Breast Cancer Surgery

What is breast cancer surgery?

Breast cancer surgery is a key part of breast cancer treatment and involves the removal of the cancer. The procedure can be done alone or in combination with other treatments, the most common being chemotherapy, radiotherapy or hormone therapy.

In addition, in people with a high risk of breast cancer, surgery is the best option to reduce the risk of breast cancer in the future. In any case and in any technique used, the patient will receive anesthesia, to make the operation as comfortable as possible and not feel anything.

Depending on the type of breast cancer and the stage of the tumor, there may be different types of surgery:

  • Mastectomy: surgery that removes the entire breast.
  • Surgery to remove the tumor, that is, part of the breast tissue.
  • Surgery to remove the surrounding lymph nodes.
  • Reconstructive surgery of the breast, after a mastectomy.

Breast cancer surgery is used to eliminate all the cancerous cells.

Why is it performed?

This surgery is performed in most women with breast cancer as part of their treatment. As mentioned above, there are different types of surgery, and the general surgeon may recommend a particular operation based on the characteristics of the patient’s breast cancer and her history.

The goal of breast cancer surgery is to remove all the cancerous cells that may be present in the breast. It is used to treat most breast cancers, and depending on the patient’s risk:

  • High risk of breast cancer. These are women with a strong family history, some non-cancerous biopsy results or genetic mutation. In these cases a mastectomy with or without breast reconstruction may be considered to prevent cancer.
  • Non-invasive breast cancer. If the diagnosis is ductal carcinoma in situ, one option is removal of the tumor, which may be followed by radiotherapy. These patients may also resort to mastectomy.
  • Early breast cancer. Small breast cancers may be treated by removing the tumor or with mastectomy (with or without reconstruction), with the addition of radiation and sometimes chemotherapy or hormone therapy.
  • Larger breast cancer. Larger tumors can be treated with mastectomy. However, sometimes chemotherapy, hormonal or targeted therapy is used before surgery to better remove the tumor. In addition, extra treatment with radiation therapy, chemotherapy or hormone therapy is sometimes recommended.
  • Localized and advanced breast cancer. If they are large cancers or have spread to lymph nodes, they are usually treated first with chemotherapy, hormonal or targeted therapy, to reduce it and make surgery more successful. A mastectomy or removal may be performed, followed by radiation therapy.
  • Breast cancer with recurrences. The tumor can be removed with a different surgery than the previous ones.
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What does it consist of?

Breast cancer surgery will depend on each case and the stage and size of the tumor suffered by the patient. The procedure is usually as follows:

  1. Anesthetize the patient, so that she suffers as little as possible during the intervention and can be comfortable.
  2. Incision in the breast, to remove the tumor and surrounding tissue. This is the operation itself, and the amount of tissue to be removed depends on whether the patient is having part of the breast tissue removed or the entire breast (mastectomy). The incision and how large it is will depend on the position and location of the cancer in the breast.
  3. Evaluation of the lymph nodes. The specialist will remove a few lymph nodes to which the tumor may be directed (sentinel node). They will then be examined to study the possible presence of cancer. If there is no cancer, it is not necessary to remove more, but if there are traces of cancer it is likely that the specialist will remove more nodes or recommend undergoing radiotherapy in the area after the operation.
  4. Close the incision with absorbable sutures, normally, so that it heals as well as possible.
  5. Reconstruct the breast, if necessary. Sometimes this can be started at the same time as the breast cancer surgery, and sometimes it must be delayed and a second operation performed.

Preparation for breast cancer surgery

It is very important, before the operation, to attend a meeting with the specialist in cancer and breast surgery. This will help the patient understand what treatment options she has and what to expect from the procedure. It is a good idea for the patient to draw up a list of questions that will arise during the course of the treatment: what operations may be appropriate, what options the different techniques offer, what part of the tissue needs to be removed, how many operations will be necessary, when breast reconstruction will be necessary, how the breast will look after treatment, among many others.

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On the other hand, during the preparation, the specialist will take a complete medical history of the patient, to know her history and the possibility of breast cancers or other cancers. Subsequently, analytical tests with coagulation, chest X-ray and an electrocardiogram will be performed, in addition to a study of the breast to rule out any other pathology and to better understand the patient’s breast structure.

Care after the operation

After the surgery, the patient will be transferred to a rehabilitation room, where her evolution will be monitored. The patient will wear a bandage over the incision, which will be evaluated by the specialists.

On the other hand, it is normal that the patient may feel pain, numbness or a prickling sensation in the armpit, since the specialists have been working in that area. It is very important, in this sense, that the patient receives proper instructions on how to care for and heal the wound at home, as well as the drains, to recognize any signs of possible infection and to know how to act.

She will also receive instructions on how to use a breast prosthesis, which bras to use and when to start wearing them.

In general, the specialist will give the patient the appropriate instructions to know how to resume her daily chores, taking the appropriate medication, a regular diet and adapting to the routine again.

Alternatives to this treatment

There are no alternatives to breast cancer surgery. Whether the patient should undergo it or not depends on many factors, as mentioned above, and the specialist will recommend one technique or another depending on the type of cancer the patient suffers from, the stage of the cancer and the success of the intervention. Breast cancer surgery is the only existing possibility to eliminate the cancerous cells.