When it comes to cancer treatment, we often hear about three categories: surgery, chemotherapy, and radiotherapy. However, it’s not often clear that within those areas there’s a myriad of variations depending on the type of cancer you have, the stage, your age, your wider health and wellbeing, and also what you want to do. When it comes to surgical treatment for breast cancer there are generally two types that may be considered – a mastectomy or breast-conserving surgery. We wanted to take a little time to explain more about both, starting with breast-conserving surgery.
What is breast-conserving surgery?
Breast-conserving surgery is where only the part of the breast containing the cancer is removed. This can range from a lumpectomy or wide local excision, where the tumour and a little surrounding breast tissue are removed, to a partial mastectomy or quadrantectomy, where up to a quarter of the breast is removed.
For many people, this is be preferable to a full mastectomy, but depending on how the cancer has progressed to date, it is likely to also require follow up treatment such as radiotherapy, hormone therapy or chemotherapy. This is to try to make sure that there are no cancer cells left behind that could continue to grow.
Who might be offered breast-conserving surgery and why?
Breast-conserving surgery is sometimes an option for individuals in the early stages of breast cancer, although it will not be medically suitable for everyone, and this is something your doctor will advise you on.
The main advantage is being able to keep your breast(s). However, as mentioned it is likely that you will have to have some radiation treatment as well. For this reason, some women with early stage breast cancer opt for a mastectomy instead as this is far less likely to require follow up radiation treatment.
Is breast-conserving surgery right for you?
Assuming that breast-conserving surgery is a recommended option for you, there is no evidence that choosing this type of surgery plus radiation over a mastectomy affects a person’s chances of long-term survival. So, it really is something that you can exercise some control over, and for many people that is very important at a time where you may not feel as though you have much autonomy.
Some of the things that may lead you to decide that breast-conserving surgery is the option for you are:
- Considering how concerned you are about losing a breast
- Whether you feel able to get to regular radiation appointments and have a support network in place to handle the treatment
- Whether this is your first cancer treatment
- Whether the cancer is limited to one area and is a small, contained tumour
- Are you pregnant – in which case radiation therapy could harm the foetus
- Whether you are genetically predisposed to breast cancer
- Do you have other serious health conditions that may make you more sensitive to radiation?
What does breast-conserving surgery involve?
The goal of this type of surgery is to remove the cancer as well as some surrounding normal tissue in order to make sure no cancer cells are left behind. How much of the breast is removed depends on a variety of factors including where the tumour is and what size it is, and sometimes it’s not entirely possible for doctors to be sure what they will find until they are operating.
The operation usually takes an hour or two, during which they often use a type of dye/tracer that travels the path of the cancer cells and helps doctors to track where it is and what to remove. It will also help them spot any lymph nodes that need to be taken out for testing.
What to expect from surgery and recovery
One of the benefits of this type of breast cancer treatment is that, depending on the size of the lump and how much tissue is removed, the procedure tends to be less invasive and the recovery time should be faster. Most of these surgeries are outpatient procedures, in which case you should be able to go home the same day.
Once you go home you will probably feel sore and tired from the anaesthetic, but most people are fairly functional by the time they go home (otherwise they wouldn’t be allowed to leave the hospital). You should feel able to return to regular activities after two weeks or so. That said, you have still had surgery so it’s important to take things easy.
Discharging doctors will always give you care advice for recovery, especially with regards to tending to the wound. You may want to arrange to have some help at home for the first week or so, and in particular should take care not to do any heavy lifting or strenuous exercise until your wound has healed.
Things to be aware of include:
- Taking care of the wound and dressing
- Caring for your drain if you have one
- Recognising signs of infection
- Washing post-surgery and which products are safe to use (if any)
- When to start exercising again
- When you can wear a bra again
- How to manage any medications or painkillers you have been given
- What to expect regarding pain, sensation or numbness
Outcomes of surgery for breast cancer
All surgeries have side effects, some of which are temporary and others that may be permanent. In the short term, breast cancer surgery may cause pain or discomfort, and sometimes lymphedema, a type of swelling, in the arm. You will likely have a scar for a while, which may leave a long-term mark, and some people find there is a dimple where the tumour was removed and/or a firm or hard surgical scar. There are some products that can help to reduce the appearance and improve the healing time of scars – such as the Defiant Beauty Smooth Skin Balm.
Another thing that many people take a little time to come to terms with after surgery for breast cancer, is how they feel about their body image or any mental health side effects. In addition to a physical change, for many people the strain, fear and anxiety caused by a cancer diagnosis and treatment is as hard to handle as the physical impact.
While it isn’t easy to remember, and it’s easier said than done, if you find yourself in this position, you are not alone, and it’s ok to take some time to be kind to yourself. Little things can make a big difference such as self-care, meditation and even certain aromatherapy fragrances to calm the mind. Also, many of the small charities and organisations that we work with provide support through professional care or meeting other people going through a similar journey.
It may also be something that your doctor can offer advice on as well, both in terms of breast reconstruction (it’s a good idea to talk to your doctor before your breast cancer surgery if this is something you may wish to consider/think could be necessary), or mental health support. Whatever you feel is right for you, support is available both physically and mentally so never feel you have to suffer in silence.