Committed club runner Jenny Baker was in the form of her life in 2015, smashing PBs at every distance. But while feeling fitter than ever, the then 50-year-old noticed that the top of her right breast seemed to have slightly changed shape.
When she forced herself to examine her breast, she could feel an obvious lump under the skin. She was diagnosed with breast cancer soon after and told there were three tumours in her breast and cancerous cells in the lymph nodes of her armpit.
Jenny was prepared for her three-month stint of her chemotherapy to be the toughest part of her treatment. But while that was gruelling, she was shocked by how tough the next stage of her treatment was – surgery to remove her breast and create a new one in its place. ‘I had in my head that chemotherapy was going to be the worst bit – and it was pretty horrible,’ the now 60-year-old says. ‘But I was so focused on getting through chemo that I hadn’t done much research into the surgery or what the impact would be – and it really is major surgery, it was a real shock.’
Jenny is one of the tens of thousands of UK women who have surgery every year to treat breast cancer or reduce their risk of developing it. Breast cancer is one of the most common forms of the disease, with more than 56,000 women – 150 a day – diagnosed annually in the UK, according to Cancer Research UK.
About 80% of those diagnosed will undergo surgery as part of their treatment and, for some, there could be more than one operation. In addition, a growing number of women are discovering that they have genes that give them a high-risk of breast cancer and many of these will – as I did – have surgery to reduce these risks.
For runners facing surgery, wondering what impact it will have on their ability to continue with the sport they love is yet another worry at a time of turmoil. Women are reeling from a shocking diagnosis and confronted by a number of phases of treatment, explains breast surgeon, breast cancer survivor and triathlete Liz O’Riordan. There’s a number of challenging decisions that sometimes need to be made relatively swiftly. ‘There are many factors involved in the choices taken, so it needs to be a very personalised approach guided by doctors and specialist nurses,’ says Dr O’Riordan.
Surgery varies according to the size, type and how advanced the cancer is, along with whether a woman wants to reconstruct a removed breast and how this is done. Women tend to either have the lump and the surrounding tissue removed, leaving most of the breast or the whole breast removed, known as a mastectomy.
Decisions get more complex around reconstruction. The options are to have the missing tissue within the skin of the original breast filled with an implant, or to form a new breast from a wedge of skin, fat and tissue transplanted from elsewhere in the body. Tissue is most commonly taken from the stomach with an incision stretching from hip to hip, but may also be taken from the top of the inner thigh. This means that there are two operations – and that has consequences for recovery. ‘Having either type of reconstruction will lead to a much longer recovery than just surgery to remove the cancer,’ says Dr O’Riordan. ‘For implants, it’s normally two to three months before someone is back running – and for someone who has used their own tissue, it’s more like six.
‘Having tissue transferred in an operation known as a ‘flap’ involves plumbing in a tiny blood vessel to keep the tissue alive, so you want that to heal together really well before you start running, with all the movement to the chest area that brings. It also leaves a very long wound on the stomach to heal, like a caesarean section.’
Deciding on the best approach often involves many different factors, says Dr O’Riordan. These can include whether someone gets paid sick leave, if they have young children to look after, if they have enough tissue on their stomach to make a new breast and how important reconstructing a missing breast is to them.
‘I’ve treated women who are very active and just wanted to get back into their sport as quickly as possible, so they chose a full mastectomy without reconstruction,’ says Dr O’Riordan. ‘They wanted the quickest recovery and that was the right choice for them. The most important thing to remember is that after any of these surgeries, you can get back to running. It’s just that some approaches mean that you need a longer break than others.’
The road back
What’s true for all is that the pounding action of running has a high impact on the body and patience and care are vital in returning to action after surgery. Running creates a lot of movement in the arms, shoulders and chest and wounds need to be well on the way to being healed to cope with this. ‘Running after surgery can cause the wound area to get sweaty and damp, which may lead to infection or delayed healing,’ warns Dr O’Riordan. ‘You should wash your sports bra after every run and dry skin properly after showering. If your breast or tummy scars aren’t well supported when you run, the skin could move over the tissue underneath, creating a pocket where fluid builds up, called a seroma. This can also delay healing.’
For runners who choose implants, ‘vigorous running in the first two to four weeks, before the area has fully healed, could stretch the pocket the implant sits in,’ says Dr O’Riordan. ‘The implant can move around, then it’s almost impossible to fix, so you don’t want to undoall the work that your surgeon has done.’
Those who have flap surgery face an extended break. ‘It may take two to three months just to be able to fully lie flat and you’ll be exhausted, often needing an afternoon nap as your body recovers,’ says Dr O’Riordan. ‘Focus on regular walking and stretching during that period.’
Surgery can also extend up into the armpit if lymph nodes, part of the filtering system of the body, need to be removed. This can be a painful area for surgery and lead to the arm swelling, as the body can’t filter lymph fluid away from the area as effectively. ‘Often, women say that it’s the armpit that’s most sore when they get back to running,’ says Dr O’Riordan. ‘That wound will be sore whenever you move your arm.’
Jenny knew that she wanted a reconstruction using her own tissue, rather than an implant. A slice of skin, fat and other tissue was taken from her stomach and the breast reconstructed during the same eight-hour operation that removed her original breast; surgeons attaching blood vessels from the transplanted flesh into those in the chest to provide oxygen and nutrients.
‘I was in hospital for several days and I remember being shocked at how bad I felt,’ says Jenny, who wrote a book, Training for and running the, about her experience. ‘I didn’t have a lot of spare flesh on my tummy, so after they removed what they needed and sewed it up again, the whole area was really tight. I was bent over and couldn’t stand up straight for a couple of weeks. I had tubes and drains around the wounds to remove fluid and I shuffled round a lap of the ward with two carrier bags holding the bottles.’
For Jenny, the shock of how she felt post-surgery was extreme, as she’d maintained her running throughout chemotherapy. Seven miles from her home, she’d run along the Thames footpath to get treatment at Charing Cross Hospital. ‘For my final session, my two sons, two sisters and some friends joined me on the run to the hospital – it was a lovely way to mark the end of chemo,’ she says.
The good news for Jenny and others is that runners tend to heal well post-surgery, thanks to their good state of health and fitness, says Anushka Chaudhry, consultant oncoplastic breast surgeon at the Great Western Hospitals NHS Foundation Trust in Swindon. But Chaudhry warns that one aspect runners can find difficult is putting their feet up and giving themselves enough time to recover. ‘For the first couple of weeks after surgery, you need to take it really easy,’ says Chaudhry. ‘By three or four weeks, it’s normally fine to start some light exercise, such as walking, but taking three to six months to recover isn’t unusual following reconstruction. It can be really frustrating, but give yourself time.’
Jenny tried her first run six weeks after surgery but found it painful. So, she booked some sessions with a local personal trainer who specialised in helping people return to fitness after cancer. ‘We met in the local park, where I did some jogging, but also worked on strengthening my core,’ Jenny recalls. ‘Those sessions made all the difference and just helped me to pace myself. My head was telling me to just get out and run, but my PT helped me to build it up more slowly.’
Devastating loss
While breast cancer survival in the UK is generally good, with around 85% of those diagnosed still alive at least five years later, an average of 31 women a day die from the disease. On a midsummer’s day in 2018, my 34-year-old sister was one of those women.
Diagnosed while pregnant, Leah had only known motherhood while living under a terminal diagnosis and undergoing treatment. Her son was just over 18 months old when she died.
Due to her young age at diagnosis, Leah was tested for genes known to raise the risk of the condition and it was found that she carried a mutation called BRCA1 (breast cancer gene). This gives a 70% chance of developing breast cancer and 45% of ovarian cancer by the age of 80, according to Cancer Research UK. The risk of developing breast cancer in the general female population is 11%.
When I discovered that I also carried this gene, I knew that I would choose to have the surgery that gave me the best chance of being around to see my two young children grow up. This meant having a double mastectomy, that would cut away as much breast tissue as possible, reducing my risk of developing breast cancer by at least 95%.
As a runner for 20 years, albeit generally at the back of the pack having a chat, returning to it was always important to me. Heading out into the lanes through lush green fields and gritting my teeth up the steep coastal trails Five minutes of walking does this to your brain.
Running has also provided succour during the horror of my sister’s illness and the grief that began with her diagnosis.
So, in my appointments with surgeons, I included my desire to get back out running and discussed the impact of different choices around reconstruction on this. It was a difficult choice, with positives and drawbacks to all options. In the end, I went for implants – firm bags of silicone placed under the skin – as I didn’t want to also recover from surgery elsewhere on my body.
In the past, implants were often placed under the muscles of the chest wall, but this is performed less frequently now as women, particularly those who were active, reported that the implant could move unpleasantly under the muscle, says Dr O’Riordan. Although for some women, especially the very slender, this remains an option.
More women seem likely to face these choices as access to testing for BRCA mutations widens. Around one in 250 women has a variation to their BRCA1 or BRCA2 gene, which means that the body is less adept at identifying and repairing cancerous cells. There are much higher rates in certain groups of people, particularly those from some Jewish communities.
In light of this, the NHS launched a programme in 2023 that allows anyone with one or more Jewish grandparents to get tested for a BRCA gene. Of those who find that they are positive for the gene, almost 60% choose to have preventative breast surgery, according to a large UK study published in the Journal of Medical Genetics in 2022.
I had my operation in July 2019 and was home two nights later, carrying little bags holding bottles that drained fluid from the wounds. Initially my recovery was straightforward, although dull, and I was told that I could start trying to run after about three months. But at that point, I took a weekend trip to London and foolishly decided to walk for miles carrying a heavy backpack. When I woke on the Sunday I felt hot, achy and slightly dizzy. I had an infection in one breast that landed me in hospital for nine days on intravenous antibiotics, with the threat of having to have the implant removed.
Fortunately, the infection cleared up, but my confidence in my recovery was set back. It was a good six months after surgery before I was ready to run again, wearing two high-impact sports bras, one over the other, as recommended by my surgeon.
An earlier attempt had been swiftly abandoned as the movement caused by running seemed to resonate through my chest, making me aware of the movement of the implants, which felt very disconcerting. But this time, there was no discomfort or movement and I felt able to gently run/walk for a mile or so. I had downloaded the NHS Couch to 5K app, but found that I could cover that distance within a couple of weeks – and pretty quickly, I was back to my previous two or three runs a week.
Reaching milestones and returning to pre-surgery levels is obviously motivating and satisfying, but Tasha Gandamihardja, consultant breast surgeon at Mid and South Essex NHS Foundation Trust in Chelmsford, advises runners not to put pressure on themselves. ‘Manage your expectations,’ she says. ‘A lot of people think that they can get back to their former level and distances straight away, but the truth is, you probably won’t be able to straight off the bat. It’s better to start slowly and progress gradually. You will get back to what you used to do, but let go of reaching for PBs initially.’
Identity and choice
For some women, it’s not about returning to running, but discovering it after surgery and treatment. Before being diagnosed with aggressive breast cancer at the age of 39, Lauren Yeates preferred other forms of exercise. But after gruelling chemotherapy and surgery to remove her left breast in 2023, she felt compelled to lace up her trainers and run around her local park. ‘When I was diagnosed, I felt a mixture of shock and terror,’ says the mother of two young children. ‘It’s a very lonely and isolating experience. You’re put into a whole other world, an ill world of endless appointments, that you didn’t even realise existed. I needed something to focus on.’
A friend suggested training for the Royal Parks Half Marathon in 2023, so the pair signed up. ‘For the first time ever, I trained in a sensible way and set achievable aims, such as running 1km every night for a week,’ says Lauren. ‘In the past, I might have seen it as a chore, but after being ill and going through treatment and surgery, I just find it incredible that I am able to go out and run. It’s not something that I have to do – I do it because I can.’
Running also helped Lauren to process some of the grief and loneliness that going through breast cancer and treatment can bring. ‘It really helped me through some dark and difficult times, because unless you’ve been through it, there is nobody that can fully understand,’ she says. ‘Running is something practical that I can do for myself, which physically and psychologically looks after my body.’
Summer running gear sale London Marathon for the charity Breast Cancer Now, which supported her from her diagnosis, was a hugely rewarding experience and she also feels the benefit of being part of the running community. ‘I never thought of myself as a runner before, but I am now. I’ve joined a running club, I’m part of a running community through Faversham Running Club and I’ve run a marathon,’ says Lauren. ‘I will always run now, as it gets me out of my head and into my body. I really struggled with the fear of recurrence – it was immobilising – and running helps me to manage this worry and calm this fear.’
Undergoing surgery brings not just a physical change, but also a heavy emotional toll. Dealing with the loss of, or fundamental change to, a part of the body indelibly associated with femininity, often alongside a sudden plummet into a world of treatments, scans and endless appointments, can challenge our identity.
Having my healthy breasts cut away felt like a brutal assault. For me, going back out to run was both a sign of recovery and a chance to fully inhabit this different version of myself. Running slowly down to the sea a mile away, weaving around dog walkers, I was retracing the route of many previous runs – changed but still capable.
Women don’t only have to deal with their own sense of their changed selves after surgery, but also the expectations of others. Louise Butcher found that while she was happy to remain flat-chested after having both breasts removed, she came up against a perception from both doctors and society that women must want breast reconstruction. This led to her own running campaign to celebrate the changes to her body and challenge the expectations placed on women’s bodies. The 51-year-old now runs topless, proudly displaying her scars.
Louise started running during the pandemic and was increasing her mileage as she trained for her first marathon when she found a ‘tiny lump’ on one breast. In April 2022, she was told that she had lobular breast cancer – a type that starts in the milk-producing glands and had already grown to a 5cm-wide tumour.
While she has happily remained flat after surgery, she became frustrated by the perceptions of others. ‘I don’t think that I need breasts, but I found that other people – that society in general – wanted me to have them,’ she says. ‘I’m a strong person and I still found it hard to say to the doctors that I wanted to be flat. It should be an individual choice.’
For Louise, making her individual choice has had a powerful effect. ‘I find running topless so empowering,’ she says. ‘When I was diagnosed with cancer, everyone was looking at me with pity, with sad eyes. But when I’m running, I feel strong and resilient, like I’m challenging the persona of someone who has had breast cancer.’
Incredibly the 51-year-old completed her first marathon just six weeks after having surgery and three days after finishing radiotherapy. She’s well-known locally as the ‘topless runner’, running bare-chested on even the coldest days – and of course, she took the same approach when she ran the London Marathon. She mainly gets positive feedback from those who see her running and, on social media, she embraces the debate that takes place beneath her posts about running topless.
‘I have never regretted my decision to go flat,’ she says. ‘It’s about seeing beauty in scars rather than covering them up. These scars saved my life and enable me to see my children grow up.’
Like Louise, I and the other runners I spoke to feel that running has helped us maintain a sense of who we are, to build our strength and confidence and calm our whirring minds. Fear of recurrence stalks those who have had cancer and running helps us to manage the anxiety that it brings.
A decade after her cancer experience, Jenny Baker runs three or four times a week, often on her favourite route along the Thames in the early morning light. ‘Running is very much part of who I am,’ she says. ‘When I was diagnosed, I felt that my sense of identity was challenged. Running through and after treatment helped me to feel a bit more in control. I’ve realised that I won’t be as fast as I was in my year of PBs, but that doesn’t matter – it was about getting back to myself.’
Lauren Yeates ran the 2025 London Marathon for Breast Cancer Now – you can donate here.
Step by step
Here is some advice on returning to running safely after surgery, from Adrian Fautly, clinical exercise physiologist for cancer rehabilitation at leading London cancer hospital The Royal Marsden.
1. Try jogging if it’s comfortable
‘Before starting to exercise, get the green light from your surgeon, then try gently jogging on the spot. Don’t run if it’s painful – this can help to guide you on whether you’re ready.’
2. Follow a run-walk programme
‘If there’s no pain, a gentle return through a run-walk programme is safe. Focus on frequency rather than intensity, keeping the running elements slow while you build fitness.’
3. Build in strength exercises
‘You should also think about adding strength exercises to your routine, as your strength will have been impacted by surgery and other treatment.’
4. Consider your shoulders and arms
‘Breast surgery can bring stiffness to the shoulders and running is good for loosening tightness. At the end of a run, your muscles will be warmed up and more responsive to stretching, so this is a good time to complete any shoulder and arm exercises that you’ve been given by your health team.’
Support act
Before running, buy a new bra for your changed shape, says Joanna Wakefield-Scurr, head of the breast health research group at the University of Portsmouth and best known as ‘The Bra Professor’.
Professor Wakefield-Scurr has just secured funding for a research project assessing which bras work best for women post-surgery. But while she builds this evidence, she recommends that women get measured and fitted for a new high-impact sports bra when they’re ready to start running.
‘One sports bra should be sufficient, but if you find that wearing two gives you a feeling of extra safety or confidence through that compression, there’s no harm in wearing both,’ she says.
Professor Wakefield-Scurr encourages women to find bras with a well-fitting supportive under band and which separate the right and left breasts. ‘Something that has separate cups to support each breast individually is best,’ she says. ‘This is particularly important when there’s asymmetry and each breast might need different support. This style will hold the breasts in place separately, rather than just squashing them as a compression, crop-top-style sports bra might do.’
