Checklists

• Ask your surgeon what you need to do to prepare for your surgery including:
  • Preparing your skin
  • What food or liquids you can or cannot take
  • Are you allowed to take your regular medications?
  • Where to go on the morning of your surgery
  • Post-surgery care and exercises
  • What side effects should you watch for and who do you call if you experience any
  • When you will get the results
• What to bring:
  • Health card
  • Loose-fitting clothing including a top that doesn’t go over your head
  • A list of your medications and allergies (if any)
• Arrange for transportation and for someone to take care of you while you’re recovering at home
• Shop for groceries and prepare meals ahead of time
• Develop a list of chores and tasks that friends and family can help you with while you recover
• Prepare your post-surgery clothes:
  • Post-surgery mastectomy camisoles with pockets or use large pins to pin your drains to a loose-fitting camisole
  • Front-closure wire free bras
  • Comfortable and soft clothing and socks
• Glaxal base cream
• A comfortable pillow to support your arm and chest while you sleep

Contact an emergency department or your doctor if:

Some side effects are potentially more serious than others. The following may be signs of an allergic reaction that may be life-threatening

• Severe and sudden itching
• Rash or hives
• Wheezing or trouble breathing
• Fever above 38°C

Contact your oncologist if you have:

• Severe vomiting or diarrhea
• Unexplained bleeding

If you develop new or worsening side effects from your treatments, speak with your oncologist about the severity of your symptoms and what actions can be taken to help. You can also visit the emergency department after hours or on weekends; the ER staff will contact whomever is the oncologist on-call if necessary.

You may experience some mild side effects while recovering from surgery. Some side effects listed below may be more severe. Be sure to speak with your surgeon about any side effects you experience and how to treat or manage them.

• Lymphedema (swelling of the arm where the lymph nodes were removed)
• Infection
• Pain in your chest area, arm or shoulder
• Swelling or collection of fluid at the incision
• Blockages in your drain
• Bleeding
• Loss of sensation in your chest area (phantom breast pain)
• Scar tissue
• Changes to the shape of your breast (if you had a lumpectomy)
• A small risk of developing blood clots
• Cellulitis (bacterial skin infection)

You may experience some mild side effects while receiving radiation therapy. Some side effects listed below may be more severe. Be sure to speak with your surgeon about any side effects you experience and how to treat or manage them.

• Fatigue
• Skin changes
  • Itching or burning sensation
  • Soreness
  • Dry skin or blisters
  • Redness (if you are Black or have a dark complexion this reaction can often go unnoticed by physicians)
• Swelling
• Lymphedema (swelling of the arm)
• Chest pain or heart damage
• Inflammation of the lung

If you are receiving radiation for metastatic breast cancer, ask your doctor about possible side effects to the areas being treated. These side effects may include:

• Diarrhea or constipation
• Bladder irritation
• Hair loss
• Hearing loss
• Memory and speech difficulties
• Seizures

More common side effects:

• Hot flashes
• Fatigue
• Mild swelling in arms or legs
• Nausea and/or vomiting
• Rash or dry and itchy skin
• Menopausal symptoms:
  • Vaginal dryness
  • Sweating
  • Lower sex drive
• Osteoporosis (Aromatase inhibitors or LHRH agonists)
• Mild headaches
• Mild joint pain
• Higher than normal cholesterol
• Dizziness
• Constipation

Rare but serious side effects:

• Vaginal bleeding
• Heart problems (chest pain, irregular heartbeat, shortness of breath)
• Blood clots
• Hearing loss
• Confusion
• Signs of an allergic reaction
• Severe belly pain
• Sudden loss of vision
• Trouble speaking
• Feeling more thirsty than normal
• Liver problems

Drug Patient Information Sheets:

• Tamoxifen
• Letrozole
• Exemestane
• Leuprolide
• Anastrozole
• Goserelin

Mild, common side effects:

• Mild headache
• Mild joint pain
• Fatigue
• Flu-like symptoms during or shortly after your infusion
• Low white blood cell count (may be severe)
• Low platelet count (may be severe)
• Peripheral neuropathy (numbness/tingling)
• Constipation or diarrhea
• Mouth sores
• Nausea and vomiting
• Trouble sleeping
• Anemia (low red blood cells)

Severe, rare side effects:

• Heart problems (irregular heartbeat, shortness of breath, chest pain, fainting)
• Swelling in arms, legs or belly
• Signs of an allergic reaction
• Difficulty breathing
• Coughing up blood
• Severe pain or swelling in arms and legs
• Signs of stroke
• Black stool or blood in urine
• Fever, chills or signs of infection

Drug Patient Information Sheets:

• Trastuzumab
• Pertuzumab
• Trastuzumab emtansine
• Lapatinib
• Tucatinib
• Trastuzumab deruxtecan

Mild, common side effects:

• Mouth sores
• Fatigue
• Cough
• Shortness of breath
• Diarrhea or constipation
• Rash
• Nausea and vomiting
• Weight loss
• Fluid retention
• Mild headaches
• High blood sugar
• Taste changes
• Flu-like symptoms
• Low white blood cell count (may be severe)
• Low platelets (may be severe)
• Trouble sleeping

Severe, rare side effects:

• Inflammation of the lung
• Liver problems (yellowish skin/eyes, unusually dark urine, pain on the right side of your belly)
• Signs of an allergic reaction
• Heart problems (chest pain, irregular heartbeat)
• Increased risk of blood clots

Drug Patient Information Sheets:

• Everolimus
• Abemaciclib
• Palbociclib
• Ribociclib  
• Olaparib
• Alpelisib

Mild, common side effects:

• Fatigue
• Diarrhea or constipation
• Rash
• Nausea and vomiting
• Mild joint pain

Severe, rare side effects:

• Chest pain, trouble breathing or shortness of breath
• Coughing up blood
• Increased urine output or feeling very thirsty
• Signs of an allergic reaction
• Unusual bleeding

Drug Patient Information Sheets:

• Pembrolizumab
• Atezolizumab

Mild, common side effects:

• Hair loss
• Fatigue
• Mouth sores
• Nausea and vomiting
• Diarrhea or constipation
• Cystitis (inflammation of the bladder)
• Low white blood cell count (may be severe)
• Anemia
• Low platelet count (may be severe)
• Peripheral neuropathy (numbness/tingling)
• Allergic reactions
• Brain fog
• Nail changes
• Body aches and pains

Long-term, severe, or rare side effects:

• Early/premature menopause
• Leukemia (rare)
• Heart problems (rare)