Mastectomy or breast conservation?

Generally in mastectomy, the surgeon removes the entire breast, including the nipple, through some procedures, the nipple is spared after removal of the breast tissue. The procedure that takes an average of two or three hours is performed under general anesthesia, which means the patient is asleep. It is the best suited form of treatment for individuals with a large lump particularly in a small breast, lump in the middle of your breast or more than one area of cancer in your breast. To mark the beginning of the surgery, markings on your breast are made to show where the incision will be. After the incision is made, the breast tissue is separated from the overlying skin and from the chest wall muscle underneath. All of the breast tissue-which lies between the collarbone and ribs, from the side of the body to the breastbone in the center-is removed. If you are having a full radical mastectomy, some of your chest muscle may be removed as well. Prof Wasike points out that after surgery, the patient may experience temporary soreness in the chest, underarm and shoulder with the period of recovery varying from one person to another, though medicine is used to control pain. “The skin where your breast was removed may feel light and the arm and shoulder muscle may feel stiff and week, but these usually go away through physiotherapy or self-controlled exercises.” Prof Wasike points out. One or two small plastic drains or tubes are usually left in your chest to remove extra fluid from where the breast tissue used to be which are later removed during review after discharge. Breast conservation surgery procedure. Prof Wasike says that breast conservation is best for cancer stages 0, 1 or early stage 2 with conditions that the patient must be able to combine the surgery with radiotherapy and it is also dependent on the size of the breast and the tumor too. Locally, this treatment option is available at a cost of sh.250, 000 while a mastectomy is sh.300, 000 at the Aga Khan University Hospital. Breast conservation is also known as lumpectomy because the cancerous lump is removed, leaving healthy tissue behind and the breast intact. During this procedure, the skin over the surgical site will be cleansed with an antiseptic solution before a small cut is made over or near the breast tumor to remove the lump or abnormality along with a portion of the surrounding breast tissue. “The larger the portion of the breast removed, the more likely it is that you will see a change of the breast afterwards, which might call for re-constructive surgery to ensure the breasts look similar,” Prof Wasike noted. The surgeon may also remove some of the lymph nodes under the arm to determine if the cancer has spread and also administer radiation therapy is often given after breast-conserving surgery to destroy cancer cells that may not have been removed. Breast tissue and any other tissues that are removed will be sent to the lab for examination and a drainage tube may be inserted into the affected area. Later the skin is closed with sutures and a sterile bandage or dressing will be placed over the site. Prof Wasike advices that an individual can perform light duties within two weeks, but avoid strenuous activities, particularly those that involve extensive use of the arm.

Source: “Breast Cancer What We All Need to Know by Prof Ronald Wekesa. photo:www.etsy.com