Breast Care Specialist Nurses: 01274 365190 Mr Linforth secretary: 01274 365844 Mr Salhab secretary: 01274 365734 Miss Tait secretary: 01274 365734 Secretarial team available Monday to Friday (8am – 4pm) Miss Langlands secretary: 01274 365844 Secretarial team available Monday to Friday (8am – 4pm) Central Booking Office Team: 01274 274274 Monday to Friday (8.30am – 5pm) Breast Care Nurse answer machine: 01274 365190 Monday to Friday (9am – 4pm)
If leaving a message please leave your name, date of birth and a contact telephone number. This machine is checked regularly. It may not always be possible to return your call on the same day.
Prosthetic advice and appointments Clinics are run from The Dales Unit, Level 2, Area 8, Horton Wing, St Luke’s Hospital every other Monday morning. Telephone 01274 365190 to make an appointment. Monday to Friday (9am – 4pm).
Breast Research Nurse: 01274 383435
You can contact us using the Relay UK app. Textphone users will need to dial 18001 ahead of the number to be contacted.
Before your operation
An appointment will be made for you to attend the pre-assessment clinic. This is in the Horton Wing, Level 0 at St Luke’s Hospital. If your surgery is at the Yorkshire Clinic the pre-assessment will be there or on-line.
If you need an interpreter for the ward please tell us in clinic or pre-assessment.
Depending on your past medical history and general fitness, the appointment will take between 30 minutes to 2 hours to complete.
Some investigations may be performed including blood tests and MRSA (MSSA if having implants) swabs.
Covid information will also be provided prior to surgery.
You may need to see an anaesthetist before coming to hospital. If not, the anaesthetist will see you on the day of surgery.
Please bring with you information about any medication that you are taking at this time.
You will receive an admission letter. This will tell you the date and time for you to come to the ward at Bradford Royal Infirmary or the Yorkshire Clinic. It will also tell you when to stop eating and drinking.
Localisation of mammogram detected breast abnormalities.
If we are unable to feel the breast lump you will require a small marking wire or Magseed to be placed into the breast. This is done in the Pennine Suite, Area 8, Level 2, Horton Wing, St Luke’s Hospital. You will be told if this is necessary. The time to attend for this will be in the top section of your admission letter.
Sentinel node injection (for patients with Breast cancer only).
If you have been told you require a sentinel node injection this will be given either by your surgeon in the breast clinic or in the medical physics department at the Bradford Royal Infirmary.
Please check the details carefully as this may be the day before your surgery.
The dye used to find the sentinel lymph node will leave a staining on the breast for anything up to a year (only noticeable with wide local excision). To identify the sentinel lymph node you will either attend medical physics for a radioactive injection, followed by a blue dye injected in theatre by your surgeon. This may cause your urine and tears to appear green. Your skin will have a grey appearance for about 24 hours. Alternatively a Magtrace injection will be administered by your surgeon in clinic.
If you are having day surgery (going home the same day), you need to arrange for a responsible adult to stay overnight with you at home when you are first discharged.
You will need some painkillers at home for when you are discharged as these may not be provided by the ward. We suggest that you take pain relief that you know has worked for you in the past such as Paracetamol and/or an anti-inflammatory such as Ibuprofen (Brufen or Nurofen are the same). Paracetamol and ibuprofen can be taken together, and this may prove to be more helpful in managing any discomfort.
Avoid Ibuprofen if you have a history of heartburn, gastric ulcers, asthma or renal failure. If in any doubt, ask one of the team.
Read the packet to make sure that you take the correct amount and do not take more than the maximum dose stated as this can be very dangerous.
Ensure that you have appropriate transport arranged to and from the hospital and if necessary someone to assist you.
If you are on benefits, you may be able to claim for travel expenses. You can visit the NHS website: https//www.nhs.uk/nhs-services/help-with-health-costs/healthcare-travel-costs-scheme-htcs which will explain who is eligable for the scheme and how to make a claim.
If you have one, or a combination of the following medical needs, you may be entitled to hospital transport – Please speak to the clinic receptionist when arranging your next appointment.
Require a stretcher for the journey due to specific medical and mobility needs.
Require oxygen during transit.
Need to travel in a wheelchair and do not have a specially adapted vehicle.
Cannot walk short distances without continual physical support.
Have a medical condition that would compromise your dignity or cause concern to the public.
Have severe communication difficulties.
On the day of your surgery
Ensure your prescribed medication is already taken as directed by the preassessment team.
Arrive on the ward at the requested time.
Ward space is quite limited and generally you will be escorted into a shared waiting area on the ward until the staff can allocate you a bed. Please liaise with your breast care nurse if there is a specific reason you would like someone to stay with you.
Doctors and nursing staff will complete relevant admission records. You will be given an identification wrist band, a green surgical wrist band and a red wrist band if you have any allergies. The Surgeon will examine you and place a mark on the surgical site using a pen. Checklists and consent forms will be completed.
Patients are taken to theatre according to their clinical priorities. All day lists mean that some patients will wait until later in the afternoon before their operation takes place. We will inform you on admission approximately what time you are likely to go to theatre, sometimes this changes.
After your operation
When you return to the ward, you will be offered something to eat and drink. Nursing staff will perform wound checks and observations.
Day-case patients will be able to go home, once your blood pressure, temperature and pulse are normal for you, you are able to move around to a safe standard, your pain is controlled and there are no obvious problems with your wound. This is generally 2–4 hours after you have returned to the ward. Please arrange for someone to collect you.
Dressings
Most of the dressings we use have a plastic surface and are splash-proof. Keep the dressing dry by taking shallow baths, low showers or a strip wash. Beneath the dressing is a layer of steri-strips which lie on top of your wound. The wound itself will be closed using dissolving stitches.
The dressing needs to stay in place for two weeks at which point you may remove the dressings and steri-strips. No further dressings are required If your dressing leaks or become loose less than a week from the surgery, it will need to be changed as wound infection is then more common. If this happens please contact Breast Care Nurses on 01274 365190 or your Practice Nurse at your GP surgery to have the dressing replaced. Otherwise you will not routinely require the attention of the District/Practice Nurse. Relevant contact details can be found at the beginning of this booklet.
Wounds
Most of the dressings we use have a plastic surface and are splash-proof. Keep the dressing dry by taking shallow baths, low showers or a strip wash. Beneath the dressing is a layer of steri-strips which lie on top of your wound. The wound itself will be closed using dissolving stitches.
The dressing needs to stay in place for two weeks at which point you may remove the dressings and steri-strips. No further dressings are required If your dressing leaks or become loose less than a week from the surgery, it will need to be changed as wound infection is then more common. If this happens please contact Breast Care Nurses on 01274 365190 or your Practice Nurse at your GP surgery to have the dressing replaced. Otherwise you will not routinely require the attention of the District/Practice Nurse. Relevant contact details can be found at the beginning of this booklet.
If you have had surgery to your armpit (axilla), the numbness is usually a long term side effect, generally in the inner aspect of the upper arm.
Some discomfort is expected and will gradually settle. Take pain relief as suggested. See your GP if your pain is not controlled or if you are unsure of what to take.
Drains – (Are only used in a small number of patients). You may be sent home with one in place. This is safe, you will be shown how to manage this. The drains will be removed by nursing staff in the Dales Suite at St Luke’s’ Hospital 3-10 days after your operation depending upon the type of surgery.
A seroma – This is a collection of fluid which occurs at the operation site causing swelling which is normal following breast surgery. This is nothing to worry about and will be re-absorbed by the body; this can take weeks and sometimes months.
We do not routinely drain a seroma as there is a potential risk of introducing infection.
However occasionally the seroma causes skin tightness which limits arm movement, prevents sleep and is painful even with painkillers. If this happens, we can drain the seroma with a small needle.
This is done in clinic, and is not usually painful. You are likely to get a sense of immediate relief as the fluid drains and the tension goes. Unfortunately the fluid can return and the seroma may have to be drained more than once.
Rarely the wound may open slightly and the fluid causing the seroma floods out. This can be frightening, but do not worry. You may even feel better for the fluid coming away. If this happens, you need to ring the ward or the Breast Care Nurses for advice.
Breast Reconstruction
A 5 day course of oral antibiotics will be prescribed if your reconstruction is implant based. You must complete the course.
If you have had a reconstruction using a tissue expander, your chest wall may still look ‘flat’. This will be filled in clinic with saline at regular intervals until we obtain a satisfactory size.
If you have been given a magnet, please bring this with you to each clinic appointment.
Ensure you have a sports bra to wear post operatively.
Anti-embolic stockings (TEDs) will be provided. These should be worn for at least 24 hours following your surgery, or until you are back to your normal level of activity. They should be taken off for 30mins per day when worn for more than 24 hours.
Causes for concern
New bruising and swelling which increases in colour and size in the area of surgery.
Increased levels of pain.
Any form of wound leakage.
Significantly limited arm movement.
Uncontrollable shivers, feeling generally unwell, or a temperature of 38°C
Redness around the wound site/breast.
All of the above can be signs of infection/bleeding and must be acted upon quickly.
If you experience any of these symptoms, you can contact:
Breast Care Nurses: 01274 365190 Monday to Friday (9am – 4pm) (Please leave a message and someone will call you back or see your GP if this is easier and quicker for you.Out of hours, please contact
Surgical Assessment Unit (SAU) - BRI: 01274 383205 (This is an acute surgical ward. If at all possible, try to contact the breast team before a weekend if you think you may run into problems.
You can contact us using the Relay UK app. Textphone users will need to dial 18001 ahead of the number to be contacted
Returning to normal activities
This will depend on the type of surgery you have had, your usual level of activity and your personality. We recommend that you listen to your body and gradually return to your normal lifestyle at your own pace. If you are struggling with anything (physical or psychological) it is important to take a step back and try again later. There is no right answer to this; it is a case of pushing yourself a little but also resting when you need to. We are all different.
In the first 24 hours following a general anaesthetic you should have a responsible adult with you. You should not take any alcohol or non-prescription drugs. You should not sign any legal documents.
Some pain killers (particularly codeine based preparations) can cause constipation. It is sensible to drink plenty of water and follow a balanced diet following surgery.
Follow the shoulder/arm exercises from the leaflet in the Primary Breast Cancer Resource Pack given to you at your earlier appointment.
Walking is encouraged. Swimming needs to be avoided until the wound has healed completely. This is when the dressing has been removed and there is no leaking from the scar (4–6 weeks).
There is no hard and fast rule about when you can resume your normal sex life. Listen to your body and when you feel comfortable to try.
You are advised not to drive for the first 24 hours after a general anaesthetic. It is important that you feel able to control a car in an emergency and feel comfortable wearing your seatbelt. Talk to your insurance company if you have any concerns about your cover.
The amount of time you take off work will depend on your occupation and how you are feeling. Talk to your Breast Care Nurse or Breast Consultant at your clinic appointment if you have any concerns about returning to work.
Fit (sick) notes can be obtained whilst you are in hospital or from your GP. Please ask on the ward if you need one prior to discharge.
If the time required to be off work will have an impact upon you financially, talk to your Breast Care Nurse.
General long term side effects
If you have had axillary node clearance you may have numbness or changes in sensation along the scar line.
Indentation, asymmetry and volume loss of the breast tissue.
Swelling of any part of the affected arm or breast (lymphoedema)
Struggling to come to terms with your experience
Please contact your Breast Care Nurse, Breast Consultant or GP if you are struggling with any of the above side effects.
Follow up appointments
Your surgical clinic appointment will normally be in 3 weeks after surgery. The date and time of your appointment will be posted to you.
It is timed so that your histology results are ready and your case has been discussed at the Multi-Disciplinary Team Meeting (MDT).At this appointment, we will check your wound and discuss with you your histology results and treatment/follow up care plan.
We will offer you a written summary of your histology and treatment plan to take away with you.
Oncology appointment
It is usual to require some form of other treatment following surgery for breast cancer. The doctors who discuss this treatment with you are called ‘Oncologists’. This generally starts 4–6 weeks after surgery. You will be given an appointment card with the date and time for your Oncology appointment when you attend the surgical follow up appointment.
Prosthetic fitting
If you have had a mastectomy or your breast is noticeably smaller than the other side, the breast care nurse will fit you with a ‘softie’ (lightweight temporary breast shape) before you leave clinic pre operatively. When you feel ready to consider a more permanent breast prosthesis which is usually around 6-8 weeks after surgery, please ring the Breast Care Nurses on Bradford (01274) 365190 Monday to Friday between 9am and 4pm.
If there is no one available to speak to you, please leave a short message clearly stating your name, date of birth and telephone contact number. They will ring you back on picking up this message to arrange an appointment.
Experienced fitters come to the hospital from the companies that make the prosthetic breast forms. They also provide expert bra fitting advice and provide a free bra on initial assessment. The clinics take place every other Monday.
You can come for a fitting when your wound is fully healed, any swelling has gone down, and you can wear a bra for at least an hour. This can be anytime from surgery, but normally around 6 to 8 weeks after.
Remember, we are all different so it is perfectly acceptable to come when you feel ready, your wound may allow for it to be sooner or later than the times stated.
Please ensure that you complete the checklist below before your admission to hospital
Pain control at home that you know works for you.
Transport to and from hospital.
Responsible adult overnight if you are having day case surgery.
Help with activities for 4–6 weeks (heavy shopping, vacuuming, meal preparation).
Bring your exercise booklet with you.
Organise help for dependants/pets.
Make sure you have an understanding of what medication you are taking and what this is for. If needs be, ask for a medication review from your GP prior to admission.
Bring all of your medication in the original boxes.
Have you been told if you need/or when to stop taking?
Diabetic tablets
Insulin
Blood thinning medication e.g. Aspirin, Warfarin, Clopidopgrel or Riforoxibam.
If not, contact pre assessment on 01274 365758
Useful numbers
Bradford Cancer Support Daisy House Farm, 44 Smith Lane, Bradford Teaching Hospitals NHS Foundation Trust BD9 6DA Telephone: 01274 776688 bradfordcancersupport.org.uk
Maggie’s Leeds St James's University Hospital Alma Street, Leeds LS9 7BE Telephone: 0113 4578364 E-mail: leeds@maggies.org
If you need this information in another format or language and are in the hospital, please ask a member of staff. If you are accessing this leaflet online or on your phone you can see our Google Translate automated guidance on the Digital Patient Information Hub home screen.
People with hearing and speech difficulties
You can contact us using the Relay UK app. Textphone users will need to dial 18001 ahead of the number to be contacted.
Smoking
Bradford Teaching Hospitals NHS Foundation Trust is a smoke-free organisation. You are not permitted to smoke or in use e-cigarettes in any of the hospital buildings or grounds.
Published by Breast Services, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ.
