Treatment of Breast Cancer
The treatment of breast cancer depends on the stage of breast cancer and to a lesser extent on the type of cancer. Once a diagnosis is made a number of investigations will be done to accurately stage the cancer. The investigations will include but may not be limited to the following:
- Blood tests including your liver function tests, tumour markers and tests to assess the possibility of spread of the cancer to the bones
- A Chest X-ray to make sure there is no spread to the lungs
- An ultrasound of the liver to make sure there is no spread to the liver
- A bone scan to make sure there is no spread to the bones
Surgical treatment of Early Breast Cancer – Stage 0 – II:
The aims of surgical treatment in all of these stages of Breast Cancer are:
The aims of surgical treatment in all of these stages of Breast Cancer are:
- To surgically remove the cancer with adequate margins of normal cancer free tissue.
- To assess the lymph nodes/glands in the axilla (armpit). Breast cancer can spread via the lymphatic vessels to the glands in the armpit or axilla and a biopsy of the first or ‘sentinel’ gland will need to be done. If this sentinel gland is positive for cancer all the glands from the axilla will be removed at the time of your surgery.
Surgery For The Cancerous Lump
An excision is performed of the cancerous lump with a margin of normal breast tissue.
The advantage is that the surgery is smaller and the rest of your breast is left intact without causing major deformity and ytou should not require any reconstruction surgery.
The disadvantages are:
The advantage is that the surgery is smaller and the rest of your breast is left intact without causing major deformity and ytou should not require any reconstruction surgery.
The disadvantages are:
- If the margin of the specimen shows microscopic cancer cells you may require further surgery which may have to be a mastectomy
- You will require post-operative radiotherapy
Complete removal of the entire breast and nipple leaving behind a flat chest on the affected side with a scar along the chest wall.
The advantage is that you will not require any further surgery on the affected side for removal of the lump but if you choose you may want reconstruction. (See below)
The disadvantages are:
The advantage is that you will not require any further surgery on the affected side for removal of the lump but if you choose you may want reconstruction. (See below)
The disadvantages are:
- The operation is more invasive and is disfiguring
- You will have a larger scar
- If you choose you may want to have reconstruction
Surgery For The Glands In The Axilla (Armpit)
If the biopsy is negative you do not require any further surgery of the axillary glands.
If the biopsy is positive you will need to have all the glands removed in the axilla. This is determined in theatre at the time of your operation and will be done immediately.
If the biopsy is positive you will need to have all the glands removed in the axilla. This is determined in theatre at the time of your operation and will be done immediately.
Reconstruction Options:
If you choose a mastectomy you maybe a good candidate for an immediate reconstruction. You will be given the option to decide whether this is an option you would like to explore before making decisions about your surgery. We will get a plastic surgeon involved in your management who will do a full assessment to evaluate your suitability and to explain the different reconstruction options.
Summary
There are three surgical options:
Option 1:
Wide local excision of the cancerous lump with a Sentinal Lymph node biopsy with immediate full axillary gland dissection if the biopsy is positive.
Option 2:
Total Mastectomy with a Sentinal Lymph Node biopsy with immediate full axillary gland dissection if the biopsy is positive.
Option 3:
Total Mastectomy with a Sentinal Lymph Node biopsy with immediate full axillary gland dissection if the biopsy is positive. Additionally a reconstruction maybe added to the procedure and the nature of this will be discussed with you by the involved plastic surgeon.
Option 1:
Wide local excision of the cancerous lump with a Sentinal Lymph node biopsy with immediate full axillary gland dissection if the biopsy is positive.
Option 2:
Total Mastectomy with a Sentinal Lymph Node biopsy with immediate full axillary gland dissection if the biopsy is positive.
Option 3:
Total Mastectomy with a Sentinal Lymph Node biopsy with immediate full axillary gland dissection if the biopsy is positive. Additionally a reconstruction maybe added to the procedure and the nature of this will be discussed with you by the involved plastic surgeon.