Dear valued patient,
The purpose of this guidance is to provide you with information that will help you go through the hospitalization and recovery period in the best and safest way possible.
This guidance does not replace the explanations given by the doctor, nor does it replace the consent form for the surgery. The surgery you have been scheduled for will be performed on the breast or in the lymph nodes of the breast area. The following guidance is suitable for most patients, but there may be differences in treatment options based on individual findings. You will receive the complete instructions relevant to you personally from your operating physician.
Background:
Treatment for patients diagnosed with breast cancer is conducted through a combination of different departments, with a focus on the Breast Health Center. At the Breast Health Center, you will have access to a dedicated breast nurse who will serve as a liaison and support you as needed. The current hospitalization will be handled by the surgical department staff, who will address all your needs and inquiries in addition to the support from the dedicated breast nurse.
The Surgery:
Regarding the type of surgery, the extent of the removal, and the involvement of the breast area, you will receive an explanation from the doctor before hospitalization and the surgery.
Before the Surgery:
You will receive a referral to the hospitalization from the operating doctor.
You will be asked to undergo blood tests, chest X-ray, ECG, and additional imaging as per the doctor's instructions.
If you have any underlying medical conditions, you will be asked to bring additional medical approvals (e.g., cardiology approval and a letter from your treating physician). Please bring all these documents, including the admission commitment, to the preoperative clinic before the surgery. If not instructed otherwise, please keep your breast imaging results (mammography, ultrasound, etc.) with you and bring them to every appointment and hospitalization.
In the Preoperative Clinic:
You will be scheduled for an appointment at the Preoperative Clinic through the Breast Health Center secretary (Tel: 02-6555265). The process at the Preoperative Clinic takes a few hours, so please plan accordingly.
You will be examined by a surgical doctor who will explain the nature of the surgery and ask you to sign the "Consent for Surgery" form.
You will be examined by an anesthesiologist who will explain the purpose of the anesthesia and have you sign the "Consent for Anesthesia" form.
A nurse will measure your pulse, blood pressure, and weight, and complete any missing tests.
At the end of the preoperative process, you will be allowed to return home. The Preoperative Clinic staff will contact you by phone and inform you of the surgery date and admission (Tel: 02-6555489).
General Surgery Department:
You will be asked to arrive for hospitalization at the General Surgery Department on the 8th floor at the time provided to you by the Preoperative Clinic. Your patient unit will include a bed, a nurse call button, a cupboard, and an adjacent toilet and shower. If you need to undergo lymph node mapping before the surgery, a doctor will inject a marking material into the area of interest. The injection will be performed at the Nuclear Medicine Institute on the 4th floor, usually an hour after the injection, mapping the nodes for demonstration. The injection and mapping will take place on the day before the surgery or the morning of the surgery day.
Before the Surgery:
Before coming to the department, you are requested to take a shower, wear clean clothes, and remove nail polish and jewelry. It is advisable to shave the breast area carefully. The department staff will complete the necessary preparations for the surgery. You may bring personal items such as toiletries, an upper garment, and slippers.
During the Surgery:
You will be asked to wear a gown without underwear.
Regular medications and relaxation medications, aimed at reducing the expected stress due to surgery, will be administered according to the doctor's instructions.
At the designated time, a messenger will accompany you to the operating room. Please remove glasses, contact lenses, dentures, and hearing devices.
If you come without an escort, you can leave your valuables with the security personnel before entering the operating room.
After the Surgery:
You will be transferred to the recovery room, which is adjacent to the operating room.
When you are ready to leave the operating room, you will have a drainage bag, and you may be connected to an infusion from the surgical wound.
In the recovery room, you will be closely monitored by the medical staff.
If you experience any pain, you can request painkillers, as well as medication for nausea and vomiting prevention.
One family member can visit you in the recovery room after coordinating with the nurse.
In the Department:
Continued monitoring.
Administering pain-relief medications via IV or pills. The dosage will be adjusted according to the level of pain defined by you. If the quantity is not sufficient, please inform the nurse.
The first time getting out of bed after surgery will be with the assistance of a nurse.
You will be assisted in taking a shower if necessary.
The wound dressing will be changed as needed, according to the operating doctor's instructions.
Physical therapy will be provided for patients who had lymph node removal from the breast area. The physical therapist will guide you in performing recommended exercises for the hand, as well as breathing and coughing exercises for efficient lung ventilation.
Discharge and Ongoing Treatment at Home:
Hospitalization can last between a day and three days, depending on the type of surgery and your recovery pace.
Upon discharge, you will receive a discharge letter with instructions for ongoing treatment.
You will be given sick leave according to the doctor's recommendation.
Treatment of the Surgical Wound:
Maintain maximum cleanliness of the surgical area through daily washing with water and soap.
Treating the Incision or Drains at Home:
• You will receive instructions from the nurse on how to treat and empty the drains at home.
• Keep the drain bag in a vacuum (compressed).
• Empty the bag as needed and record the amount of fluid drained (using a measuring cup provided by the nurse upon discharge). Summarize the amount of fluid drained once per day for each drain separately.
• Starting from the fifth day after the surgery, if the amount of fluid drained from a drain is less than 30 ml, please notify the Breast Health Center through the secretary, mentioning the amount of fluid drained and the name of the operating doctor. If we can bring your follow-up appointment forward, we will notify you.
• Drains are usually removed between 5-10 days after the surgery.
Home Instructions after Lymph Node Removal from the Breast Area:
(Instructions tailored to you will be provided by the operating doctor before discharge from the hospital).
• If you require physical therapy under the health fund, it will be noted in the discharge letter.
• Perform the exercises taught by the physical therapist in the department at least three times a day.
• In case of swelling, redness, or difficulty in moving the arm, please contact the treating physician or the breast nurse coordinator. You can reach out at any time of day to the Surgical Department at Tel: 02-6555569/769, or to the Breast Health Center coordinator, Mrs. Susan Ben-Dahan, at 050-8685826.
Pay Attention at Home: If you experience a body temperature above 38°C, local heat, redness, or drainage from the surgical wound.
In any case, you can contact the surgical department at 02-6555569/769 at any time, day or night, or reach out to the operating physician or the hospital's triage room.
Additionally, you can also get in touch with the breast care coordinator, Mrs. Susan Ben-Dahan, at 050-8685826.