Breast cancer is a cancer that occurs in the breast cells and it is the most common cancer in women over the age of 50 but can also occur in younger women. The cancer typically forms in the ducts or lobules of the breast. If breast cancer is diagnosed at an early stage, there is a good chance of a cure. The more advanced the cancer, the less chance that treatment will be curative.
Most of the women suffering from breast cancer have some type of surgery as part of their treatment. Depending on the situation, breast cancer surgery may be performed to:
Treatment options for breast cancer include surgery, chemotherapy, hormone therapy and radiotherapy. A combination of two or more of those treatments is often used. The treatment modalities used depend on: the cancer itself-its size and stage (whether it has spread), the grade of the cancer cells and whether it is receptive to hormones or contains HER2 receptors. Alongside, causes and risk factors are also taken into consideration before suggesting the treatment option for breast cancer.
Surgeries used to treat breast cancer include:
Why is it done?
The purpose of breast cancer surgery is to remove cancer cells from the breast. A procedure for inserting breast implants or reconstructing a breast from the patient’s own tissue (flap surgery) can be performed at the same time or later for those who prefer breast reconstruction.
Breast cancer surgery is used to treat most of the breast cancer stages, including:
Surgical Treatment of Breast Cancer
There are two main types of surgery to remove breast cancer:
Breast-Conserving Surgery or Mastectomy: What to choose?
Most women with early-stage cancers have the option to choose between BCS and mastectomy. The significant advantage of BCS is that a woman can have most of her breast as only the part of the tissue with cancer cells will be removed, yet she still needs radiation in most cases. Women who undergo mastectomy are less likely to get chemotherapy for early stage cancers.
Mastectomy could be a better and safer option for many women because of the breast cancer type, tumor size, prior radiation treatment, or other factors. Many women may be concerned about the possibility of cancer recurrence from a less extensive surgery. Over the past 20 years, studies show that the survival rate for the people having BCS with radiation is equivalent to undergo mastectomy.
Surgery to Remove Nearby Lymph Nodes
To assess the spread of breast cancer to axillary lymph nodes, one or more of these lymph nodes will be removed and observed in the laboratory. This is an important aspect to find out the cancer stage. Lymph nodes can either be removed as part of breast cancer surgery or as a separate operation.
There are two main types of surgery to remove lymph nodes including:
Breast Reconstruction After Surgery
Many women who have breast cancer surgery can have the option of breast reconstruction. A woman having mastectomy prefers have the breast mound rebuilt after surgery to restore the appearance of the breast. A woman may consider in getting fat grafted into the affected breast in certain breast-conserving procedures to remove any dimples left from the surgery. The option of breast reconstruction depends on the medical situation and personal preferences of the woman. The patient can opt for breast reconstruction at the same time as the surgery (immediate reconstruction) or later (delayed reconstruction).
Patients may undergo breast reconstruction surgery at the same time or after mastectomy. A plastic surgeon with special training in reconstruction surgery performs this kind of procedure. The surgeon uses an implant or tissue from another any part of the body to create a breast-like shape that substitutes for the missing breast. The surgeon may even make a nipple outline and add a tattoo, which looks like the areola (the dark region around the nipple).
There are two main types of breast reconstruction surgery:
Breast implant: Breast reconstruction with an implant is performed in steps such as:
Breast implants do not last a lifetime. If you want to have an implant, you will possibly need further surgery to remove it or repair it later on. Implants can cause issues such as breast hardness, pain and infection. An implant can break, move or change its position too. These problems can occur soon after the surgery in in later times.
Tissue flap: A reconstructive plastic surgeon with special training performs this surgery. He creates a new breast-like shape from the muscle, fat, and skin taken from other parts of the body (usually the belly or back) in tissue flap surgery. This new shape to the breast should last for lifetime. Women who are extremely underweight or obese, who smoke or who have severe health issues cannot undergo tissue flap surgery. Healing after this surgery sometimes takes longer than healing after surgery with the breast implant. You may have other issues, such as infection, low wound healing capacity and pain.
If you are thinking of getting reconstructive surgery, it is a good idea to explore it before your mastectomy or BCS with your breast surgeon and with the plastic surgeon. It gives the time for the surgical team to prepare the best treatment recovery plans for you, even if you opt for the reconstructive surgery later
Risks After Surgery
Breast cancer surgery is one of the safest surgeries, but it may sometimes carry few possible risks of complications, including:
Radiation Therapy (RT) After Surgery
Many women who undergo a lumpectomy may have radiation treatment to the breast following surgery, and sometimes the underarm area. Likewise, some of the women who are under the treatment of mastectomy can have radiation therapy to chest along with the underarm area. Radiation therapy is given after the chemotherapy if the treatment plan includes chemotherapy.
Points to Remember for a Patient After Breast Cancer Surgery
Any patient who undergo breast cancer surgery can expect few after effects including:
It is important for a patient to follow certain set of measures to avoid any complications after the surgery. Doctor should give instructions to the patient on:
Author: (Dr. Ramakant Tayade)