How to choose the right breast cancer surgery
by: Mai Brooks
Once you have
been diagnosed with breast cancer, usually treatment starts first
with surgery. There are generally two components to the operation:
1) the breast, and 2) the axilla (armpit).
In the breast, there are two choices: 1) lumpectomy (removing the
cancer lump and some surrounding tissue), or 2) mastectomy (removing
the entire breast). Just a quarter of a century ago, almost all
patients had mastectomy, even if their breast cancer is small. But
over the past few decades, it has been demonstrated that for small
cancers, lumpectomy followed by radiation treatment is just as good
as mastectomy. Now, �small� is a relative term. The goal of a
lumpectomy is that the breast would still look like a breast after
all the treatment is done. In someone with small breasts, a �small�
cancer may occupy a significant portion of her breast. An adequate
lumpectomy in this case may result in an unacceptable cosmetic
outcome, and the patient may actually prefer having mastectomy with
plastic surgery reconstruction. Another factor is the number of
cancers in the breast. Usually, mastectomy is required for
multifocal cancer (cancer discovered in two or more locations in the
same breast)
At the same time as the breast operation, surgery in the axilla also
is carried out for invasive (or infiltrating) breast cancer, as well
as in selected cases of DCIS (ductal carcinoma in situ). This is
done to determine whether the breast cancer has spread to the lymph
nodes in the axilla. In general, there are two choices: 1) sentinel
node resection, or 2) axillary node dissection. In sentinel node
resection, the surgeon maps the lymphatic drainage of the breast
cancer to the first lymph node that receives this lymph, i.e. the
sentinel node(s). Only a few (1-3) nodes are then usually removed.
In axillary node dissection, more lymph nodes are resected, usually
8-25. Sentinel node resection is a good choice for small early
cancer that is unlikely to have spread to the axilla. When the
suspicion for cancer already in lymph nodes is high, then full
axillary node dissection should be performed.
The above are only general guidelines. No two breast cancer patients
are exactly alike, and therefore the decision making process is
different and unique for each individual person. Regardless of any
one else�s advice, you should make the choice that you personally
will be able to live with for the rest of your life.
Dr. Mai Brooks is a surgical oncologist/general surgeon, with expertise in early detection and prevention of cancer. More at http://www.drbrooksmd.com, http://thecancerexperience.wordpress.com and http://progressreportoncancer.wordpress.com.
To find other free health content see
e-healtharticles.com
