After a breast cancer diagnosis, surgical options are diverse. There are some factors that affect these options. The size of the cancer, the region of the breast where it is located, the breast size of the person, and personal factors should be evaluated.
Removal of only the cancerous area
Removal of only the cancerous area in the breast is called large local removal or lumpectomy. In medical practice, we call it breast-conserving surgery. Together with the cancerous tissue, the adjacent surrounding tissue is removed with clean borders and as much healthy breast tissue as possible is left behind. This surgery is used in women whose tumor size is suitable for removal according to breast volume. Tumor location should also be in a place suitable to leave a healthy breast behind. The tumor should be confined to a single area of the breast. Radiotherapy is usually used after this type of surgery. Radiotherapy is important to safely follow the remaining breast tissue. With radiotherapy, all the cells that are left behind and still have the potential to carry cancer are destroyed.
After removing the tumor with clean margins during surgery, the margins are checked by the pathologist. After learning that the borders are clean, the breast operation is completed. Meanwhile, underarm lymph nodes are also checked for cancer involvement. Lymph nodes sampled from under the arm are examined under a microscope by the pathologist. If the presence of cancer is not found, it is reported as healthy tissue. If cancer is detected, the lymph nodes under the arm are also cleaned in the same session.
Sampling of lymph nodes under the arm
If lymph nodes are not observed in your preoperative ultrasonography, During the operation for breast cancer, the lymph nodes are checked for the presence of tumors. For lymph node involvement, the radioactive material method given intravenously on the morning of the operation or the blue dye method given from the nipple during the operation are used. The radioactive material or blue dye will flow from the breast to the underarm lymph nodes. The surgeon finds the first lymph nodes involved (sentinel lymph nodes = guard lymph nodes). Usually 1-3 lymph nodes are sampled. The pathologist checks to see if cancer has reached these sampled lymph nodes. If it is shown that there is no cancer in the sampled lymph nodes, no further lymph node removal is required. If there is a tumor in the guard lymph nodes, the underarm lymph nodes should be cleaned.
Blue dye can also dye the breast blue. It can take several months for the blue paint to fade. It doesn’t matter in terms of health.
Wound healing
As in all surgeries, you will have scars. Usually, this scar is not visible when wearing a bikini or bra. You will also have a small scar in the area where lymph node sampling is performed under the arm. These scars fade over time and take on the color of mother-of-pearl.
This operation usually does not change much breast size. Thanks to the intramammary tissue shifting methods, a symmetrical breast with the other breast is obtained. Sometimes the opposite breast may be larger and drooping. If such a risk is foreseen, symmetry can be achieved by lifting or reducing the opposite breast in the same session. You should talk to your doctor about this issue while making your surgical plan, explain your expectations and question what awaits you.