Any breast cancer surgery can be a deeply traumatic experience. You may feel that your breasts are very important to your idea of yourself as a woman. The first months are likely to be very upsetting. Many women have conflicting emotions, such as grief, fear, shock, anger and resentment. These emotions may be mixed with relief that the cancer has been found and treated.

The change to your appearance may lower your self-confidence. Many women need time to come to terms with this. Women find different ways of trying to come to terms with the change to their bodies. Some prefer to see the results of the surgery for the first time alone. Others may want the support of a partner or close friend, or doctor or nurse, when they take their first look at the scar.

Although breast surgery will not affect your physical ability to have sex, the emotions you feel may reduce your desire for sex for a while. Women often need to feel relatively happy with their bodies to have a fulfilling sex life. Fear that a partner – even a long-standing one – may be put off by scars or the change in body shape, can make women very nervous about letting anyone see or touch their body. There is no right or wrong time to take this step. You can wait until you and your partner feel ready. Our section on sexuality and cancer discusses these issues in detail.

While you are still in hospital, the nurses can prepare your partner for how the scar may look. A nurse, or your doctor, can be with you both when you let your partner see it. Instead, you may prefer a close relative or friend to be there and talk it over with you both afterwards.

You will find that the difficulties and emotions get less with time. After the operation, the swelling will go down, the bruising fades and the scar will gradually become less obvious. As you become more used to the soft breast prosthesis, your confidence should gradually come back.

Getting used to having had breast cancer can take months or years. The emotions and anxieties may come back each time you have to go for a follow-up appointment or if you see cancer mentioned in papers, magazines or on the television.

Many women cope well with the surgery and treatment for breast cancer. This is partly due to support from hospital staff

and friends and family. However, women are often surprised that they find it very difficult to cope once the treatment has finished. Instead of feeling able to forget about the cancer and get on with normal life it is common to feel anxious and tearful for a while once the treatment is over.

Some women are very anxious that the cancer may come back. They worry that any ache or pain is a sign that the cancer has returned. Anxieties and worries can make it hard to sleep. It is not unusual to feel depressed and isolated. These feelings can often feel worse at night.

After breast cancer surgery you may feel emotionally and physically drained. It is important for you to allow yourself plenty of time to recover and get help if you feel you need it.

Our section on adjusting to life after cancer discusses how to cope once treatment has finished.

After your surgery, you may need to have some further tests to see if there has been any spread of the cancer. Whether you need the tests will depend on the size and grade of the breast cancer and whether any lymph nodes were affected. The tests help your doctors to decide on the best type of treatment for you.

You may have some of the following tests:

• a liver ultrasound scan
• a bone scan
• a magnetic resonance imaging (MRI) scan
• a chest x-ray.

We can give you information about these tests. If you have to wait for the results, you should be given the details of a member of staff you can contact if you are worried or have questions.