Breast Care - Breast cancer
Breast cancer is the second-leading cause of cancer deaths in American women. About 180,000 women will develop breast cancer in the United States annually. Breast cancer can also occur in men, but it's far less common.Over the last 30 years, doctors have made great strides in early diagnosis and treatment of the disease and in reducing breast cancer deaths. In 1975, a diagnosis of breast cancer usually meant radical mastectomy Today, radical mastectomy is rarely performed. Instead, there are more and better treatment options, and many women are candidates for breast-conserving operations.
Most breast lumps aren't cancerous. Yet the most common sign of breast cancer for both men and women is a lump or thickening in the breast. Often, the lump is painless. If you find a lump or other change in your breast — even if a recent mammogram was normal —have it evaluated promptly.
Other potential signs of breast cancer include:
- A spontaneous clear or bloody discharge from your nipple, often associated with a breast lump
- Retraction or indentation of your nipple
- A change in the size or contours of your breast
- Any flattening or indentation of the skin over your breast
- A diagnosis of breast cancer is one of the most difficult experiences you can face. Treatments exist for every type and stage of breast cancer. Most women will have surgery and an additional (adjuvant) therapy such as radiation, chemotherapy or hormone therapy.
Lumpectomy. This operation saves as much of your breast as possible by removing only the lump plus a surrounding area of normal tissue. In general, lumpectomy is almost always followed by radiation therapy to destroy any remaining cancer cells.
Partial or segmental mastectomy. Another breast-sparing operation, partial mastectomy involves removing the tumor as well as some of the breast tissue around the tumor and the lining of the chest muscles that lie beneath it. In almost all cases, you'll have a course of radiation therapy following your operation, similar to if you had a lumpectomy.
Simple mastectomy. During a simple mastectomy, your surgeon removes all your breast including the nipple and areola.
Modified radical mastectomy. In this procedure, a surgeon removes your entire breast, including the overlying skin, and some underarm lymph nodes (axillary lymph node dissection), but leaves your chest muscles intact.
Sentinel lymph node biopsy
Because breast cancer first spreads to the lymph nodes under the arm, all women with invasive cancer need to have these nodes examined. Rather than remove as many lymph nodes as possible, surgeons now focus on finding the sentinel nodes — the first nodes to receive the drainage from breast tumors and therefore the first place cancer cells will travel. If a sentinel node is removed, examined and found to be normal, the chance of finding cancer in any of the remaining nodes is small and no other nodes need to be removed. This spares many women the need for a more extensive operation and greatly decreases the risk of complications.
Axillary lymph node dissection
If the sentinel lymph node does show the presence of cancer, then your surgeon removes additional lymph nodes in your armpit (axilla). Knowing if cancer has spread to the lymph nodes is important in determining the best course of treatment.
Reconstructive surgery
If you want to have breast reconstruction done, discuss this with your surgeon before you have any surgery done. A plastic surgeon will be needed and can describe the various procedures. Reconstructive surgery can be performed at the time of your mastectomy or at a later date.
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University Surgical Consultants