“In healthcare today, great effort is made to achieve the highest possible cure rates with the least invasive surgery.\u00a0 Combination treatment with chemotherapy or radiation therapy provides some patients the option to undergo less aggressive surgery than would otherwise be needed…”<\/p>\n
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October is National Breast Cancer Awareness Month and we at Preferred Care at Home seek to <\/span>honor the fight against breast cancer<\/span> and provide support for those currently facing the battle with cancer. \u00a0While breast cancer can affect patients of all ages, even in one\u2019s 20\u2019s, the risk of breast cancer continues to increase with age and approximately \u2153 of breast cancer diagnoses occur in patients over 70 years old.<\/span>1<\/span><\/p>\n As many breast cancer survivors will tell you, navigating the healthcare maze of breast cancer treatment can be confusing and overwhelming at times. \u00a0Surgery, chemotherapy, and radiation therapy seem invasive when compared to taking a pill for a common medical condition. To make matters more confusing, new research can lead to changing society guidelines or recommendations. \u00a0In this article, I hope to provide some clarity by answering a few common questions related to breast cancer surgery.<\/span><\/p>\n The surgical management of breast cancer has changed significantly since William Stewart Halsted introduced what is now known as the \u2018radical mastectomy\u2019 at Roosevelt Hospital in New York City in 1882. \u00a0That procedure involved removal of all breast tissue,the pectoralis muscles of the chest wall, overlying skin, and all regional lymph nodes. While this technique provided remarkable advances in achieving a cure from breast cancer, you can imagine that such an invasive procedure left many patient struggling with the effects of nerve damage, significant lymphedema, and disfigurement.<\/span><\/p>\n In healthcare today, great effort is made to achieve the highest possible cure rates with the least invasive surgery. \u00a0Combination treatment with chemotherapy or radiation therapy provides some patients the option to undergo less aggressive surgery than would otherwise be needed. \u00a0The surgical options available to each patient depend on several factors, including the particular stage one\u2019s breast cancer. If you are currently facing evaluation for treatment of breast cancer, here are descriptions of several types of mastectomies.<\/span><\/p>\n Modified Radical Mastectomy<\/i><\/strong><\/p>\n This surgery involves removal of the all breast tissue including the tumor, the nipple, areola, and skin overlying the tumor, as well as the axillary (under arm) lymph nodes. <\/span><\/p>\n Simple Mastectomy (synonymous with \u2018Total Mastectomy\u2019)<\/i><\/strong><\/p>\n This surgery is less invasive than the modified radical mastectomy as only the breast tissue and skin components removed. \u00a0The axillary lymph nodes are not removed in this procedure. In some cases, \u2018skin-sparing\u2019 or \u2018nipple-sparing\u2019 mastectomy may be an option.<\/span><\/p>\n Breast Conservation Therapy (synonymous with \u2018Lumpectomy\u2019)<\/i><\/strong><\/p>\n This surgery involves removing the breast cancer but leaving behind some amount of normal breast tissue. \u00a0When combined with radiation therapy, this treatment option can provide high treatment success with a better cosmetic outcome.<\/span><\/p>\n One of the important factors in determining the stage of breast cancer is whether or not the axillary (under arm) lymphnodes contain cancer. \u00a0The positive or negative result will have a significant impact on one\u2019s treatment. One way to determine if there is cancer is to remove a majority of the axillary lymph nodes, what is called an \u2018axillary lymph node dissection.\u2019 \u00a0While it seems logical to want to remove as many lymph nodes as possible, there can be significant complications of aggressive lymph node removal such as serious nerve damage and lymphedema of the arm.<\/span><\/p>\n The sentinel lymph node biopsy provides reliable information about whether there is cancer in the lymph nodes while removing far less lymph nodes. \u00a0The procedure, which may be performed at the same time of breast conservation therapy, involves the injection of a dye or radioactive tracer into the affected breast. \u00a0This then travels to the involved lymph nodes, and the surgeon is able to visualize or use a special detector to identify the \u2018sentinel\u2019 lymph node, which is then removed. \u00a0This procedure is less invasive and better tolerated by the patient when compared to axillary lymph node dissection. <\/span><\/p>\n The goal of breast reconstructive surgery is to correct any visual abnormality following mastectomy and improve cosmetic appearance. \u00a0The decision to undergo breast reconstruction is a deeply personal choice, and should be discussed at length with your surgeon prior to undergoing the knife. \u00a0Some patients may have the option to undergo immediate reconstruction at the time of mastectomy depending on the particular cancer type and treatment plan. However, if you are not sure if you want reconstruction right away, you may always choose to proceed at a later time. \u00a0After discussion with your surgeon, some patients may end up with a better cosmetic result if reconstruction is delayed until other cancer treatment can be completed.<\/span><\/p>\n<\/h3>\n
I have heard about different types of mastectomies. What options are available to me?<\/b><\/h3>\n
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My physician mentioned the need for a sentinel lymph node biopsy. \u00a0What is involved in this procedure and why is it necessary?<\/b><\/h3>\n
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What are the options for breast reconstructive surgery? Do I have to decide by the time of the initial surgery or can I decide to have breast reconstruction later?<\/b><\/h3>\n