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How To Remove Breast Cancer

What Are The Potential Risks Or Complications Of Lumpectomy

Breast Cancer | Tumor Removal Surgery | Nucleus Health

Every surgery has some risk. But lumpectomy is a common procedure that offers a high level of safety and effectiveness. Its less invasive than mastectomy, a breast cancer surgery that removes the entire breast.

Potential complications of lumpectomy surgery include infection, bruising and swelling in your arm or hand closest to the affected breast.

Why Should I Get Radiation After Surgery

Most people have radiation treatments after lumpectomy surgery to destroy any remaining microscopic cancer cells. This combination is a standard treatment option for women with breast cancer. . It effectively treats cancer while preserving more of how your breast looks and feels.

Research has shown lumpectomy plus radiation offers long-term survival rates that are similar to those who have a mastectomy .

Signs And Symptoms Of Infection

Having drains provides bacteria an access route to your body, and the longer drains are in place, the greater the risk of infection.

Signs of a drain-related infection may include:

  • A fever with a temperature of 101 degrees F or higher
  • Redness of your skin surrounding the drain
  • Hardness or firmness where the drain exits your body
  • Thickening rather than thinning of the drained liquid
  • Foul smelling drainage or pus at the entry site
  • Pain or discomfort at your drain sites
  • A sudden change in the smell or color of the drainage

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Choosing To Stop Treatment Or Choosing No Treatment At All

For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.

Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but its important to talk to your doctors and you make that decision. Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.

Checking Lymph Nodes Before Surgery

Removal of breast tumor by surgery...

If you have invasive breast cancer, your treatment team will want to check if any of the lymph nodes under the arm contain cancer cells. This helps them decide whether youll benefit from any additional treatment after surgery.

Usually an ultrasound scan of the underarm is done before surgery to assess the lymph nodes.

If this appears abnormal, youll have a fine needle aspiration or a core biopsy to see if the cancer has spread to the lymph nodes. An FNA uses a fine needle and syringe to take a sample of cells to be looked at under a microscope. A core biopsy uses a hollow needle to take a sample of tissue for analysis under a microscope.

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What Is Breast Reconstruction Surgery

You may choose to have breast reconstruction surgery after a mastectomy to rebuild the breast so that it looks similar to the way it did before the surgery. Many times this can be done at the same time as your breast cancer surgery. But it is also possible afterward, even years later. There are many options for reconstruction. After lumpectomy, doctors can enhance the appearance of the breast using fat injections to plump up any dimpled areas where tissue has been removed. They can also perform a breast lift or breast reduction or do plastic surgery on the other breast to create a closely matched pair. After mastectomy, methods of rebuilding the breast include breast implant surgery and using tissue from another part of your body to create a new breast.

Checking Lymph Nodes During Surgery

The sentinel node is the first node that fluid drains to from the breast into the armpit. This means its the first lymph node the breast cancer could spread to.

A few hours before the operation, you have an injection of a small amount of mildly radioactive liquid into your breast close to the cancer. You usually have this in the nuclear medicine department in the hospital. The radioactive liquid is called a tracer.

During the operation, your surgeon may also inject a small amount of blue dye into the breast. The dye and the tracer drain away from the breast tissue into nearby lymph nodes.

The surgeon can see which group of lymph nodes the dye reaches first. They also use a radioactive monitor to see which group of lymph nodes the tracer gets to first.

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Summary Of Surgery Timing

Though we don’t have a solid answer on how soon surgery should be done after a diagnosis of breast cancer , it would seem earlier surgery is ideal .

Delaying for a lengthy period of time can be dangerous, with studies finding that those who delay over six months are twice as likely to die from the disease. This is important to keep in mind for those who have breast lumps they are “observing” without a clear diagnosis. Any breast lump needs to be explained.

Removing The Lymph Nodes

Nalie’s Mastectomy | Surgically Removing Breast Cancer

Cancer cells might have spread into the lymph nodes close to the breast.

Lymph nodes are found in many parts of the body. They filter out bacteria and damaged cells from the lymphatic fluid, and contain cells that fight infection.

Before your surgery you have an ultrasound scan to check the lymph nodes in the armpit close to the breast. You will have a biopsy of the lymph nodes if they look abnormal. This is to see if they contain cancer cells

Doctors need to know if the lymph nodes in the armpit contain cancer as this helps them to plan your surgery.

You may have a sentinel lymph node biopsy or an axillary lymph node dissection. You usually have one of these at the same time as your breast surgery. But some people might have an axillary lymph node dissection at a second operation.

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The Purpose Of Drains

Surgical drains perform an important role in healing after breast surgery. Fluid often builds up in the area where a breast is removed and can cause discomfort and delay healing if it is not drained.

Drains also reduce the chance that you will develop a seroma, a collection of fluid that can be uncomfortable and sometimes cause scarring. For this reason, your surgeon will place drains in the regions where fluid is expected to accumulate.

The downside of drains is that they offer bacteria a way to enter the body, so keeping the area around your drains clean and dry is important.

While there are different types of surgical drains, the type used most often for breast surgeries is the Jackson-Pratt drainage system. These drains are placed within your surgical field and are attached to flexible tubing that passes through and is stitched to your skin. The tubing is capped with a soft plastic bulb, which catches and holds the fluid, and a stopper outside of your body.

Most drains are left in place for two to three weeks, but some may be removed before you leave the hospital and others may need to be left in place for longer than three weeks. The risk of infection, however, begins to increase rapidly after they have been in place for 21 days.

Physical Emotional And Social Effects Of Cancer

In general, cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

  • Music therapy, meditation, stress management, and yoga for reducing anxiety and stress.

  • Meditation, relaxation, yoga, massage, and music therapy for depression and to improve other mood problems.

  • Meditation and yoga to improve general quality of life.

  • Acupressure and acupuncture to help with nausea and vomiting from chemotherapy.

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How To Care For Surgical Drains

When you wake up from surgery, your recovery room nurse will probably warn you that you need to be careful with your drains. Depending on the length of the tubes , it’s easy to get these tangled up with IV lines, your bedclothes, and anything else nearby.

Your nurse will periodically drain your bulbs and show you how it’s done. He or she will log the amount of drainage from each tube, and you will be instructed to continue the log on your own until your drains are removed.

Before you leave the hospital, your healthcare team will review drain management, tell you about symptoms that should prompt you to call, and schedule a follow-up visit to have them removed.

Breast Cancer: Types Of Treatment

Breast Cancer Surgery Photograph by Dr P. Marazzi/science ...

Have questions about breast cancer? Ask here.

ON THIS PAGE: You will learn about the different types of treatments doctors use for people with breast cancer. Use the menu to see other pages.

This section explains the types of treatments that are the standard of care for early-stage and locally advanced breast cancer. Standard of care means the best treatments known. When making treatment plan decisions, you are strongly encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug and how often it should be given, a new combination of standard treatments, or new doses of standard drugs or other treatments. Some clinical trials also test giving less treatment than what is usually done as the standard of care. Clinical trials are an option to consider for treatment and care for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

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Breast Reconstruction Surgery After Mastectomy

After having a mastectomy a woman might want to consider having the breast mound rebuilt to restore the breast’s appearance. This is called breast reconstruction. Although each case is different, most mastectomy patients can have reconstruction. Reconstruction can be done at the same time as the mastectomy or sometime later.

If you are thinking about having reconstructive surgery, its a good idea to discuss it with your surgeon and a plastic surgeon before your mastectomy. This allows the surgical teams to plan the treatment thats best for you, even if you wait and have the reconstructive surgery later. Insurance companies typically cover breast reconstruction, but you should check with your insurance company so you know what is covered.

Some women choose not to have reconstructive surgery. Wearing a breast prosthesis is an option for women who want to have the contour of a breast under their clothes without having surgery. Some women are also comfortable with just going flat.

How Long Will I Stay In The Hospital After Breast Cancer Surgery

The length of stay in the hospital depends on the type of surgery and reconstruction that is performed. Generally, lumpectomies are done on an outpatient basis, and the patient recovers in a 23-hour, short-stay observation unit after the procedure.

Mastectomies with lymph node removal usually require a one- to two-night stay in the hospital with tissue flap breast reconstruction, the stay may be 4-7 days.

Most women can resume driving 10 to 14 days after surgery. Please ask your surgeon for specific recommendations.

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Are Exercises Beneficial In The Healing Process After The Breast Cancer Surgery

Once the patient recovers from the breast cancer surgery procedure, the doctor may recommend some stretching exercises that may be beneficial to regulate and gain mobility. It is important to talk to the surgeon before starting with the exercises.

Arm Lift Exercises: Arms lifts are seen to be beneficial after the breast cancer surgery. While standing or sitting on the edge of the chair, both of the arms may be lifted over the head with elbows close to the ears. The position should be held for five counts and then repeated.

Arm Swing Exercises: Arm swings are another form of exercise helping in mobility. As the patient stands straight, she may swing both arms forward and backward from the shoulder like a pendulum keeping the elbow straight.

Wall Climbing Exercises: Wall climbing may be recommended for patients at times. In this, the patient has to stand facing the wall with hands on the wall. The fingertips of both the hands may be used to climb up the wall until the arms are stretched over the head. Again, the patient has to climb the fingers down the wall.

Mastectomy: Advantages And Disadvantages

Does Removing the Ovaries Reduce Breast Cancer Risk?

For some women, removing the entire breast provides greater peace of mind . Radiation therapy may still be needed, depending on the results of the pathology.

Mastectomy has some possible disadvantages:

  • Mastectomy takes longer and is more extensive than lumpectomy, with more post-surgery side effects and a longer recuperation time.
  • Mastectomy means a permanent loss of your breast.
  • You are likely to have additional surgeries to reconstruct your breast after mastectomy.

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What Happens After The Sentinel Lymph Node Biopsy

If the lymph nodes do not contain cancer cells, you wont need to have any more nodes taken out.

If there are cancer cells in the sentinel nodes you usually need more treatment. You may have another operation to remove most or all of the lymph nodes under your arm . This is generally about 2 weeks after you get the results.

Some people have radiotherapy to the armpit to destroy any remaining cancer cells instead of surgery.

What Are Some Of The Possible Risks Or Complications

Minor complications include:

  • Slight swelling of the breast during radiotherapy. This usually goes away within six to 12 months.
  • The skin becomes darker during the course of radiotherapy, similar to tanning from the sun. In most cases, this also fades gradually over six to 12 months.
  • Most women will have aches or pains from time to time in the treated breast or the muscles surrounding the breast, even years after treatment. The reason why this happens is not clear however, these pains are harmless, although annoying. They are NOT a sign that the cancer is reappearing.
  • Rarely, patients may develop a rib fracture years following treatment. This occurs in less than one percent of patients treated by modern approaches. These heal slowly by themselves.

More serious complications include:

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Treatment Options For Breast Cancer

Surgery

There are two main types of surgery to remove breast cancer:

Breast-conserving surgery is a surgery in which only the part of the breast containing the cancer is removed. The goal is to remove the cancer as well as some surrounding normal tissue. How much breast is removed depends on where and how big the tumor is, as well as other factors.

Mastectomy is a surgery in which the entire breast is removed, including all of the breast tissue and sometimes other nearby tissues. There are several different types of mastectomies. Some women may also get a double mastectomy, in which both breasts are removed.

Chemotherapy

Chemotherapy is a treatment method that uses a combination of drugs to either destroy cancer cells or slow down the growth of cancer cells.

Cytotoxic drugs are usually given orally or through a vein .Chemotherapy is a systemic therapy, meaning that the drugs travel in the bloodstream throughout the entire body.

Radiation therapy

Also called radiotherapy) uses high-energy rays to kill cancer cells. It affects cells only in the part of the body that is treated with the radiation. Breast cancer radiation therapy may be used to destroy any remaining mutated cells that remain in the breast or armpit area after surgery.

Hormonal therapy

Hormones like estrogen and progesterone are chemicals produced by glands in the body. Normally, these hormones help regulate body cycles, like menstruation. However, sometimes these same hormones can cause cancer to grow.

Surgical Options To Remove Breast Cancer

More cancer patients choosing breast removal ...

For people diagnosed with breast cancer, surgery will likely be a part of treatment. Breast cancer surgery will remove the tumor and any surrounding area that may be affected. Successful removal of the cancerous tumor during surgery lowers the chance of it spreading and recurring. Breast cancer surgery also can be used in combination with other treatments, such as chemotherapy, endocrine therapy and radiation therapy.

There are two main surgical procedures for breast cancer either of which may include removing some lymph nodes:

1. Lumpectomy

Lumpectomy is a surgical procedure that removes the cancer or other abnormal tissue from the breast. In this procedure, only a portion of the breast is removed, and a small amount of normal tissue around the lump also is taken to ensure the cancer and any other abnormal tissue is removed. Lumpectomy is also called breast-conserving surgery and is an option to consider if you want to preserve your breast, and it’s recommended if the cancer is believed to be small and at an early stage.

2. Mastectomy

Mastectomy is a surgical procedure that removes the breast. A unilateral mastectomy removes one breast and a bilateral mastectomy removes both breasts.

A mastectomy is recommended if:
Sentinel lymph node biopsy

M. Kathleen Christian, M.D., is a surgeon in La Crosse, Wisconsin.

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