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Breast Cancer Surgery – Lumpectomy or Mastectomy

 
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The first type of treatment many will undergo with breast cancer is surgical removal of any cancerous tumors. The surgery type that you chose will depend on the size of the tumor, aggressiveness of the cancer and even the outcome you can live with. In this article, the two types of surgeries discussed will be lumpectomy and mastectomy, but there are actually seven breast cancer surgery options:

Lumpectomy
Mastectomy
Lymph node removal
Breast reconstruction

Prophylactic mastectomy
Prophylactic removal
Cryotherapy

Lumpectomy

As BreastCancer.org defines it, a lumpectomy is the removal of the breast tumor and some of the normal tissue that surrounds it. Sometimes, this term is used interchangeably with terms like biopsy, partial mastectomy, re-excision, quandrantecomy or wedge resection. This is true even though with each of the procedural terms listed, the amount of breast tissue may vary. Therefore, get a full understanding of how much breast is going to be removed during your consult with your doctor.

The following are pros and cons of a lumpectomy as indicated by BreastCancer.org:
The main advantage of lumpectomy is that it can preserve much of the appearance and sensation of your breast. It is a less invasive surgery, so your recovery time is shorter and easier than with a mastectomy.

You are likely to have five to seven weeks of radiation therapy, five days per week, after lumpectomy surgery to make sure the cancer is gone.

Radiation therapy may affect the timing of reconstruction and possibly your reconstruction options after surgery. Radiation therapy also may affect your options for later surgery to lift or balance your breasts.

There is a somewhat higher risk of developing a local recurrence of the cancer after lumpectomy than after mastectomy. However, local recurrence can be treated successfully with mastectomy.

The breast cannot safely tolerate additional radiation if there is a recurrence in the same breast after lumpectomy. This is true for either a recurrence of the same cancer, or for a new cancer. If you have a second cancer in the same breast, your doctor will usually recommend that you have a mastectomy.

There is usually some numbness and loss of sensation in part of the breast after lumpectomy, depending on the size of the lump removed. Some or most of this ability to feel can return.

Your breasts may not match precisely in size and shape after surgery. This is because removing breast tissue during surgery usually makes the affected breast appear smaller. You may not know this right away, because swelling in response to surgery may make your breast appear temporarily larger.

Mastectomy

Mastectomy is the removal of the whole breast. This procedure, as well as breast cancer surgery in general, has made many advancements and changes for the better. Doctors are now skilled in skin-sparing incisions; the incision is even put in a location so the patient doesn’t have to change her wardrobe. We all have seen the picture of women who’ve had this type of surgery with depressed areas and deep scars that literally run up to the collarbone.

There are five types of mastectomy surgeries:

Simple – basically, only the breast is removed, unless lymph nodes unexpectedly are present

Modified radical mastectomy – the removal of the entire breast and lymph nodes

Radical mastectomy – most extensive type of mastectomy; removal of breast, lymph nodes, and wall muscles in chest

Partial mastectomy – removal of cancerous breast tissue and healthy tissue around cancerous area

Subcutaneous mastectomy – sometimes called nipple-sparing mastectomy, the entire breast is removed, except the nipple

As related by BreastCancer.org, the following are noted pros and cons of choosing any mastectomy-type surgery:

For some women, removing the entire breast provides greater peace of mind.

Radiation therapy may still be needed, depending on the results of the pathology.

Mastectomy takes longer and is more extensive than lumpectomy, with more post-surgery side effects and a longer recuperation time.

Mastectomy means a permanent loss of your breast.

You are likely to have additional surgeries to reconstruct your breast after mastectomy.

Numbness of the skin along the incision site and mild to moderate tenderness of the adjacent area; numbness and tenderness can happen because the nerves were cut during surgery.

There may be extra sensitivity to touch within the area of surgery. Touch sensitivity is also due to irritated nerve endings. The sensation usually improves as the nerves grow back.

Fluid collection under the scar may be the result of hematoma — an accumulation of blood in the wound — or seroma, an accumulation of clear fluid in the wound. Both usually resolve on their own or after being drained with a needle by your doctor.

During mastectomy, the blood vessels that supply your breast tissue are cut. Occasionally that can present problems when your body tries to heal the incision site. If there isn't enough blood flow to the flaps of your incision, small areas of skin may wither and scab or need to be trimmed by your surgeon. This is uncommon and is usually not a serious complication.

There may be an increased risk of infection in the surgical area. If infection happens, it can usually be discovered early and responds well to treatment. Talk to your doctor about the warning signs of infection.

With mastectomy alone and mastectomy plus reconstruction, there is a risk for scar tissue to form and build up over time. Sometimes the scar tissue can be lumpy or painful. Your surgeon can tell you about ways to manage any discomfort.

Your Own Decision

Remember, ultimately, as long you are not endangering your overall health, it is your decision. After all of your important health factors are taken in consideration, you might want to ask yourself several questions. Like, do you want to keep your breast? Do you want your breast to match as much as possible? How anxious will you be about breast cancer coming back?
Resource: BreastCancer.org
Dita Faulkner is a freelance writer. She loves to write poetry. Please preview her poetry at:
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.