Three basic types of breast cancer surgeries include:
This type of surgery removes a portion of the affected breast - how much is removed depends on the site and location of the tumor. Breast-conserving surgery may come in the form of a lumpectomy (removal of only the breast lump and a surrounding margin of healthy tissue) or a qudrantectomy (removal of more breast tissue than a lumpectomy, also known as a partial or segmental mastectomy.) Both of these usually require radiation post-operation.
A mastectomy removes the entire breast, including all of the breast tissue and sometimes surrounding tissue. Mastectomies vary in whether or not they remove lymph nodes, certain muscle tissue, and/or skin.
Sentinel node biopsy
Breast cancer that has spread to the lymph nodes may spread to other
areas of the body. In a sentinel node biopsy, the lymph node nearest
your breast tumor (which receives the lymph drainage from your cancer)
is removed and tested for breast cancel cells. If no cancer is found,
the chance of finding cancer in any of the remaining lymph nodes is
small and other nodes may not need to be removed.
Lymph node surgery
One or more axillary (underarm) lymph nodes may be removed to determine if the breast cancer has spread. This is an important part of staging and helps to determine whether further treatment is needed. If there are cancer cells present in the lymph nodes, there is a higher chance that cancer cells have also spread through the bloodstream to other parts of the body.
After a mastectomy or certain types of breast-conserving surgeries, a woman may consider having the remaining breast tissue rebuilt in order to restore the breast's appearance after surgery. Breast and plastic surgeons are highly skilled in these types of procedures and can help you decide which option is best for you.
Since women experience different types and amounts of discomfort after surgery, the goal of pain management is to assess your own level of discomfort and take medication as needed. You will have better results controlling your pain if you take your medication before your pain is severe.
Your doctor will prescribe the right type of pain medication for you. Ibuprofen or acetaminophen can be added to your prescription narcotic for more pain relief. Eventually, ibuprofen or acetaminophen will be used in place of your prescription narcotic as you begin to feel better.
Narcotics can cause or worsen constipation, so be sure to increase your fluid intake, add fiber such as prunes and bran to your diet and make sure that you take several short walks each day.
Icepacks may be helpful in decreasing the discomfort and swelling at your surgical site, particularly under the arm after a lymph node dissection. A small pillow may also help make you feel more comfortable.
Healing and recovery improve with good pain control, so if one pain management plan is not working for you, another should be pursued.
Your doctor will provide you with specific instructions to follow in preparation for your surgery. These instructions will depend on the type of surgery you are having, the type of anesthesia being used, your age and other factors, but general pre-op guidelines include:
- Not taking aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) for one week prior to your surgery
- Not eating or drinking for twelve hours prior to surgery
- Not applying perfumes, colognes or body lotion prior to surgery
- Removing all nail polish and jewelry, including piercings
- Arranging for someone to drive you home from the hospital and stay with you for 24 hours in case of complications.
Lymphedema is a swelling in the arm on
the surgical side, which is caused by a buildup of fluid due to missing
or damaged lymph vessels or lymph nodes. While there is no single cure
for lymphedema, our specialists are prepared to help determine the best
regimen to reduce swelling and control pain. This may include:
- Wrapping your arm or leg
- Pneumatic compression
- Compression garments