Smx and slnb recovery

Hi @rainclouds , thanks for the update. That all sounds very normal for this stage of recovery. Numbness around the breast and underarm is common after a mastectomy and SLNB and can last as nerves heal. Some swelling in the armpit is also typical, especially early on. Keep up with the gentle exercises as advised, and let your care team know if swelling increases, becomes painful, or if you notice redness or warmth.

Please keep us posted on how things go!

Warmly,

The Mods

what type of exercises were recommended post smx? my surgeon told me to act like my arm is in a sling so I'm not moving it much.

@kc5365 —

From what I've seen, advice about exercise following a single mastectomy (smx?) is all over the map. For instance, I suspect the recommendations will depend on whether you had or are having reconstruction.

I've now had BC twice. The first time was 2008, when I was dx'd with a 1.8 cm (Stage I) IDC in my left breast. I had a mastectomy with an "asthetic flat closure" — no reconstruction. Three sentinel nodes were removed and were negative. I had 2 J-P drains, one of which stayed in for 2 weeks if I recall correctly. The advice at that time was no lifting more than 10 pounds, and restricted movement of the arm on my affected side until after the drains were removed. (No raising arm above shoulder height, etc.) After my drains were out, I was allowed limited, gentle stretching that was gradually increased over time.

The advice at my most recent dx (18 years later — different surgeon, different medical center) was very different. I was dx'd with DCIS in late December 2025, and again chose a mastectomy with flat closure (no recon). The 4 axillary nodes that were removed were negative. This time I was told no lifting more than 5 pounds but my usual day-to-day movements were allowed (dressing, showering, cooking, etc.). I was told to begin a regimen of stretching exercises at day 7 post-surgery. The exercises were meant to restore range-of-motion in my right arm and chest. The only limitation was "stop when the stretch becomes painful."

I still had a J-P drain on day 7, but I wasn't told anything about waiting until that drain was out. As a result, the volume in that drain doubled once I started those stretching exercises — it went from 20 ml/day to more than 40 ml/day. At my surgery recheck the following week, my surgeon seemed concerned. The rule she used was that the drain had to be producing 20 ml or less 2 days in a row before she would remove it. I think she'd assumed she could pull it by that recheck appointment, but noooo…..

So, she said no more exercises at all — keep movement of that arm at a minimum. She set up another recheck for 2 wks later (4 wks post-op), at which she would pull the drain regardless of fluid output. The trade-off is development of a seroma if it's pulled too early, vs. risk of infection if it's left in too long.

I'm hating the exercise restriction. Those stretching exercises felt really good, and I was almost back to full range-of-motion after just one week of exercises. (There was no risk to my incision, which was protected by subcuticular sutures, glue, and dermabond mesh tape.) Now I'm stiff and achy again, but the fluid in my J-P drain is decreasing, so I'm hopeful.