A B C D E F G H I J K L M N O P R S T U V W

BREAST CANCER OPERATIONS

Why are Breast Cancer Operations being performed ?

The aim of any operation on the breast is to remove the cancerous area. Sometimes it is only necessary to remove either the small lump or the abnormal area of breast seen on x-ray (lumpectomy). With larger lumps, it may be necessary to remove the whole breast (mastectomy). In addition, it may be necessary to remove the lymph glands from the armpit (axillary clearance). This is done to see whether the tumour has spread to these glands. If this is so, it is usually necessary to recommend additional tablet treatment to help cure the disease. Finally, radiotherapy to the breast area may be recommended to kill off any stray cancer cells that may remain undetected in that area.

Preparations needed for Breast Cancer Operations

All operations on the breast will require a short stay in hospital. This ranges from 1 to 2 days, if only the breast lump is to be removed, to 7 to 10 days if a full mastectomy or operation on the armpit is to be performed. Any of these operations on the breast will require a period of about 2 weeks at home to recover fully.

What Happens during Breast Cancer Operations

All operations for breast cancer will require a general anaesthetic and are performed in an operating theatre. For lumpectomy , a small incision will be made close to the lump. This will be removed, together with a small rim of normal surrounding tissue. Usually the wound is closed with stitches over a small tube drain, which is removed quite painlessly after 24 hours. A mastectomy involves removing the whole of the breast tissue, some skin, together with the nipple and areola. This is usually done through an incision across the chest wall. Normally, two small tube drains are needed to prevent fluid and blood from accumulating under the skin. These will be removed when they stop draining. This usually occurs between 3 and 7 days after the operation. The lymph glands in the armpit can be removed either as part of the mastectomy operation or as a separate operation. In the latter case, a further incision is made in the fold of the armpit. All the lymph glands which reside in the fat of the armpit are removed. Again, the wound is closed with stitches over a tube drain, which will be required for about 5 to 7 days, after which the drain can be removed. The skin stitches will need to be removed between 7 and 10 days after the operation.

Possible Complications of Breast Cancer Operations

After any operation on the breast, bruising in the skin may occur. After mastectomy or lymph gland removal, tissue fluid may continue to accumulate under the skin after the drains have been removed. The fluid may then need to be drawn off using a needle and syringe. After lumpectomy, you should have minimal pain and discomfort. After mastectomy or lymph gland removal, there may be a feeling of numbness in the upper and inner part of the arm on the operated side. There may also be reduced movement of the shoulder for a few days. With physiotherapy, your movements will return to normal quite quickly. The numbness may last for up to a year or longer, but this does not affect the use of your arm.

After Breast Cancer Operations

After minimal surgery to remove a breast lump there should be no long-term problems. If lymph glands are found to be affected by cancer, then you will probably be given further tablet treatment to arrest the growth of these cancer cells . A test is done on the cancer cells removed at operation to see if they are sensitive to female hormones. If so, you will probably be given a tablet called tamoxifen to take for five years. This drug stops your hormones from stimulating any cancer cells which may be left, and has been shown to improve outcome. If your cells are not sensitive to female hormones, then you will probably be advised to have a course of chemotherapy of up to six months, sometime followed by tamoxifen. It is usual to stop tamoxifen after 5 years, since there is a small risk of it causing cancerous changes in the womb. An operation on the armpit can lead to slight swelling of the arm and hand, especially if radiotherapy treatment is also given. This swelling can occur during the first few months but may be made worse if radiotherapy is given. If the whole breast has been removed, you will usually be provided with a false breast before you leave hospital. You can wear this inside your bra. A nurse counsellor will often be available to discuss your problems before and after the operation. She will also be able to give you back-up and support when you return home. Some blood tests may be required from time to time during follow-up, to check that the cancer remains cured.

If Breast Cancer Operations are not performed

The cancer would enlarge and spread. The operation may then need to be more extensive and may even then prove unsuccessful. Anti-cancer drugs (chemotherapy) and x-rays (radiotherapy) can reduce the size of a tumour but by themselves do not provide a cure: it would still need to be removed.

Effects on Family of Breast Cancer Operations

If you have had breast cancer, you will need a great deal of support immediately after diagnosis, and again following any surgical or radiotherapy treatment. The simple fact of having had cancer itself causes worry, regardless of the treatment given. Support and reassurance from your family helps enormously. Not only is there the worry of the cancer, but also concern about the change of body shape. The breast may be seen not only as a sexual organ but also as a symbol of womanhood. You may understandably feel that your femininity and attractiveness have been lost and will appreciate help from a nurse counsellor. It is vital for family and friends to both listen to and understand all these worries and fears.