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TREATMENT > Surgery
SURGERY
Breast cancer treatment usually begins with surgery to remove the cancer. This surgical procedure may be a lumpectomy or a mastectomy:
- A lumpectomy removes the cancerous part of the breast and a small amount of surrounding tissue. It is sometimes known as a partial mastectomy or breast-conserving surgery because most of the breast is saved. If the cancer is an invasive breast cancer, some lymph nodes in the underarm will usually be removed as well.
- A mastectomy removes the entire breast and nipple along with some axillary (underarm) lymph nodes.
The option that is best for you will depend on many factors, including the characteristics of your breast cancer, the size and location of the tumour, whether or not you require radiation therapy after surgery, and your risk of recurrence (the cancer coming back).
It may take some time for you to consider your options and weigh the risks and benefits of each type of surgery. For example, some patients may want to keep as much of their breast as possible, while others will have more peace of mind if they remove the entire affected breast. You can discuss these issues with your health care team to get all the information you need. Their advice and your preferences are important considerations in deciding on the type of surgery.
Lymph nodes in the underarm (on the same side as the breast surgery) are often removed as part of the surgery to determine if cancer cells are also present there. This is called an axillary lymph node dissection.
An alternative to this procedure is a sentinel lymph node biopsy. In this newer procedure, the surgeon identifies a sentinel node or nodes, which is the first lymph node or nodes that lymph fluid from the breast drains into. Removing a sentinel node or nodes and checking for cancer cells is a very accurate way of finding out whether the breast cancer has started to spread. In this procedure, fewer lymph nodes are removed for testing, which results in an easier recovery after surgery and less likelihood of complications.
Examination of the lymph nodes is important because the presence or absence of cancer in the lymph nodes helps your doctor understand how your disease might progress. The information from the lymph node tests helps you and your health care team to make decisions about your subsequent treatment plan.
Some of the possible short-term side effects of surgery include fatigue, infection, pain or tenderness, swelling, and weakness or stiffness of the arm or shoulder.
When lymph nodes are removed, a possible long-term side effect is lymphedema.
See your doctor for further discussion of possible side effects.
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