Planning Treatment for Breast Cancer - Surgery for Breast Cancer
Surgery usually involves removing part, or sometimes all, of the breast (mastectomy). The type of operation you have usually depends on the size and position of the cancer. Your surgeon will recommend surgery that keeps as much of the breast tissue and the shape of the breast as possible. This is called breast-conserving surgery. However, in some situations removing all of the breast (mastectomy) is advised. Your doctor and breast care nurse will talk you through your options.
Your surgery may also involve having the lymph nodes in your armpit removed or you may have tests to check the nodes. Sometimes women are given treatment with hormonal therapy or chemotherapy to shrink the cancer before they have surgery.
In early breast cancer, studies show that removing the lump followed by radiotherapy is as effective as a mastectomy. Some women may be asked to choose for themselves which operation to have
Typesof surgery for breast cancer include:
· Wide local excision (lumpectomy)
· Mastectomy
Wide local excision (lumpectomy)
This is when the cancer and an area of surrounding tissue is removed. It’s called a wide local excision or lumpectomy. This operation removes the affected breast tissue and for most women the appearance of their breast after a lumpectomy is good.
If the lump is very small, a fine wire (guide wire) is used to mark the area to be removed so that the surgeon can find it more easily. The doctor or radiologist will inject some local anaesthetic into the area to numb it before inserting the wire, using x-ray or ultrasound to guide them.
Occasionally, an operation called a quadrantectomy is done. This removes a larger area of breast tissue. The effect on the appearance of the breast will be more noticeable than after a lumpectomy. The treated breast will be smaller than your other breast and there may be a noticeable dent in it. Women can have surgery to reduce the size of the other breast (mammoplasty) so that both breasts are the same size.
After these operations you’ll need to have radiotherapy to the remaining breast tissue to destroy any cancer cells that may have been left behind.
Some women may need to have all of the breast removed (mastectomy). A mastectomy is usually advised if:
· the lump is large in proportion to the rest of the breast
· there are areas of cancer in different parts of the breast (multi-focal)
· there’s widespread DCIS in the breast
· you’ve previously had radiotherapy to the chest, for example, to treat Hodgkin lymphoma.
Mastectomy
Types of Mastectomy
A mastectomy removes all of the breast tissue. At the same time, you may have a test to check the lymph nodes in your armpit, or have some (or all) of the nodes removed.
A radicalmastectomy is where all the breast tissue, the muscles behind the breast and the lymph nodes in the armpit are removed. It’s only done if the cancer is found in the muscle under the breast. But this type of mastectomy is rarely needed as chemotherapy or hormonal therapy can usually be given before surgery to shrink the cancer. This means a mastectomy that removes only the breast tissue can then be done.
Breastreconstruction
If you’re having a mastectomy, you’ll usually be offered breast reconstruction at the same time. This is when a new breast shape is formed. Breast reconstruction is very specialised surgery. Surgeons who do this type of operation may be plastic surgeons or oncoplastic surgeons, who are trained in both breast cancer surgery and reconstruction surgery.
Different techniques are used – for example, muscle from the back or the tummy area, or a silicone implant can be used. Some women may decide not to have it done immediately – it can be done months or even years after a mastectomy.
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