| Surgery
Surgical treatment aims to remove the cancer
from the breast so it is less likely to grow bigger, spread or return
later to the breast area. It involves an operation to remove part
or all of the breast. It is also known as primary treatment.
What types of breast
surgery are there?
There are two main types of surgical treatment.
For most women, both types are equally effective in treating breast
cancer. The two treatments are:
- Breast conserving treatment. This
treatment removes part of the breast, taking out the cancer and
a margin of normal breast tissue around the cancer. This procedure
is also known as a lumpectomy, wide excision, partial mastectomy,
quadrantectomy or segmental mastectomy.
- Mastectomy. A mastectomy removes the whole
breast.
Most women who have breast cancer surgery will
have an axillary dissection
at the same time; this removes some of the lymph nodes in the armpit
near your affected breast. For further information refer to Lymph
Node Involvement.
What factors should
I consider in choosing my surgery type?
The following table summarises factors to be
considered when choosing which type of surgery is most appropriate
for you.
| |
Breast conserving treatment that includes radiation
therapy
|
Mastectomy |
| Effectiveness |
Breast conserving treatment with radiation therapy is as effective
as mastectomy. |
A mastectomy is as effective as breast conserving treatment
accompanied by radiation therapy.
|
| Tumour size and position |
If the tumour is small then your surgeon will probably recommend
that you choose between breast conserving treatment and mastectomy.
|
If the tumour is large or involves the nipple or there is
more than one tumour your surgeon will probably recommend a
mastectomy. |
| Radiotherapy |
Radiotherapy is nearly always recommended and is usually administered
each weekday for about 6 weeks.
|
Radiation therapy is only occasionally recommended; this is
dependent on the pathology test results at surgery |
| Changes to your body appearance |
A small amount of your breast will be removed. Partial prostheses
are available. |
Your whole breast will be removed. Prostheses and/or breast
reconstruction are available.
|
| Fear of the cancer returning |
Some women feel concerned
about getting cancer in the remaining part of the breast &
in other parts of their body. Breast conserving treatment that
includes radiation therapy is as effective as mastectomy in
treating early breast cancer. |
It is very unlikely that the cancer will come back in the
breast area after a mastectomy. It is no 'safer' to have a mastectomy
than breast conserving treatment. |
What is breast reconstruction?
Breast reconstruction is the surgical rebuilding
of a breast after a mastectomy. This may be done at the time of the
original operation or some time later.
When considering a breast reconstruction, a woman with breast cancer
may want to consider two aspects. She needs to consider her feelings
about her body image and self esteem, and whether having a breast
reconstruction would be helpful. Also, she may want to consider the
long-term impact of breast surgery, particularly a mastectomy, on
her balance and posture.
For further information refer to Better
Health Channel's "Breast Reconstruction and Mastectomy".
What happens
before the surgery?
Before your surgery, your doctor will explain the risks involved and
ask you to read and sign a consent form. All surgery and anaesthesia
have some risks, including infection, swelling, pain, bleeding and
deep vein thrombosis (blood clot in the leg). These are not common,
but you need to understand the risks before you sign the consent form.
If you are not clear, ask for more detail.
What happens after
the surgery?
After the operation there will be 1 or 2 wounds.
This will depend on the position of your breast cancer and whether
or not you have had lymph nodes removed from the armpit (an axillary
dissection to test whether there is
Lymph Node Involvement). The wound(s) will be held together by
internal, dissolvable stitches.
You will have dressings on the wounds and
you may also have 1 or 2 drainage tubes in place. These will stay
in place for approximately 2 to 5 days.
You will be in hospital for two to five days, depending on how well
you recover, how you feel and what your doctor suggests.
Most women will experience some pain around the wound areas. Generally
those who have had an axillary dissection will also experience numbness
or tingling in the underarm area. Generally, these feelings go away
in the months after surgery, although the numbness may last longer.
Ask your doctor or nurse for pain relief if you do have any pain.
After a mastectomy, most women have a
horizontal scar across their chest. Some women will choose to have
Breast Reconstruction
surgery. Other women may choose to wear a breast prostheses.
After breast-conserving surgery, you will
have small scars on your breast and under your arm. Your breast
may be a different shape. This change in breast shape will vary
depending upon the amount of breast tissue removed.
Where to
next?
After surgery additional treatment may be recommended
such as chemotherapy, radiotherapy or hormone treatment. For this
treatment you would usually be referred to other members of the medical
treatment team.
This treatment is often referred to as Adjuvant
Treatment.
Is there another
website which gives further information?
For further information refer to The
Cancer Council's "Surgery".
Are there relevant
sections in the Multidisciplinary Care Guidelines for Women with
Breast Disease?
For a woman with breast cancer about to undergo
surgery refer to:
For the Health Care Professional refer to:
|
