Surgery overview
Breast-conserving surgery removes the tumor and the tissue surrounding the tumor, with the goal of removing enough tissue to make the postoperative breast look as normal as possible, but at the same time ensuring that the chance of cancer recurrence is low.
Each person’s tumor is different in size and location, and therefore the amount of tissue removed during surgery varies. Briefly, there are two common breast-conserving procedures to consider:
- Mastectomy, is the surgical removal of a breast lump and some of the tissue surrounding it, with the lump being removed intact and sent to a laboratory for testing.
- Partial mastectomy, which is a larger excision, removes the area of the breast that contains the tumor, some of the breast tissue surrounding the tumor, and the fascia of the pectoralis muscle below the tumor.
Some axillary lymph nodes may also be removed during breast-conserving surgery. The lymph nodes are removed separately. If a tumor is found in the removed lymph nodes, more lymph nodes may be removed.
Most patients who undergo breast-conserving surgery will have radiation therapy. Patients may also have chemotherapy, endocrine therapy, or a combination of both.
What to expect after surgery.
If lymph nodes are not removed, a mastectomy may be performed under local anesthesia. If lymph nodes are removed or a partial mastectomy is performed, the patient will need to be under general anesthesia. After surgery, the patient will be taken to the recovery room. If there is nausea, pain, or anxiety, seek assistance from a nurse.
Many people are discharged home the same day as the surgery, but patients may choose to stay in the hospital for 1 to 2 days. The doctor or nurse will instruct the patient on pain management and surgical wound care. Bandages are usually removed and showers are taken on the second day after surgery. Female patients may wear a bra if they feel comfortable. Some doctors may recommend wearing a bra day and night for several days for support.
Most people are able to return to normal activities within a few days. But it is important to wait for your doctor to tell you when you can do more strenuous physical activity, depending on the extent of the surgery and other treatments the patient may be receiving.
If the patient is going to receive radiation therapy, it should not be done until after the wound has healed, which usually takes at least 2 weeks.
Why do I need breast-conserving surgery?
Why breast-conserving surgery?
Breast-conserving surgery is performed for early-stage breast cancer to remove as much breast tumor tissue as possible and to provide the best chance of cure.
What are the results of this surgery?
For early-stage breast cancer, breast-conserving surgery combined with radiation therapy has the same survival rate as mastectomy.
Risks
Complications of breast-conserving surgery are uncommon. Possible complications include infection, bleeding, poor wound healing, or an adverse reaction to the use of intraoperative anesthetics. Blood or clear fluid may accumulate in the wound site and require drainage. Patients may have pain in the chest with stretching, pinching, tingling, or numbness.
Patients who undergo breast-conserving surgery have a slightly higher chance of cancer recurrence compared to patients who undergo mastectomy.
Cautions
The more breast tissue that is removed during surgery, the greater the likelihood of significant postoperative breast changes. Experts recommend that before undergoing breast-conserving surgery, patients should consult with their physicians (and possibly plastic surgeons) about the appearance of their breasts after surgery.
Breast-conserving surgery may be considered after cancer staging is complete. For some patients, breast-conserving surgery may not be the best option, depending on the size of the tumor or the presence of several tumors that are too far apart.
Breast-conserving surgery is usually followed by radiation therapy. If the patient does not want or is unable to receive radiation therapy, breast-conserving surgery is usually not the best option.
Radiotherapy must be received on a schedule that takes a total of several weeks. If a patient cannot guarantee that they will be seen on time every time, they should consult their doctor about other treatment options.
Surgery is often used to treat breast cancer. If breast-conserving surgery is not the best option, a better choice is to choose from one of the three types of mastectomy.