Breast cancer surgery involves the surgical removal of a tumor and a portion of the surrounding normal tissue to prevent its spread to the other parts of the body. Breast cancer is generally malignant (spreads to other parts), developing from the uncontrolled growth of breast cells. It is caused due to a genetic abnormality, which can be inherited, or can occur due to aging and wear and tear of the body.
Breast cancer generally begins in lobules (milk-producing glands) or ducts (milk-draining passages extending from the lobules to nipple). Breast cancer can sometimes occur in the fatty and fibrous breast tissues. If left untreated, the tumor cells may invade into the nearby healthy breast tissues and into the lymph nodes of the underarm, which can spread to the other body parts.
Self-breast examination, mammograms, biopsies, blood tests and imaging studies can be ordered by your doctor to detect and monitor breast cancer.
Breast cancer is generally treated with a combination of surgery, hormone therapy (blocks some hormones), radiation therapy (use of high-energy rays) and chemotherapy (use of certain drugs). Deciding on the appropriate type of surgery for you will depend on the stage of cancer, type of cancer and its long-term benefits.
The two main types of breast cancer surgeries include:
The various types of mastectomy procedures include:
In some cases, you can choose between mastectomy and lumpectomy. If you have only one cancerous site, less than 4 cm of tumor and a clear margin of healthy tissue, lumpectomy with radiation are as effective as mastectomy.
Lymph node dissection: The removal of the lymph nodes is an important step in breast cancer surgery as the cancer cells can spread to the other parts of the body through lymph.
Your surgeon can remove five to thirty lymph nodes, an irregular pad of fatty tissue which contains lymph nodes, or sentinel nodes, which are the first lymph nodes into which the cancer cells can spread.
Following the removal of breast tissue, the breasts can be rebuilt to achieve a similar shape and size of the original breasts. Your doctor may perform reconstruction either during surgical procedure or a few months after the procedure. Breast reconstruction can be performed in two ways:
Other surgical therapeutic or preventive procedures can also be performed. Cryotherapy or cryosurgery uses extreme cold to kill cancerous cells of the breast. Your surgeon will insert small needles to deliver liquid nitrogen or argon gas into the cancer tissue. The procedure is performed under local anesthesia and a mild sedative. Another procedure is prophylactic ovary removal, which is a preventive surgery where ovaries and fallopian tubes are removed to lower estrogen levels in the body so that the chances of triggering the development of breast cancer are lowered.
Mastectomy and lumpectomy, without the dissection of the lymph nodes, is an outpatient procedure, where you will be discharged on the same day of the surgery. When dissection is involved, you will be required to stay in the hospital for a few days.
You will be prescribed medicines to relieve pain. You will be discharged with an external drainage device to collect fluid from the surgical site. You should keep the incisions clean and dry for a week after the surgery. A special surgical bra can be used to hold the bandages in place. You may experience tingling, numbness or discomfort in the armpit. The bluish-black color and swelling will lessen after a few days. You will be instructed to begin arm exercises on the next day after surgery to prevent stiffness, and to increase the exercise routine after consulting with your doctor.
You will be able to continue with your normal activities a few weeks after mastectomy, but may require only a few days for lumpectomy.
As with any surgery, breast cancer surgery involves potential risks and complications. They may include: