Most types of breast cancer are treated with breast cancer surgery. The removal of a tumor can be done by either a mastectomy or a lumpectomy. A lymph node biopsy or reconstructive surgery may be necessary after the removal of your breast to look for cancer in your lymph nodes. It is almost always recommended to undergo surgery if you have localized breast cancer.
The primary treatment for breast cancer is surgery if it is technically possible to remove the affected tissue. In some cases, breast cancer surgery involves cutting out a single tumor from the breast, known as a lumpectomy. You may also have to undergo a mastectomy if cancer has spread throughout your breast.
In addition to being a treatment, breast surgery for cancer can be a diagnostic procedure or even cosmetic. There are times when surgery is performed to look for signs of cancer spreading. Following a mastectomy, may involve reconstructing your breast. In addition to your cancer type, how advanced it is, your general health, and your personal preferences, your healthcare team will recommend the type of surgery you should have. You may only need surgery as part of your overall treatment plan, or you may require it as the only option.
Types of Breast cancer surgery?
A mastectomy and a lumpectomy are the two types of surgery used to treat breast cancer. Additionally, lymph nodes can be removed and analyzed, as well as breast reconstruction can be performed to treat breast cancer.
Mastectomy:
Most breast cancer patients undergo mastectomy surgery or breast removal surgery. Breast cancers can be treated both at late stages and early stages with mastectomy. Also, some people who are at high risk of developing breast cancer in the future elect to undergo prophylactic mastectomy. The following types of mastectomy procedures are available:
• Total mastectomy: The entire breast is removed, sparing the chest muscles underneath.
• Double mastectomy: Both breasts need to be removed. There is a possibility that a mastectomy will be necessary to prevent cancer from spreading to both breasts or if it has already spread.
• Skin-sparing or nipple-sparing mastectomy: The breast tissue is removed, but the skin and, if possible, your nipple are spared, so they can be used for breast reconstruction.
• Modified radical mastectomy: Breast tissue and underarm lymph nodes are removed. It is common for breast cancer to spread first to the lymph nodes.
• Radical mastectomy: An operation to remove your breasts, the lymph nodes under your armpits, and your chest muscles. Breast cancer infiltrates the chest muscles, making this a rare surgery.
Lumpectomy:
Only a small amount of breast tissue is removed during a lumpectomy, which is also known as breast-conserving surgery. Breast cancer at an earlier stage can be treated with this alternative method.
It is often possible to avoid radiation therapy by having a total mastectomy instead. In early-stage breast cancer, lumpectomy combined with radiation therapy is equally effective as total mastectomy for those who have the option. There are several types of lumpectomy procedures:
• Excisional biopsy: Tumors are removed for biopsy in this procedure. It can be determined if the tumor is cancerous by analyzing it in a laboratory.
• Wide local excision: A cancerous tumor and a margin of surrounding tissue are removed during surgery. Tests will be performed on marginal tissue afterward to determine whether it is cancerous.
• Quadrantectomy: This is a segmented mastectomy in which a quarter of your breast is removed, which includes the ducts and lobes. Tumors with ductal spread are recommended for this procedure.
• Re-excision lumpectomy: This procedure is performed after the tumor and its margin of tissue have been removed. An open surgical site will be opened and additional margins of tissue removed until no more cancer cells are found.
Lymph Node Investigation:
Cancer spreads to your lymph nodes first, and cancer in your lymph nodes may indicate that cancer has spread beyond your breast. A lymph node under your arm next to your affected breast can be removed and analyzed by your surgeon to find out. The most likely area for breast cancer cells to drain would be here. The following procedures are performed on lymph nodes:
• Sentinel lymph node biopsy: A lymph node biopsy is performed to determine if lymph nodes have been affected by cancer. Sentinel lymph nodes serve as an early indicator of breast cancer because they filter fluid draining away from the affected area of the breast. You will likely undergo a sentinel node biopsy after your surgeon removes your original tumor. An analysis of the sentinel node will be performed to determine if it contains cancer cells.
• Axillary lymph node dissection: Your surgeon may remove a larger portion of lymph nodes to analyze if the sentinel node biopsy results indicate cancer, or if the surgeon believes you have pervasive cancer in your lymph nodes. A surgeon removes a group of lymph nodes from an axillary region by dissecting a pad of fatty tissue. To detect cancer, they will carefully examine the tissue.
Reconstructive Breast cancer Surgery:
Reconstructive surgery can restore your breast shape if you have some or all of your breasts removed for cancer treatment. Often, plastic surgery techniques can be used immediately following a lumpectomy or mastectomy to reconstruct the breast. If your tissues have recovered from radiation therapy or chemotherapy, your surgeon may perform a separate surgery.
Even if you have immediate or delayed reconstruction surgery, a follow-up procedure may improve your results. You may need follow-up surgery to balance the size of your breasts or to reconstruct your nipple. Different methods can be used for breast reconstruction, and the process can be staged. Based on your condition and preferences, you and your surgeon will determine the best method and timing. The following methods can be used for breast reconstruction:
• Implant reconstruction: To restore your breast’s shape and volume, breast implants replace the tissue that has been removed. Saline or silicone gel fills the silicone shell of the implant. You can either have your original breast skin or a skin graft from another area of your body put over or under your muscle.
• Autologous or “flap” reconstruction: Reconstruction of your breast with this method involves taking tissue from another part of your body. The look and feel of breast tissue are more similar to those found on the belly or buttocks because of the fat and muscle they contain. To achieve more realistic results, surgeons sometimes combine flap reconstruction with implant reconstruction.
• Nipple reconstruction: The surgeon preserved your nipple in a nipple-sparing mastectomy or lumpectomy to use in your breast reconstruction. A skin graft taken from another part of your body can be used if your original nipple could not be preserved. The procedure may be done after breast reconstruction.
What advantages of Breast Cancer Surgery?
In breast cancer surgery, the main goal is to remove cancer, which if left untreated can be life-threatening. There are far more risks associated with breast cancer than with surgery.
Complications of Breast Cancer Surgery
The following complications may arise:
• Wound infection: If the area is swollen, hot, or red, these are telltale symptoms.
• Blood clots: If your leg is painfully swollen, you have chest pain, or your breath is short, call your healthcare provider.
• Seroma: The surgical site is swollen due to fluid buildup. The fluid usually dissolves on its own, but if it bothers you, a needle can be used to remove it.
• Lymphedema: You may experience swelling in your arm or hand if your lymph drainage system is disrupted. If this happens, contact your healthcare provider immediately.
• Nerve damage: It is possible to experience numbness, tingling, or pain during surgery in the chest, armpit, upper arm, or shoulder due to nerve damage. It usually takes several weeks for the nerves to heal themselves. Pain medication can be prescribed by your healthcare provider. • Hematoma: The pain and swelling caused by this are caused by blood collecting in tissues around the wound. However, it can take several months for it to disappear on its own. In case the swelling needs to be drained, you can do so.
How Long Does Breast Cancer Surgery Take?
Depending on how extensive it is, it might take a while. Simple lumpectomies with or without sentinel node biopsy can usually be performed in about one hour. In most cases, you will be able to go home the same day. The surgery may take between three and four hours for a mastectomy with axillary lymph node dissection or flap reconstruction at the same time. Depending on the surgery, one or more nights may be spent in the hospital. If you are in good health and the surgery is not extensive, you may be able to have a mastectomy and go home the same day.
How Long Does it Take to Recover from Breast Cancer Surgery?
There may be soreness and limited mobility in your chest and arms a few weeks after the procedure. Painkillers will be provided for you to take home. In addition, you will be given exercises to practice every day for your arm and shoulder.
To prevent stiffness, these exercises are essential. It is possible that you will feel tired for a while. Regaining your former energy levels may take several weeks. If you need assistance around the house, you may need someone to help you. The process of returning to normal activities typically takes about a month.
Preparing for Breast Cancer Surgery: Important Steps and Guidelines
Introduction: Preparing for breast cancer surgery is a crucial part of your treatment process. It involves following specific instructions and undergoing necessary tests and screenings before the surgery. This article aims to simplify the steps involved in preparing for breast cancer surgery, making it easier for non-medical professionals to understand.
- Consultation with your surgeon: Schedule a meeting with your surgeon to discuss the surgery options available to you. This is the time to ask questions and share your goals and expectations for the surgery.
- Pre-operative instructions: Your surgeon will provide you with important instructions to follow before the surgery, such as:
- Fasting: You may need to avoid eating or drinking for a certain period before the surgery. This helps reduce the risk of complications during anesthesia.
- Medication guidelines: Inform your surgeon about all the medications you are taking. They will guide you on which ones to continue or stop before the surgery.
- Smoking cessation: If you smoke, your surgeon may advise you to quit smoking a few weeks before the surgery. Smoking can affect healing and increase risks.
- Bathing and hygiene: You may be asked to take a thorough shower using a special antibacterial soap on the day of surgery. This helps prevent infections.
- Clothing and personal items: Your surgeon will provide instructions on what to wear and bring on the day of surgery for your comfort and safety.
- Pre-operative tests and screenings: Before the surgery, you will undergo various tests and screenings to assess your overall health and ensure you are physically prepared for the procedure. These may include:
- Blood tests: These tests evaluate your blood cell counts, clotting abilities, and general health.
- Imaging tests: Your surgeon may order mammograms, ultrasounds, or MRIs to better understand the tumor’s characteristics.
- ECG and chest X-ray: These tests assess your heart and lung function in some cases.
- Anesthesia consultation: You may meet with an anesthesiologist to discuss your medical history, allergies, and any concerns about anesthesia.
- Preparing yourself mentally and emotionally: Breast cancer surgery can be emotionally challenging. Take care of your mental well-being by seeking support from loved ones, support groups, or counseling services.
Conclusion: Preparing for breast cancer surgery involves following instructions and undergoing tests and screenings to ensure your safety and well-being. By communicating with your surgeon, taking care of your physical and mental health, and following guidelines, you can approach the surgery with confidence and focus on your recovery.
When to Consult a Doctor for Surgery in Nepal?
If you want to have your breast cancer surgery done, you can first consult with an oncologist in Nepal. To move further with your procedures, you can either talk with a surgical oncologist or a medical oncologist in Nepal. After looking at the report, your breast cancer oncologist can then provide you with the available treatment option. Furthermore, the best breast cancer treatment doctor in your region will help you get the best treatment.
Breast cancer QnA
MS (NMC Regd.2902)
Head of the Department, Sr.Consultant Surgical Oncologist at Nepal Cancer Hospital and Research Center
Director: Breast Cancer Program
Interest: Breast Cancer Surgery, Gastro Intestinal Cancer Surgery (Stomach and Colo-Rectal Cancer)
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