it advises against elasticated crop tops that give little support.

Numbness, itching and pins and needles in the scar and surrounding skin are normal and usually temporary, according to Birmingham. A seroma, which is a pocket of fluid under the wound, is described by Oxford as common after breast surgery and usually left to reabsorb unless painful.

Both Birmingham and Worcestershire say to drive once you can make an emergency stop without discomfort in the wound and a seat belt is comfortable. Birmingham puts this at around ten to fourteen days and suggests a first trip with another driver. Oxford suggests at least one week, or two if the armpit was operated on, because insurers may not cover you otherwise. GOV.UK says to ask your doctor if unsure, and to tell the DVLA if you are still unable to drive three months after an operation.

Work depends on the job. Birmingham says about two weeks, possibly longer after lymph node surgery, and notes that many people wait until they know the results and any extra treatment before deciding. Oxford advises two to four weeks off and gives a fit note if you need one.

• Avoid heavy lifting and housework in the first days, as Birmingham advises.

• Take it easy for a couple of weeks, with no hoovering or ironing, according to Oxford.

• Sex can resume when you feel comfortable, and Birmingham invites you to ask about contraception if you take hormone-based medicines.

Birmingham advises gentle arm exercises after the operation to encourage a full range of movement, and says to speak to the breast care nurse if the pain stops you moving the arm properly. If lymph nodes were also dealt with, follow the exercise sheet you were given. Worcestershire says to begin shoulder exercises from day two and encourages daily walking.

Gym classes, swimming and sports are not given fixed dates in these leaflets, so ask your breast care nurse. A sensible pattern is to build up gradually and stop if the wound pulls or the breast swells.

The results of the removed tissue decide the next step. Birmingham says that if cancer cells are found at the edge a further operation may be advised, and that radiotherapy is commonly given afterwards, with anti-oestrogen tablets, chemotherapy or anti-HER2 treatment in some cases. Oxford describes a telephone or video appointment with the surgeon around two weeks after surgery, and later follow-up may become telephone or self-supported once treatment is complete.

Contact the breast care nurse or your GP if the wound becomes red, hot, very painful, swollen or oozes pus, or if bleeding is more than a few spots on the dressing. NHS 111 can advise out of hours. Call 999 for chest pain, sudden breathlessness or collapse.