Surgical options for the breast
There are two main approaches. Which one is suitable depends on the size and position of the tumour relative to the volume of the breast.
The tumour is removed together with a margin of healthy tissue around it; the rest of the breast is preserved. Radiotherapy is then needed in almost every patient. In suitable patients, no difference in survival has been shown between breast-conserving surgery and removing the whole breast.
The whole of the breast tissue is removed. It is preferred when the tumour is in more than one focus, when it is large relative to the breast volume, or when radiotherapy is not suitable. Reconstruction can be performed in the same operation.
In some patients drug treatment is given first to shrink the tumour, which then makes breast-conserving surgery possible. Surgery and oncology make this decision together.
Why the armpit is assessed
Breast cancer spreads first to the lymph nodes in the armpit. The state of this area is needed in order to plan treatment after surgery.
- Sentinel lymph node biopsy: the one or few lymph nodes the tumour drains into first are marked and removed. If they are clear, the others are left untouched.
- Axillary dissection: in selected patients with proven spread, the lymph nodes of the armpit are cleared more widely.
The sentinel method markedly reduces the risk of arm swelling (lymphoedema), so it is preferred in every patient in whom it is possible.
The day of surgery and afterwards
Blood tests and an anaesthetic assessment are carried out. If you take blood-thinning medication, it is adjusted a few days in advance.
It is performed under general anaesthesia and mostly takes one to two hours. Depending on the extent of the procedure, a drain may be placed.
One day is usually enough after breast-conserving surgery, and one to two days after a mastectomy.
You will mostly return to daily activities within a week. Doing the prescribed arm exercises regularly is important.
The detailed report on the removed tissue usually arrives within a week. Oncological treatment is then planned if it is needed.
Surgery is one step of treatment, not the whole of it. Whether radiotherapy, hormone therapy or chemotherapy is required is determined by the pathology result; we guide you through that process.