Breast cancer surgery involves removing the tumor and nearby margins to reduce the risk of the cancer coming back and to stop its spread. It is usually the first treatment for breast cancer, although sometimes chemotherapy or hormone therapy is offered first to shrink the cancer so that surgery may be less extensive.
In consultation with a Breast surgeon, the type of surgery would be decided based on the grade and stage of tumor. Commonly done under general anaesthesia, it can be of various types -
Lumpectomy - It is a procedure where the cancerous tumor is removed along with a rim of healthy tissue around it, without removing the entire breast.
Partial or Segmental Mastectomy or Quadrantectomy - It involves removal of more breast tissue than with a lumpectomy, approx one quarter of the breast is removed.
Mastectomy - Also known as Simple or Total Mastectomy, this surgery requires removal of the breast, nipple, areola, and sentinel lymph node or nodes. It leaves the chest wall and more distant lymph nodes intact. This procedure is usually performed to treat in-situ, microinvasive, or stage IA breast cancers.
Radical Mastectomy - This is an extensive surgery where the entire breast, axillary lymph nodes, and the pectoral (chest wall) muscles under the breast are removed. Less extensive surgery (such as modified radical mastectomy) has been found to be just as effective and is preferred over it. It is opted for large tumors that are growing into the pectoral muscles under the breast.
Modified Radical Mastectomy - This procedure requires removal of the entire breast, nipple, areola, and axillary lymph nodes but often leaves the chest wall intact.
In some women, mastectomy is accompanied by either an immediate or delayed breast reconstruction, using either breast implants or the patient's own tissue - usually from the lower abdomen.
The length of the operation depends on the type of surgery being done, varying from two to three hours. Hospital stay may be of 2-5 days.
One or more drains/tubes is put for 1 to 2 weeks, coming out from the breast or underarm area to remove blood and lymph fluid that collects during the healing process. Once the drainage has decreased to about 30 cc each day, the drain is removed.
Movement of the arm soon after surgery is very important to avoid stiffness and to prevent lymphedema. The required exercises would be suggested at the hospital. There could be problems like pain, numbness, tingling, skin tightening, etc. in the chest and arm area, which shall gradually reduce with time.
Depending on the type of surgery, most women can resume their regular activities within 2 to 4 weeks.