Mastectomy - breast cancer advice

Breast Cancer and surgeryWhat is a mastectomy?

Mastectomy means the surgical removal of the entire breast and until recent years it was the standard treatment for breast cancer. Thanks to research studies, medical advances and patient empowerment, women with early stage breast cancer are now likely to be offered the less radical option of a lumpectomy (a breast conserving operation involving the removal of only the cancerous tumour and some surrounding tissue).

If you’re in the unenviable position of having to choose between a lumpectomy and a mastectomy obviously this is going to be one of the biggest (and possibly most frightening) decisions you’ve ever had to make in your life. So it’s vital to take your time, make sure you fully understand the implications of both operations, talk it through with those closest to you and get a second opinion if you feel you need to.

It might help you to talk to other women (via online chat rooms and forums or in a local patient support group) about their experiences and how they dealt with this awesome decision-making process.

Your doctor may present a mastectomy as the best option open to you because of certain factors – the tumour may be too large to make a lumpectomy viable or you may have already undergone a lumpectomy or had the other breast removed.

In some cases a mastectomy is performed as a preventive measure in women who have no symptoms of the disease but who are at high risk of developing it due to family history or genetic factors. This may seem like drastic action but some women prefer to undergo the removal of both breasts rather than live with the fear and uncertainty that comes with knowing the disease is likely to strike at any time.

The operation itself is carried out under general anaesthetic and usually takes around two hours. Good hospitals have a dedicated breast care nurse who can talk you through all aspects of a mastectomy, both physical and emotional, and tell you exactly what to expect after the operation.

The surgery involves removal of the breast, nipple and sometimes the lymph nodes in the armpit (known as axillary lymph nodes). Radical mastectomy, which was common a few years ago but thankfully is only performed on rare occasions nowadays, involves removal of the entire breast together with the muscles of the chest wall. This type of surgery is obviously more extensive and disfiguring and is only carried out when the cancer cells have spread to the muscles below the breast.

You may feel sick when you come round from surgery and you’re likely to suffer considerable soreness in the breast and arm pit area for several days (though some women report virtually no post-operative pain).

In some cases women suffer a great deal of pain, including throbbing and tingling sensations due to nerve damage. Don’t be afraid to ask for help if you’re suffering unduly because often the pain can be relived with medication, massage and gentle exercise.

A small plastic drainage tube, inserted into the breast or under arm, will remain in place for a week or more after surgery to enable blood and fluid to drain from the wound during the healing process.

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