- Overview
- Treatment
- Managing Life While Having Breast Cancer
- Concerning Health
- Cancer
- Cancer of the Breast
- What Specific Kind Of Surgery Is Performed On Patients Who Have Breast Cancer?
- What Specific Type(s) of Surgery are Involved in the Breast Cancer Treatment Process?
- There are many different options to think about, and the one you choose will depend on your current state of health as well as your personal preferences.
- In order to diagnose breast cancer, a radiologist will examine an X-ray image of the breast.
One of the most popular ways to treat breast cancer is through surgical excision. Surgeons have made great strides in recent years in discovering new techniques that make operations not only safer but also more successful and require less invasive procedures. Because to recent medical advancements, patients diagnosed with breast cancer now have access to a variety of surgical options, including the following:
- Surgical procedure aimed at preserving breast tissue, often known as a lumpectomy
- Surgical removal of the breasts with flat closures
- Surgical removal of the breasts followed by reconstructive surgery
With the help of these possibilities, you will be able to construct a treatment strategy that takes into account not only the severity of your breast cancer diagnosis but also your priorities and way of life. In spite of this, being forced to make a significant choice at a time when you might already be feeling emotionally or physically spent might give you a sense of being completely overwhelmed.
Mark Mugiishi, MD is the president and chief executive officer of the Hawaii Medical Service Association. Previously, he worked as a surgeon at the Ekahi Health-Central Medical Clinic in Honolulu, where he specialised in breast surgery. In this section, he gives direct responses to the most often asked concerns regarding what each operation comprises in order to assist you in feeling secure about your choice in the end.
Breast cancer diagnosis with surgical excision
According to Dr. Mugiishi, breast cancer can be diagnosed by surgery and treated through surgery. Surgeons will extract a sample of a suspicious location with a needle if it shows up on a mammography or an ultrasound scan. These scans look for breast abnormalities. After that, they will examine it under a microscope in order to make a determination.
It is only through this process, which is known as a biopsy, that your surgeon will be able to determine whether or not a painful lump, a spot on your mammogram, or a change in your breast is caused by cancer.
A surgical procedure to remove the malignancy
Your healthcare provider (HCP) and you might talk about the various surgical procedures that are available to treat your diagnosis, taking into account your individual preferences. The majority of people have the following options:
Breast-conserving surgery, or lumpectomy, is another name for this procedure. The tumour and some of the good tissue that is located around it, which is referred to as the margin, are both going to be removed during the BCS procedure. After that, the margin is analysed to find out whether or not all of the tumour was successfully removed, or whether or not some cancer cells were still present. The amount of breast tissue that needs to be removed is determined by a number of criteria, including the size of the lump, where it is located, and the stage of the cancer.
According to Mugiishi, breast conservation surgery (BCS) is preferred by surgeons whenever it is an option since it prevents the removal of healthy breast tissue along with the tumour.
The length of time needed to recover from BCS is not particularly long. It is possible to carry out the treatment as an outpatient, which means that you won’t have to spend the night in the medical facility.
“After that, you’ll be allowed to resume activities whenever you see fit,” Mugiishi says, although it could take some people up to two weeks to feel ready to do so.
Radiation is a type of therapy that uses intense rays to eliminate any cancer cells that may still be present after BCS has been completed for the majority of patients. Radiation therapy is a local treatment that is administered to just the area of the breast where the cancer has manifested itself. Radiation may induce adverse effects such as fatigue and skin irritation, although everyone reacts differently to it in their own unique way. Alterations in the size, colouring, porosity, sensitivity, and thickness of the breasts may be another potential long-term effect of radiation exposure.
A mastectomy is a surgical procedure in which the patient’s entire breast is removed. It’s possible that some of the tissues around the tumour, such the chest muscles and lymph nodes, will need to be removed as well, depending on how far the cancer has gone. It’s possible that you’ll need to spend the night in the hospital after this operation, and it might be a few weeks before you can get back to your regular activities.
It is possible that you will have a mastectomy rather than BCS if the tumour has certain traits or if you have certain circumstances, which may include the following:
- Your tumour is either quite huge or the margins around it are not very apparent.
- You have many tumours
- Radiation is something you do not want or are unable to have.
- You have already undergone BCS in that breast; nevertheless, the cancer has returned.
- There are changes in either the BRCA1 or BRCA2 gene in your body.
- You are at an increased risk of developing a second cancer.
- You suffer from inflammatory breast cancer, a kind of breast cancer that is known for its high degree of malignant potential.
It is possible that pregnant women who have been diagnosed with breast cancer will be encouraged to have a mastectomy rather than BCS.
You may decide to have breast reconstruction performed immediately after your mastectomy if you opt to have both the mastectomy and the reconstruction done at the same time. Following a mastectomy, this procedure will reconstruct the natural form of the breast. (It’s also a possibility following a BCS operation that’s more intrusive.)
Before undergoing a mastectomy, you should consult a surgical oncologist who specialises in breast cancer as well as a plastic surgeon to discuss your options for reconstructive surgery. This is true even if you plan to delay the procedure for some time. Your healthcare provider will be able to guide you through the process of selecting the breast reconstruction method that is most appropriate for you given the variety of options available.
“If you are going to have reconstructive surgery in the future, you might even get the plastic surgeon who is going to be engaged in the initial mastectomy operation,” adds Mugiishi. “This is something to consider if you are going to have reconstructive surgery.” They are able to position the scars in precisely the same way that they would for repair.
Keeping an eye out for the progression of cancer
During the breast cancer removal procedure, your surgeon will most likely perform a biopsy on the sentinel node. Lymph nodes are small glands that are located throughout the body and have the function of collecting trash, pathogens, and cancer cells before filtering them out of the body. When cancer spreads, it typically reaches a subset of lymph nodes known as “sentinel nodes” before moving on to other lymph nodes. During a sentinel node biopsy, the lymph node or nodes (typically one to three) that filter and drain the breast tumour region are removed, and then they are examined for signs of malignancy. After performing the biopsy, the surgeon will send it to a laboratory so that a research technician can examine the cells under a microscope to confirm or disprove the presence of cancer.
According to Mugiishi, there is no need to remove any additional lymph nodes if the sentinel node tests negative for the presence of malignancy. If the cancer has advanced to the first lymph node, your surgeon will likely need to remove additional lymph nodes from the area around your armpit in order to assess the full extent of the disease.
Survival rates, compared
A Swedish research of 48,986 participants was published in JAMA Surgery in 2021, comparing those who received breast conserving surgery (BCS) with those who opted for mastectomy. According to the findings of the study, the overall 5-year survival rate for patients who underwent BCS in conjunction with radiation was greater (95.1 percent) than the survival rate for patients who underwent mastectomy in conjunction with radiation (86 percent). The breast conserving surgery (BCS) group treated with radiation had a 5-year breast cancer survival rate of 98.2 percent, whereas the mastectomy group treated with radiation had a survival rate of 90.5 percent.
Because you keep your breast after BCS treatment, there is a possibility that the cancer will return in that region. This is an important point to keep in mind. Mugiishi advises that a mastectomy should be considered at that moment if it does occur.
Anticipations following medical procedures
It is possible that you will leave the hospital with drains still in your breasts after surgery. These drains were placed there during the treatment. Before you leave the hospital, the medical staff may take out some of the drains. You won’t be able to move anything heavy or your arms if you have drains, which may stay in place for up to two weeks after surgery. This could happen anywhere from one to two weeks after surgery.
During this time of recovery, it is absolutely necessary to dress in shirts that can be buttoned or zipped. Your healthcare staff will provide you with advice on how to manage pain, how to change bandages in a safe manner, and how to take a shower.
In the end, the decision between breast conservation surgery (BCS) and a mastectomy is highly individualistic. The option to not participate in the reconstruction is also available. Catherine Guthrie, a health journalist, made this decision for herself following a double mastectomy after being diagnosed with two bouts of breast cancer at the age of 38. Flat: Reclaiming My Body From Breast Cancer is a memoir that she wrote to talk about her experience with breast cancer and to encourage others to advocate for themselves. She titled the book “Flat.”
While this was going on, Hoda Kotb, a journalist for the Today show, discussed her history with breast cancer live on the air in May of 2022. Kotb underwent a mastectomy in 2007, and she was initially upset with the surgical scars that resulted from the procedure. She made the decision to get reconstruction, and 15 years later, she expressed a new appreciation for how she looked in general.
She is quoted as saying, “Now I look at my scars, and I’m happy.”
Identifying the surgical procedure that will best serve your needs.
You may experience a sense of urgency about eradicating the cancer as early as possible when you are attempting to determine which operation to have. This may affect your decision. However, it is essential to make sure that you take the time to perform the following:
Investigate the various possibilities. Make sure you ask your healthcare provider for handouts on each operation. Make a list of questions you want to ask your surgeon as you continue to read, and then take notes when you have those conversations.
If it is at all possible, you should include a surgical oncologist who specialises in breast cancer as part of your care team.
Talk to the people you care about about your treatment strategy.
Find out about your family’s medical history, including whether or whether any of your loved ones have ever been diagnosed with cancer.
If at all possible, you should also try to seek a second opinion. Your HCP will not take offence at this; rather, they will want you to have confidence in the choice that you have made. Your mind can be put at ease, and you can regain control of your treatment plan, if you gather as much information as you possibly can.
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