If you have been diagnosed with a breast cancer you should have surgery with a dedicated specialist oncological breast surgeon.
I head a team of specialists who all optimise each of my patient’s care. This is called MULTIDISCIPLINARY CARE and has been proven to improve survival but when done well can help the entire breast cancer journey be less traumatic.
Because I have 20 years of experience helping patients through a breast cancer treatment and continuing to monitor and care for them I am able to educate my patients on what to expect – it really helps to know the changes that will occur and what the ‘new normal’ is after surgery.
Every breast cancer is different and cancer care is tailored to each patient.
The role of surgery is to remove the cancer and have a clear margin of tissue. If this is done as removing a lump the breast should be left with an excellent cosmetic outcome.
If there are multiple cancers in the one breast, if the cancer is large compared to the breast size or if there is also extensive precancer or if the patient elects they would rather, than a mastectomy is performed. Every patient should understand the decisions taken to their surgical options and be a part of the decision making process. Every patient having a mastectomy should be offered immediate reconstruction (with the exception being inflammatory breast cancer where the change is also in the skin) and meet with my Reconstructive Plastic Surgeon to discuss this further.
Surgery for a breast cancer also involved checking the armpit lymph gland/node of the same side. If the node appears normal on imaging this is done as a sentinel node biopsy to minimise disrupting the armpit lymph flow and sensation, removing 1 or 2 nodes. If an axillary dissection is needed the incidence of lymphoedema is minimised by an experienced surgeon.
While surgery removes a cancer the breast and body are then protected.
If a breast lump only is removed radiotherapy is done to reduce the chance of the breast making another cancer.
The systemic protection given depends on the cancer – and can be chemotherapy, an oral anti-hormonal therapy, Herceptin therapy or combinations thereof. The aim is to protect from any single cells that may have escaped.
When the cancer protection will need to be with chemotherapy this can be given prior to surgery and is called NEOADJUVANT therapy. This protects the entire body straight away and allows time for gene testing, coming to grips with surgical options and importantly seeing a response from the cancer shrinking.