When your doctor tells you that you need to have surgery for breast cancer, it's normal to feel a lot of fear, anxiety, and uncertainty. You probably have a thousand questions in your mind, like, 'What kind of surgery will I have?', 'Will my breast be completely removed?', 'What happens next?' All of these are reasonable. So don't be afraid, today we'll talk about all of this, in simple Sinhala that you can understand, as if you were talking to a close friend.
What is the main purpose of surgery?
Simply put, the main goal of breast cancer surgery is to completely remove the tumor and a small amount of healthy tissue around it . This is done so that no cancer cells remain. This is hoped to prevent the cancer from coming back and spreading to other parts of the body. Doctors also try their best to preserve the natural appearance of the breast as much as possible.
The type of surgery you have will depend on several factors. For example, the size of the tumor, where it is in the breast, how far the cancer has spread, and your personal thoughts and feelings about it. After discussing all of these with you, your doctor will choose the surgery that is best for you.
Main types of surgeries for breast cancer
Breast cancer surgeries can be divided into two main types. One is surgery that removes only part of the breast, and the other is surgery that removes the entire breast. Let's look at each of these separately.
| Surgery Name | Simply put, what is happening? | Who is it usually recommended for? |
|---|---|---|
| Lumpectomy (Also called Partial Mastectomy) | Only the cancerous tumor and a small amount of healthy tissue around it are removed, leaving the rest of the breast intact. | This is a good option for those whose cancer is not very large and who can receive radiation therapy after surgery. |
| Simple/Total Mastectomy | The entire breast, including the nipple, is removed. Sometimes one or more lymph nodes in the armpit may also be removed. | For those who have a low risk of cancer spreading to the lymph nodes or who are undergoing surgery to reduce the risk of future cancer. |
| Modified Radical Mastectomy | The entire breast, nipple, and most of the fat under the armpit are removed, but the chest muscles are left intact. | This may be suitable for people with invasive breast cancer. |
| Radical Mastectomy | The entire breast, armpit hair, and even the chest muscles underneath the breast are removed. | This surgery is now rarely performed. It is usually only recommended if the cancer has spread to the chest muscles. |
| Skin-Sparing Mastectomy | Although the tissue inside the breast is removed, most of the skin overlying it is left behind. The remaining skin can be used for breast reconstruction surgery. | Suitable for those whose cancer cells are not very close to the skin and who are undergoing breast reconstruction surgery soon. |
| Nipple-Sparing Mastectomy | Although breast tissue is removed, the nipple and surrounding skin (areola) are left intact. This also allows for a more natural look when reconstructing the breast. | This may be suitable for people whose cancer cells have not spread to the nipple or surrounding skin. |
Why are armpit lymph nodes removed?
This is a problem that many people have. Think of lumps as little checkpoints in our bodies. When cancer cells start to spread throughout the body, they first travel to and get stuck in these checkpoints. So, by removing a few lumps from under the armpit and examining them, you can know for sure whether the cancer has spread outside the breast or not. This information is very important for your doctor to decide what additional treatments (e.g. chemotherapy, radiation) you need after surgery.
There are two main methods for removing warts:
- Sentinel Lymph Node Biopsy: This involves finding the "first checkpoint" or sentinel node that the cancer is likely to go to if it spreads, and removing only that node for examination. If it does not contain cancer cells, the other nodes do not need to be removed. This method reduces the risk of swelling in the arm (lymphedema).
- Axillary Lymph Node Dissection (ALND): In this procedure, about 10 to 20 lymph nodes under the armpit are removed and examined for cancer cells.
Breast Reconstruction
Many women who undergo a mastectomy decide to have breast reconstruction surgery. This is a completely personal decision.
This surgery can be done at the same time as your cancer surgery, or it can be done months or years later. It can use breast implants or tissue taken from another part of your body (often from your abdomen). Talk openly with your doctor about your options.
How do you prepare before surgery?
No matter what type of surgery you have, it requires some preparation beforehand.
First, your doctor will ask about your complete medical history .
- You should tell your doctor about all medications you take (including vitamins and supplements ).
- Tell us if you have had any previous allergic reactions to medications or anesthesia.
- If you have any other medical conditions such as heart disease, diabetes mellitus, or high blood pressure, be sure to let us know.
As you approach surgery, your doctor will order several tests to see if your body is ready for surgery.
- Chest X-ray
- EKG test
- Blood and urine tests
- A CT scan or breast MRI may be needed to determine the exact size and location of the tumor.
How long will I have to stay in the hospital?
The number of days you will have to stay in the hospital depends on factors such as the type of surgery you have and your health condition after the surgery.
- Lumpectomy surgery is usually done on an outpatient basis. This means that you will be monitored for a few hours after the surgery and may be able to go home the same day.
- If you have a mastectomy or ALND, you will need to stay in the hospital for a day or two.
This journey is not a solo one. Your family, friends, and especially your medical team are with you. Don't hesitate to talk to your doctor about any questions or concerns you may have.
Take-Home Message
- It's normal to feel scared when you hear about breast cancer surgery. Talk openly with your doctor about your options.
- The type of surgery that is right for you depends on several factors, such as the nature and extent of the cancer, and your personal preferences.
- Checking the lymph nodes in the armpit is an essential step in determining whether the cancer has spread and planning future treatment.
- If a breast is completely removed, there are options for breast reconstruction surgery. Discuss this with your doctor.
- Remember that you have a medical team to support you before and after surgery. Share your concerns with them.
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