The Art of Conservative Surgery: A Comprehensive Guide
– Conservative surgery, also known as breast-conserving surgery (BCS), removes the cancer while preserving as much normal breast tissue as possible.
– BCS is a good option for many women with early-stage breast cancer.
– Most women who undergo BCS will also need radiation therapy.
– BCS may be a good option for women who are concerned about losing a breast, are willing to have radiation therapy, have not had radiation therapy or BCS on the breast before, have a tumor smaller than 5 cm, are not pregnant or do not need immediate radiation therapy if pregnant, do not have certain gene mutations or connective tissue diseases, and do not have inflammatory breast cancer or positive margins.
– BCS is typically done in an outpatient surgery center.
– Post-surgery care instructions may include caring for the surgery site and dressing, caring for drains if applicable, recognizing signs of infection, bathing and showering tips, when to contact the doctor or nurse, and how to start using the affected arm again and perform arm exercises.
– After BCS, patients may experience pain, tenderness, or swelling in the breast.
– Formation of scar tissue and dimples at the surgical site is possible.
– Swelling of the breast due to fluid collection (seroma) might occur, requiring drainage.
– The shape of the breast may change after surgery.
– Nerve pain in the chest wall, armpit, and/or arm can persist after surgery.
– Patients who have axillary lymph nodes removed may be at risk of developing lymphedema.
– Pathologists examine the removed tissue to determine if all cancer cells were removed.
– Negative or clear margins indicate no cancer cells at the edges of the removed tissue.
– Close margins indicate cancer cells near the edges, while positive margins indicate cancer cells at the edge.
– If positive margins are found, further surgery may be needed, including a re-excision or mastectomy.
– Breast reconstruction surgery may be an option if significant changes in breast shape occur after BCS.
– Small metallic-like clips may be inserted during surgery to mark the area where the cancer was removed for radiation therapy planning.
– Most women will require radiation therapy and hormone therapy after BCS to reduce the risk of cancer recurrence.
– Some women may also require chemotherapy, in which case radiation therapy and hormone therapy are typically delayed until chemotherapy is completed.
– Risks of BCS include short-term breast swelling, changes in breast size and shape, scar tissue formation, wound infection or bleeding, and swelling of the arm.
– Reconstructive surgery may be an option to restore the appearance of the breast.
– Patients should discuss their expectations and options with their doctor before surgery.
– The recovery process after BCS depends on the type of procedure and anesthesia used.
– Patients may go home the same day or within 1 to 2 days after BCS.
– Pain levels vary and pain relievers should be taken as advised by the doctor.
– Wearing a supportive bra may be recommended.
– Normal activities can be resumed in 2 weeks, but strenuous activities should be avoided.
– Patients should follow the doctor’s instructions for driving, returning to work, and radiation therapy.
– Patients should notify the doctor if they experience certain symptoms or complications.
– Lymph node removal during BCS can affect lymphatic fluid drainage and increase the risk of infection and blood clots.
– Patients must follow safety steps for the rest of their lives after lymph node removal, including avoiding needle sticks and IVs in the affected arm, following arm exercise instructions, avoiding injuries, elevating the arm to drain fluid, wearing gloves during certain activities, avoiding sunburns, using a clean razor to shave, and avoiding tight clothing.
– Additional instructions may be provided by the doctor depending on the individual situation.
