Living With Breast Cancer

Types of Mastectomy

Getting a mastectomy doesn’t always mean the complete removal of both of your breasts. While that is a possibility for some women with breast cancer, there are many different types of mastectomies available today depending on your diagnosis. You should discuss the best available options with your doctor.

  • Lumpectomy: Removal of the breast tumor and a portion of normal tissue around the cancer.
  • Partial mastectomy: Removal of cancer and a larger portion of normal breast tissue surrounding the tumor. It may also require removal of the lining over the chest muscles adjacent to the tumor location, as well as some axillary lymph nodes.
  • Total (or simple) mastectomy: Removal of the entire breast including the nipple, the areola and most of the overlying skin. This procedure may also include the removal of some axillary lymph nodes under the arm.
  • Modified radical mastectomy: Removal of the entire breast (including the nipple, the areola and the overlying skin), some of the lymph nodes under the arm (also called the axillary lymph glands) and the lining over the chest muscles.
  • Radical mastectomy: Removal of the entire breast (including the nipple, the areola  and the overlying skin), the axillary lymph nodes under the arm and the chest muscles.

Changes in Mastectomy

For many years, radical mastectomy was the standard operation for women with breast cancer. Today, radical mastectomies are rarely performed and generally only used if the cancer has spread to the chest muscles. Some research suggests that women with breast cancer have an equal, if not better, chance of survival with conservative treatments, such as minimally invasive lumpectomy with radiation therapy.

Breast Reconstruction: 

Having part, or all, of your breast removed can be one of the most emotionally challenging parts of your breast cancer journey.

There are many options for breast reconstruction depending on the type of surgery you’ve had, the stage of the cancer treated and your follow-up treatment. Discussing the following options with an experienced breast reconstruction surgeon can help you make an informed decision:

  • Some breast reconstruction surgeries use tissue from your own body.
  • Other reconstruction surgeries use a prosthesis or implant.
  • Breast reconstruction can sometimes be performed at the time of your cancer surgery; other times, it may need to be done at a later date.

Recovering from Breast Reconstruction:

  • Breast reconstruction does not have any connection to an increased or decreased risk of breast cancer recurrence.
  • After surgery, you will likely have soreness, swelling and bruising for two to three weeks.
  • Full recovery from breast reconstruction typically takes about six weeks.
  • You may have areas of numbness or tightness in your new breasts after the surgery.
  • Your surgeon will map out a care plan for you to ensure a complete and healthy recovery from the reconstructive surgery.

Recurrence of Breast Cancer

The question that looms over any breast cancer survivor is, “Will the cancer return?” Let’s sort out the facts. Breast cancer recurrences typically happen within 5 years of treatment. About 25% of recurrences and half of new cancers in the opposite breast occur after 5 years. If you’ve had breast cancer in one breast, you have a 1-2% chance per year of developing a breast cancer in your opposite breast, if you have no other risk factors.

There are several factors that determine the risk for recurring breast cancer:

  • Location of the tumor and how far it has spread
  • Whether the tumor is hormone receptor-positive or -negative
  • Tumor markers
  • Gene expression
  • Tumor size and shape
  • Rate of cell division

Follow-up Care

Once your breast cancer treatment is complete, follow-up care with your primary care doctor is important to help detect any recurrence early. Because follow-up care varies so widely between different types of breast cancers, partner with your physician for your personalized follow-up care program.

  • You’ll typically have a six-month follow-up visit and exam.
  • If all goes well at your six-month visit, you’ll continue with annual exams if there are no changes or problems.
  • Be sure to do a monthly breast self-exam-remember early detection is key to survival.
  • Continue scheduling regular breast exams and an annual mammogram, as recommended by your physician.
  • Stay educated about recent breakthroughs in breast cancer treatment.
  • Commit to living a healthy lifestyle that includes exercise and a balanced diet.
  • Join a support group for friendship and continued support on your journey.