Breast Cancer Surgery

This page covers the most common surgical treatment options during breast cancer.

Surgery is important because most cancer cells are invisible so the surgeon needs to get in there to determine what is cancerous tissue and what is healthy tissue. It’s kind of like crabgrass - from far away you might think the grass looks like healthy grass; however, you won’t know until you take a closer look.

Your surgery can be scheduled anywhere from one to six months after diagnosis dependent on whether your team prescribes pre-operative treatments for your tumor – this is called neoadjuvant therapy and typically includes chemotherapy, radiation therapy, or endocrine therapy.

On the day of your surgery you’ll check in at an outpatient surgery center or hospital.

• You’ll be placed in a bed in the pre-operative room.

• You may have blood drawn for testing.

• Your surgeon will meet with you and describe the surgery and what they think they will remove.

• And your anesthesiology team will ask you questions about your health.

Once you’re on the surgical table your surgeon will mark where the tumor is located and additional tissue around the tumor – this is called the margin.

• They will remove this tissue and a pathologist will immediately examine to determine if there are any cancerous cells within this margin. If the margins are not clear then more surgery will be required until the margins are clear.

• I picture the tissue removed like a fried egg. The yellow yolk is the original cancerous tissue, and the egg white is the margin that will be examined for cancerous cells.

After they receive pathology on your tumor tissue your surgeon might perform a sentinel node biopsy. These nodes are the 1st few lymph nodes that track from your breast. These lymph nodes will be removed and examined immediately by a pathologist.

After your surgeon receives pathology on the sentinel nodes, he or she will determine whether to remove some of all your underarm lymph nodes on the side of your cancer – these are called axillary nodes.

• Lymph node removal is not painful.

• It will impact your recovery time.

• And you will need to minimize the risk of lymphedema after surgery.

Depending on the extent of your surgery you might have drains placed near your surgical incisions.

• The purpose of the drains is to prevent the accumulation of fluids around your incision.

• They usually remain in place 2-3 weeks.

• And you’ll be asked to clear and measure the drain output daily.

When you emerge from surgery, you’ll want to confirm the results from the pathology completed during the surgery and find out when the final pathology report will be available. The final surgical pathology report provides important details of your cancer. This along with scans and imaging will guide decisions about any future breast cancer treatments. Your mobility after surgery will depend on the extent of your surgery, whether you have drains, and your general health.

Watch our video on breast cancer surgery on YouTube https://youtu.be/1f9h99m-UGs

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