My Breast My Health
BREAST CANCER SURGERY
If you were diagnosed with breast cancer, one of your treatment options may include surgery. Broadly speaking you can either have have a mastectomy with or without a reconstruction or breast conservation surgery (lumpectomy).
Mastectomy
A mastectomy is an operation that removes the entire breast. A simple mastectomy is when the breast is removed, including the nipple-areolar region. You can also have a mastectomy as part of a reconstruction (skin-sparing / nipple preserving mastectomy). This is where the skin of the breast is preserved, creating a pocket for the reconstruction. Sometimes, the nipple-areolar region can be preserved.
Q. When would we do a mastectomy?
Generally, if the cancer is large in relation to your breast size, then a mastectomy is
recommended. Other indications would include: more than two cancers in different parts
of the breast and inflammatory breast cancer.
Q. What does it involve?
For a simple mastectomy, the scar is placed across the chest. The breast, nipple-areola
region, and skin are removed. The result will be a flat chest.
Q. What does the scar look like?
The scar usually runs across the chest wall.
Q. How long does the surgery take?
Normally about 90 minutes.
Q. How long is recovery time?
Recovery time is usually relatively quick. You should not feel much pain or discomfort
and regular pain relief should be enough. It may take about 2 weeks to fully recover.
Q. Would I need any further treatment afterwards?
It depends on the final outcome of the surgery. Once the specimen is analysed in the lab,
we will have a better idea about whether further treatment is needed.
Q. Do I have to stay overnight?
You don’t have to stay in the hospital overnight. However, you will need someone to be
with you overnight if you are going home.
Q. What are the potential side effects and complications?
Like any surgery, a mastectomy has its risks and complications. These may include but
not limited to bleeding, infection, seroma (collection of fluid under the skin), numbness,
asymmetry and delayed wound healing. Some people also experience chronic pains.
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Lumpectomy
A lumpectomy means removal of a lump, in this case, the removal of the breast cancer lump. As the rest of the breast is left intact, it also known as breast conservation surgery. Other names for a lumpectomy include wide local excision or wire guided wide local
excision (if we use a wire to localise the cancer).
Q. When would we do breast conservation surgery?
We would do this operation when the size of the cancer is small in relation to the size of
the breast.
Q. What does it involve?
The aim of the operation is to remove the cancer with a good rim of healthy normal breast
tissue surrounding it. Once the cancer is removed, the surrounding breast tissue is
mobilised to close the defect created by removing the lump. This minimises the risk of
having a defect or dimple in the breast.
If after analyses by the histopathologist in the lab, the cancer is seen to be too close to the
margins, we will need to do a further operation to remove a little bit more of breast tissue,
to ensure a good clearance. This operation is done normally a few weeks after the first
operation.
Q. What does the scar look like?
The scar is usually not very long. We always try to make sure that the scar is placed as
hidden away as possible. But the most importantly, the placement of scar should not
hinder the removal of the cancer.
Q. How long does the surgery take?
It normally takes about an hour.
Q. What are the potential side effects and complications?
A lumpectomy is not a big operation, however, all surgeries carry risks.
These may include but not limited to: bleeding, infection, seroma (fluid collection),
numbness, change in breast shape.
Q. How long is recovery?
The operation is very well tolerated by most patients and recovery is usually relatively
quick. You should be able to return to normal activities within 7 – 10 days.
Q. Do I have to stay overnight?
No, the majority of cases are performed as day case surgeries. This means you can go
home on the same day after surgery.
Q. Would I need any further treatment afterwards?
This depends on the final characteristics of your cancer. If the cancer is an invasive
cancer, it is likely you will be recommended to have radiotherapy. Other treatments
include chemotherapy, endocrine treatment, and immunotherapy. However, these can only
be determined after the surgery.
