Healing in a hurry: enhancing recovery after breast cancer surgery

Kirsten Edmiston, MD, is a board certified surgeon and fellowship trained breast surgical oncologist. She serves as the Chief Surgical Quality Officer at Inova and practices at Inova Breast Surgery – Fair Oaks.

Whether breast cancer surgery involves removing all or part of the breast, with or without reconstruction, the operation can be hard on the body.

Yet there are steps you – and your surgical team – can take to help you recover faster.

The best place for patients to start:

• Quit smoking. This is the most important thing you can do before surgery. The sooner the better, but even quitting a couple of days beforehand can speed recovery.
• Control blood sugar. If you’re diabetic, try to lower your A1C level (a marker of blood sugar) before surgery.
• The better shape you’re in before surgery, the better your odds of a smooth recovery. If you’re not already active, try walking at least 10 minutes a day, 3 times a day, in the weeks before the operation.
• Eat well. Aim for lots of fruits and vegetables and lean protein, and avoid saturated fats.

Surgical teams, too, can do a lot to help patients get back on their feet as soon as possible. Thanks to a new protocol known as Enhanced Recovery After Surgery (ERAS), patients are recovering more quickly and more comfortably. ERAS involves several key components:

• State-of-the-Art Anesthesia. To better treat pain, surgeons are now placing nerve-blocking medications directly into the surgical site. The blocks can last 3 or 4 days, allowing patients to move more comfortably, eat normally and return home sooner – with a reduced need for narcotic pain medications.
• Earlier Mobility. Doctors used to recommend patients stay in bed and rest for several days after surgery. We now know that getting up sooner lowers the risk of complications such as blood clots or pneumonia. We encourage patients to get up and walk the day of surgery.
• Food and Drink. Once we told patients not to eat or drink after midnight the night before surgery. With ERAS, we encourage them to swallow clear liquids like water, Jell-O, tea or coffee (without milk or sugar) up to 4 hours before the operation. That helps patients stay nourished and satisfied.
• Better Communication. Surgical teams are taking more time to engage with the patient and her family so they know what to expect before, during and after surgery. Don’t be afraid to ask questions.
• Evidence-Based Care. ERAS focuses on practices backed by scientific evidence. For instance, we make sure patients are getting sufficient fluid, their blood sugar levels are managed and they stay warm during surgery and recovery.

Breast cancer surgery is a collaboration between you and your medical team. By working together, we’ll help you recover as quickly as possible. Learn more about the Inova Breast Cancer Program.

Discover how Inova tackles Breast Cancer at inova.org/gameplan.