Why would breast surgery be needed?
Breast cancer, one of the most common forms of cancer among women in our country, is often approached with a combination of chemotherapy, radiation therapy and surgery. While treatment options differ for each type of breast cancer, a lumpectomy or mastectomy is often part of the treatment.

How is breast surgery done?

Because the type and stage of the breast cancer are different for each individual, each woman's treatment strategy will be unique. Breast surgery like a lumpectomy and mastectomy may be a part of treatment. Both of these surgeries require open surgery. The size, location and type of tumour as well as lifestyle and psychological concerns will be considered by your general surgeon when deciding which surgery will be best.

Lumpectomy

A lumpectomy (otherwise known as breast conserving therapy) is the removal of a tumour and surrounding tissue from the breast. Under general anaesthesia, Dr Aikman will make a small incision between 2 and 5cm in length into the breast. For aesthetic reasons, Dr Aikman will try to make the incision in a hidden place. The lump is then removed along with surrounding tissue. The surrounding tissue is sent for testing to see if the cancer cells are present in this tissue. This is done so that your general surgeon can see if all of the cancer was removed. Removing a lump from the breast should not affect the shape and size of the breast.

Mastectomy

A mastectomy, on the other hand, is the removal of the entire breast as well as the lymph nodes. Under general anaesthesia, Dr Aikman will make a much larger incision so that he can remove the entire breast tissue. Because many women feel that their breasts are an important part of their feminine identity and sexuality, if you are to have a mastectomy, Dr Aikman may assist your plastic surgeon in reconstruction of your breasts post-mastectomy.

In both cases, the lymph nodes may also be removed during this surgery to prevent spreading of cancer to the rest of the body.

What will recovery entail?

Depending on which of the two surgeries was done, your recovery may differ. If a lumpectomy was performed, you might experience some pain in your breast and chest and red skin around your wounds after surgery. If a mastectomy was done your recovery will be very different. Due to the presence of a large potential space where the breast tissue used to be, two drains are placed during the operation to evacuate any fluid that can build up in the wound. These drains will only be removed once the daily drainage has decreased sufficiently. Physiotherapy is begun in hospital to prevent stiffness of the shoulder on the side of the operation. After breast surgery the following symptoms should not be concerning as they are normal:

• Pain in the chest and breast.
• Itching and sensitivity as nerves grow back.
• Red skin around your incisions.

You may need to stay in the hospital for a day or two after surgery to check the drainage and ensure your incisions are healing as they should be before you go home. Symptoms to look out for include an unusually high fever, chills, vomiting, swelling and bleeding around the incisions and excessive pain as these are not normal may require additional intervention.

You should be able to return to your normal lifestyle in a few days, but you should take caution when doing physical activities for the next 6 – 8 weeks. After 32 weeks, Dr Aikman will check your post-surgery incisions and give you instructions for care in the following few weeks. You may be given exercises to do by a physiotherapist to assist in recovery.