surgical treatment - partiial mastectomy
partial mastectomyThis is also known as lumpectomy, segmentectomy or wide local excision. This procedure means that only the cancer is removed together with a margin of healthy breast tissue. The rest of the breast is preserved. If the lump can not be felt in the breast, a wire localisation procedure is performed before the surgery to direct the surgeon.
The site of the skin incision is carefully planned to give the best cosmetic appearance. Often this means the incision is around the margin of the areola. In time, this type of scar is virtually invisible. Sometimes the incision is made at the edge of the breast and if this is the case it is done as unobtrusively as possible. If the tumour is lying directly behind the nipple, the nipple will have to be removed.
If you have very large breasts, another option is to remove the tumour at the same time as performing a breast reducing operation on both sides. This can give excellent control of the tumour.
A number of big studies have shown that the outcome is the same whether you have a partial mastectomy or a total mastectomy (as long as your surgeon agrees that you are suitable for breast conserving surgery). Radiotherapy is an important part of the treatment.
Recovery time
Everyone recovers from an operation at different rates. The minimum time off work is usually one week. More realistically, two weeks should be taken off before returning to work. Hospital stay is usually one or two nights but in some situations it is possible to do this type of surgery as a day-case procedure.
Wound Care
When you leave hospital you will have a thick pressure bandage over the breast. This can be removed after two days and a light dry dressing can be applied and changed as required. The surgeon uses layers of dissolving stitches under the surface. Consequently there is very little tension on the skin layer therefore steristrips (little paper sticky tapes) are used to close the skin incision. These steristrips should be left untouched and dry for a week. If you inadvertently get the area wet, it can be dried with a hairdryer. Once the wound has healed (one week after the operation) the steristrips are removed. Micropore tape should be placed over the breast scar for four to six weeks and changed as required, perhaps twice a week. This ensures the skin edges 'knit' together and achieves a cosmetic result. You do not have to keep changing the tape after bathing as it can dry on the skin.
Complications
Only one or two women in every 100 will develop a post-operative complication such as a wound infection or haematoma (bleeding in the wound). If an infection develops the area will become painful, red and swollen. If there is bleeding into the wound the area will become swollen and painful. Generally you should expect comfort levels to improve each day and if for any reason the reverse happens notify St Mark’s. Most complications are easily treated.
Radiotherapy
Radiotherapy is usually mandatory when women have a partial mastectomy. The 'Rule of Five' applies - radiotherapy begins usually about five weeks following the operation for five working days for five weeks for about five minutes a day. The radiotherapy 'sterilises' the breast tissue that remains and this reduces local breast cancer regrowth. Generally women who have mastectomy do not need to have radiotherapy but in some cases it is required. Your surgeon and oncologist will talk to you about this once the histology report has been received.
