If diagnosed with breast cancer, you will be assured of the best treatment possible for your condition. Your specialist will explain in detail the procedures to be undertaken, surgery being one of the initial treatments. This will involve the removal of cancer cells from your breast and assessing the possible spread to your lymph nodes in the armpit.
There are several surgical procedures appropriate to the treatment of breast cancer. Which type you have will depend on the location of the cancer cells, how large or widespread they are, and your personal preference will also be considered. Your surgeon and our knowledgeable team will be able to advise and help you make an informed decision.
Partial Mastectomy or Lumpectomy
A partial mastectomy or lumpectomy (sometimes known as breast conservation) involves the removal of the lump and a small portion of breast tissue surrounding it. This procedure will be recommended after consideration is given to the size of the lump, the size of your breast and your preference. You will most probably be advised to undergo radiotherapy afterwards.
A mastectomy involves the removal of all breast tissue including the nipple and areola. This procedure may be recommended over breast conservation surgery if you have previously received radiation therapy to that breast, have had a partial mastectomy, your lump is large when compared with the total size of your breast, you have multiple tumours, or because you have expressed a personal preference for mastectomy.
If you have an invasive breast cancer, your surgeon will recommend that some of your axillary lymph nodes (the glands under your armpit) be removed during your surgery. This allows us to determine whether the cancer has spread beyond your breast. There are two types of procedures to remove axillary lymph nodes, these will be explained to you in detail by your surgeon and an appropriate option selected to suit your individual needs.
Sentinel Node Biopsy
During this procedure, a blue die is injected near the tumour assisting your surgeon in identifying the first lymph nodes the breast cancer might spread to. These few nodes will be removed for testing during your operation. A sentinel node biopsy minimizes the surgical procedures required and lowers the risk of complications such as lymphedema, which causes swelling in your arm.
Removing more axillary lymph nodes than a sentinel node biopsy, your surgeon may recommend you have axillary clearance if your breast cancer is larger, or if there is existing evidence the cancer cells have already spread to this region.
During discussions concerning your surgery and treatment, you will be asked to consider the options of breast reconstruction surgery or breast prosthesis. We will provide all information you need pertaining to the procedures, risks and outcomes.
Our breast reconstruction surgeons emphasise that your reconstructed breast may never perfectly match your original breast, but it can provide you with a very acceptable outcome. Aiding your appearance after a mastectomy, it can also help to improve your balance, posture and personal well-being.
Depending on your individual circumstances, we may recommend you have the surgery at the same time as your mastectomy. In some cases, it is advisable that you wait up to 12 months and completely recover from the initial phases of your treatment.
Breast reconstruction after mastectomy is the creation of a new breast using either your own body tissue or breast reconstruction implants. Your surgeon will help you evaluate the best option for you.
Breast Reconstruction Implants
Before inserting breast reconstruction implants, surgeons may first place an inflatable “tissue expander” under your skin. Over several weeks, saline injections gradually fill this expander to stretch your skin. When ready, the surgeon will remove the tissue expander and insert a silicone breast implant to create your new breast.
Breast Reconstruction using your own tissue
A new breast can also be reconstructed using your own tissue (autologous tissue reconstruction) presenting a very natural looking and feeling breast. This method can be utilised when implants may not be suitable, or through your own choice. Common locations from which tissue can be used for reconstruction include the lower abdomen or the back. This method of reconstruction is the more complex of the two – your surgeon will work alongside a plastic surgeon to ensure the best results.
Breast Surgery Anaesthesia Information
Most surgery requires a general anaesthetic, or sometimes a local with sedation. You will be provided with a comprehensive fact sheet detailing the procedure you will be undertaking and the associated risks, accompanied by a questionnaire asking you to record your current medications and conditions.
You can be assured that your anaesthetist is highly qualified and experienced, using up-to-date methods and equipment.
At the completion of your surgery, your wound will be closed with dissolving sutures (stitches) and covered with thin, adhesive strips called Steri-strips and a waterproof plastic dressing. This dressing will still be on when you leave hospital, and will be changed at your post-operative appointment.
You will need to arrange for time off work to accommodate your hospital stay and your convalescence at home. This will depend on the type of surgery you have and how physical your work is. Your surgeon will discuss this with you in detail.
You will be provided with guidelines concerning the levels of activity you may carry out in the home and workplace – it is very important you follow these instructions to ensure complications do not develop. Your surgeon will also prescribe pain relief – take it as prescribed, and call your surgeon if pain is not relieved satisfactorily.
At your post-operative appointment, your surgeon will be inform you of the results of your surgery and pathological tests. You will be invited to express any concerns you may have and will be advised of the treatment plan moving forward.