Surgical Treatment in Breast Cancer
Various breast surgeries are recommended depending on the different objectives. A surgical intervention is done:
- For removing the cancerous growth as much as possible, for example: mastectomy
- For determining the spread of the cancer to the lymph nodes mostly under the arm, for example: sentinel lymph node biopsy or axillary lymph node dissection
- For restoring the shape of the breast, for example: breast reconstruction
- For relieving advanced cancer symptoms
Types of surgery done in breast cancer
There are two types of surgical procedures for removal of the cancer tissues from the breasts. They are as follows:
- Lumpectomy: in this only a part of the cancerous breast tissue is removed. Hence it is also known as breast conserving surgery. Other synonyms are quadrantectomy, partial mastectomy and segmental mastectomy. The objective of this procedure is to discard the cancer growth as well as some surrounding normal tissue. The size of the tissue to be removed usually depends on the tumour size and location and other associated factors.
- Mastectomy – In this surgical approach the entire breast is removed with the entire breast tissue and also a part of the nearby tissues.
- Surgical removal of the lymph nodes
These are further classified into two main types:
- The procedure in which only the lymph nodes below the arm are removed is called Sentinel Lymph Node Biopsy (SLNB). Removing only one or multiple lymph nodes reduced the possibilities of surgical complications.
- The procedure in which many lymph nodes under the armpit are removed is called Axillary Lymph Node Dissection (ALND). Generally the surgeon removes maximum 20 lymph nodes from the under arm.
- Post-Operative Breast Reconstruction
The breast reconstruction surgery is used to reconstruct the breast shape and the look. There are different types of breast reconstruction depending on the medical status of the patient and the objective of the treatment.
- Advanced Surgical Interventions in Breast Cancer
This approach is taken in the following cases:
- For providing pain relief or relief from other symptoms
- In case of metastases, this is used for treating smaller areas of the cancer and its spread to other organs
- When the breast tumor results in an open wound breast or in the chest
- When the cancer is spread to the spinal cord
- For treating liver blockage
- Wire guided localization surgery
This procedure is indicated in the breast cancer when the breast tissue is difficult to locate, feel or when there is a difficulty for getting a breast ultrasound/mammogram done. In this procedure a wire is placed in the cancerous growth for guiding the breast surgeon to the affected area. This is also known as needle localization/wire localization.
Estimated cost of the breast cancer surgery
The approximate treatment cost for breast cancer treatment can be Rs 5-6 lakhs.
Some of the most important aspects of the post-operative care in breast cancer surgery are:
- Be aware of the recurrence: In case a person experiences the following symptoms, please visit your doctor immediately:
- Lump under the arm/chest wall
- Worsened or constant pain which is not relieved even by medicines
- Look for signs of metastasis: swelling in neck, back, bone, neck, or joint pain, fractures, is an important symptom of metastases in bone
- Signs of a possibility of brain metastases are as follows:
- Personality changes
- Loss of balance
- Changes in vision
- Signs of metastases in lungs are:
- Chronic cough
- Shortness of breath/difficulty in breathing
- Signs of liver metastases are:
- Pain in abdomen
- Itchy skin
- Skin rash
- Jaundice: Yellowish discoloration of skin/eyes
- Loss of appetite
- Weight loss
Post discharge care/Rehabilitation information
Following aspects should be looked into the post discharge care in a breast cancer surgery:
- Hygiene: should be maintained. The surgery wound should be kept clean and dry. Surgical dressing should be done regularly.
- Pain Relief: Pain killers are prescribed in this surgery.
- Exercise: should be done to restore the mobility. Exercises like: arm lifts, arm swings, etc are advised to the patient.
- Breast self-examination: should be done regularly.
- Regular follow-up: with the doctors should be done.