Breast Cancer Surgery

Executive Summary

The strategical method is developed to remove tumors and reduce cancer recurrence risk. The amount of breast tissue removed with the tumor varies depending on the surgical approach. Lumpectomy, simple or total mastectomy, and modified radical mastectomy are the most common surgery for breast cancer. Lumpectomy involves eliminating malignant tissue and a border of healthy tissue around it through a second incision and aims to preserve the normal breast as possible. Total mastectomy consists of removing the entire breast, but not the lymph nodes. Modified radical mastectomy includes the removal of all the breast tissue and the nipple.

Care is given to the patient facing any drainage issues after the surgery. After Breast Cancer Surgery, the incision should be maintained, cleaned, and dried for one week, so the patients have to stay in the hospital even after surgery for other follow-up checkups. Follow-up examinations involving chest, underarms, and neck exams are usually included in routine checkups. Breast self-examinations need to be carried out for checking the treated and unaffected breasts after the surgery.

Surgery in Breast Cancer

If you’ve been diagnosed with breast cancer, you may need surgery. The various choices differ in how much tissue is removed, the location of the tumor, where it may have spread, and your views about surgery.

Once breast cancer has been detected or diagnosed, surgical treatment strategies are developed to eliminate the tumor and decrease the risk of it recurring ^​1​. Breast-sparing procedures are discussed with your surgeon.

The amount of breast tissue removed with the tumor varies depending on the surgical approach. The method employed is determined by the size of the tumor, its location, if it has spread (metastasized), and your personal feelings. The surgeon may remove some axillary (underarm) lymph nodes; the lymph nodes are then analyzed to check if they contain any cancer cells. It is done to aid in the planning of your post-surgery treatment.

Before the procedure, the breast surgeon will review your surgical choices with you. The surgeon may propose a specific surgical method for you based on the size, location, and kind of breast cancer. Lumpectomy, simple or total mastectomy, and modified radical mastectomy are some of the operations your doctor may discuss with you.

Details of the procedure

What surgical treatments are available for Breast Cancer?

The amount of breast tissue removed with the tumor varies depending on the surgical approach. The method employed is determined by the size of the tumor, its location, if it has spread (metastasized), and your personal feelings. The surgeon may remove some axillary (underarm) lymph nodes; the lymph nodes are then analyzed to check if they contain any cancer cells. It is done to aid in planning your post-Breast Cancer Surgery treatment.

Before the procedure, the breast surgeon will review your surgical choices with you. The surgeon may propose a specific surgical method for you based on the size, location, and kind of breast cancer. Lumpectomy, simple or total mastectomy, and modified radical mastectomy are some of the operations your doctor may discuss with you.

Lumpectomy

Partial mastectomy is another term for a lumpectomy. The surgeon eliminates the malignant tissue and a border of healthy tissue. A second incision (cut) may be done to remove lymph nodes. This procedure aims to preserve as much of the normal breast as possible.

The residual breast tissue is routinely treated with radiation therapy for 4-5 weeks after the lumpectomy. (A 3-week course of radiation therapy, or even a one-time dosage of intraoperative radiation therapy, may be administered in some cases). Early-stage breast cancer patients are ideal candidates for lumpectomy ^​2,3​.

Women who are not usually candidates for a lumpectomy include those who:

• Had radiation therapy to the breast that is affected
• Have two or more cancerous spots in one breast that are too far apart to be removed with a single incision (though there are currently research trials looking at this option)
• Have a vast tumor or one that is linked to or close to the chest wall or nipple?

Women with cancer not entirely removed by a lumpectomy may require additional Breast Cancer Surgery to remove the remaining cancer cells. To aid with this decision, the margins of the removed specimen are assessed. 

Total Mastectomy

The entire breast is removed during a simple or total mastectomy, but no lymph nodes are removed. A simple mastectomy is most commonly done to prevent breast cancer in a woman at high risk or to treat cancer that has spread to the milk ducts (known as ductal carcinoma in situ) ^​4​.

A nipple-sparing mastectomy, which keeps the nipple and areolar complex, is sometimes an option. Breast reconstruction can be done using implants or the patient’s tissue, which is commonly taken from the lower abdomen. A sentinel lymph node biopsy is also performed in early-stage invasive breast cancer situations.

Radical Mastectomy

The surgeon removes all of the breast tissue and the nipple in a modified radical mastectomy. The axilla (underarm) lymph nodes are also removed, but the chest muscles are intact. Breast reconstruction is frequently recommended.

In a radical mastectomy, the surgeon removes all of the breast tissue and the nipple, lymph nodes in the underarm, and the chest wall muscles under the breast. This technique is only used if the breast cancer has grown to a considerable size and has spread to the chest wall muscles ^​5​.

It would be best to talk to your doctor about these surgical possibilities in detail to get the most significant results. After a brief time in the hospital, you will be able to return home, regardless of which type of Breast Cancer Surgery is ideal for you.

Recovery and Perspective

After Breast cancer surgery, how long will I be in the hospital?

The length of your hospital stay is determined by the type of surgery and reconstruction you have. Lumpectomies are typically performed as an outpatient procedure, with the patient recovering in a 23-hour, short-stay observation facility afterwards.

Mastectomies with lymph node removal typically require a one- to two-night hospital stay; tissue flap breast reconstruction may require a four- to seven-day stay. After 10 to 14 days, most women can drive again.

Drainage considerations

With an external drainage device in place, you may be discharged from the hospital. The drain will continually drain fluid from a catheter at the operation site into an external collection device. This collection device will be your responsibility to empty. Before you leave the hospital, your nurse or health care provider will go over how to care for your drain.

Throughout 24 hours, the amount of fluid evacuated will gradually decrease. The fluid’s hue may also shift from cherry-red to yellow-red, then to a straw-coloured fluid. The drainage system is usually removed at your follow-up appointment one week after surgery ^​6​.

Aftercare for incisions

Small strips of tape (called steri-strips) will stay over the incision site for 10 to 14 days after surgery and can be removed. After Breast Cancer Surgery, the incision should be maintained clean and dry for one week. As a result, sponge baths rather than showers are recommended for the first week ^​7​. If you can keep the area dry, you can bathe in a bathtub. Look for signs of infection such as redness and swelling.

Do not go swimming until you’ve talked to your surgeon about it at your follow-up appointment.

Changing the Surgical Bandage

After the Breast Cancer Surgery, you will wear a special bra (surgi-bra) to keep the bandages in place ^​8​. When you are ready to quit wearing the surgi-bra, your health care practitioner will let you know. The dressing is changed once a day. Here are the steps as a reminder:

• Remove the old dressings by opening the surgi-bra.
• Select the gauze with the slit from the new dressing package and wrap it around the drainage tube (where it comes out of your body). Place the other piece of gauze over the wound. Tape is not used. The surgi-bra must be closed. It is beneficial to have someone assist you in changing your dressing while lying in bed.

Note: A nurse will give you the supplies you’ll need to change the dressing when you get home from the hospital.

Pain alleviation. You will be given a prescription for pain treatment following the procedure before leaving the hospital. If Extra Strength Tylenol® isn’t enough, try Extra Strength Tylenol. Avoid taking aspirin or aspirin-containing products for the first three days after the procedure. Skincare is essential.

After the operation, the area may appear black and blue. In a few days, this will be gone. On the inner region of your upper arm or in your armpit, you may have numbness, tingling, or soreness. It is very typical. Increase your workout routine and take non-addictive pain medication like Tylenol. A warm shower may also be soothing, although you should wait one week after Breast Cancer Surgery before showering.

Before shaving or applying deodorant beneath the arm, look in the mirror to avoid irritating the incision. The incision may feel thick and tough while it heals. You can use a gentle lotion, vitamin E, or pure lanolin to massage the region. Avoid ointments with solid scents and any alcohol-based products. The scar will fade after a few weeks.

After Breast cancer surgery, it is critical to exercise. Perform these stretching exercises many times a day, beginning the day following surgery, to restore mobility:

• Arm lifts: Raise both arms over your head, elbows “touching” your ears, while standing or sitting on the edge of a chair. Hold for five counts before repeating.
• Arm swings: Swing both arms forth and back from your shoulders while standing (like a pendulum). Keep your elbows as straight as possible. Each time, increase the swing’s distance. Rep 10 times more.
• Standing against a wall with your feet close to the border is wall climbing. Place your hands on the wall and extend your arms out in front of you. Climb the wall with your fingertips until your arms are stretched over your head. Climb back down the wall with your fingertips. Repeat ten times more, aiming for a more excellent score each time.

Follow-up Examinations

Following breast cancer therapy, it is critical to have regular follow-up exams. Following Breast Cancer Surgery, you will most likely be monitored by an oncologist and your breast health care physician. You are continuously monitored to ensure that cancer has not reappeared. Exams of the chest, underarms, and neck are usually included in routine checkups ^​9​. You may have a comprehensive physical exam, blood tests, mammography, and potentially other imaging investigations from time to time.

Breast self-Examination

A woman who has had cancer in one breast is more likely to acquire cancer in the other. It would help to continue self-examine your breasts every month, checking both the treated and unaffected breasts ^​10​. Any changes are immediately reported to your health care practitioner.

Medication Injections/Blood Testing

It is preferable not to have blood drawn or an injection in the arm on the side where the surgery was conducted if you had an axillary dissection or lymph node removal as a preventive measure. If blood must be obtained from this arm or medicine must be administered, inform the health care provider that you have had breast surgery ^​11​.

When Should You Contact a Doctor?

Call your surgeon if you develop any of the following symptoms after returning from the hospital after Breast Cancer Surgery.

• Swelling in your arm or hand, near the incision, or beneath your arm (For the first month after surgery, a modest amount of swelling is usual.) Elevating your arm on cushions can help relieve some of the nodes).
• A temperature of more than 101 degrees Fahrenheit
• Drainage from the surgical drain has increased (more than 240 ccs or 8 oz over one 24-hour period)
• Increased pain that isn’t being treated by pain medication
• Other physical issues include a loss of appetite, irregular menstrual cycles, and hazy eyesight. It’s also crucial to report any odd or persistent dizziness, shortness of breath, coughing or hoarseness, migraines, or intestinal problems.

References