Breast Cancer Surgery: What Are My Options?

Breast cancer is the most common cancer in women in Kenya, other than skin cancers, Breast cancer treatment involves a team of doctors who work together to determine a treatment plan, which can include surgery, chemotherapy, endocrine therapy, radiation, and reconstructive surgery. Breast cancer survival rates have improved over time given earlier detection due to regular screening and education, a better understanding of the disease, and more personalized treatment. Advances in breast cancer surgery have led to more options for breast preservation and less painful recovery.

The breast surgeons atKLASS take many factors into consideration when discussing breast cancer surgery options, including the extent and location of the disease at presentation, age, family and genetic history, medical history, and a patient’s personal feelings. Your surgeon will provide evidence based advice on the optimal surgical management, but you will be able to share in the final decision making process based on appropriate personal preferences.

Breast Cancer Surgical Options

The most common surgeries for breast cancer are lumpectomy (partial mastectomy), simple mastectomy, sentinel lymph node biopsy, axillary lymph node dissection, and modified radical mastectomy.

Lumpectomy (also termed partial mastectomy), entails complete removal of the cancer along with some of its surrounding normal tissue to ensure clear edges devoid of cancer cells. This procedure is commonly referred to as breast conservation surgery as it typically preserves an optimally cosmetic and functional outcome. Subsequent radiation therapy is typically recommended and possibly chemotherapy, depending on the tumor biology, to destroy any potential remaining cancer cells and prevent recurrences.

A simple (total) mastectomy is a procedure that removes your entire breast. Chest muscles are fully preserved. There are various forms of simple mastectomy including skin sparing and nipple sparing. In some instances, particularly in those with a significant family or genetic predisposition, a prophylactic (or preventative) simple mastectomy may be indicated to reduce risk of cancer occurrence. If desired, various options of immediate or delayed breast reconstruction will be available and addressed by plastic and reconstructive surgeons.

Sentinel lymph node biopsy is usually performed in conjunction with a lumpectomy or a simple mastectomy. Breast cancer has the potential to spread to lymph nodes under the arm which can adversely affect the cancer stage and implicate the need for additional treatment. The sentinel node biopsy removes the first lymph node (or couple nodes) in the more vast chain of nodes in that location and is highly accurate in determining lymph node involvement. It is less invasive with less complications and does not require a drain. Removing greater numbers of lymph nodes may be sometimes necessary and is termed an axillary lymph node dissection.

Modified radical mastectomy is a total mastectomy combined with an axillary lymph node dissection and does not involve the chest muscles. It is necessary in more locally (relating to the breast) and regionally (relating to the lymph nodes) advanced cancers.

What To Expect After Breast Cancer Surgery

The recovery process will depend on the type of surgery performed. Patients who undergo lumpectomy and lymph node biopsy go home the same day. Those undergoing a mastectomy are often admitted overnight especially if an immediate reconstruction has been performed. As with any surgery, there are risks and possible complications involved. Our surgeons will explain the condition, surgery options and risks, pertinent procedural details, postoperative care, and address all questions. Short and longer term follow up appointments for surveillance will be necessary with your surgeon and medical oncologist.