Most patients with breast cancer have surgery as part of their treatment.
In recent years, procedures have become less invasive, and outcomes are improving. But that doesn’t mean it’s not stressful for patients.
As a breast surgeon, I’m often the first doctor a patient sees after diagnosis. My focus is not only to perform a successful procedure but to educate and encourage shared decision-making to identify the right procedure for each patient.
There are two main types of breast cancer surgery.
A mastectomy is the removal of the entire breast. Breast conservation therapy, also called a partial mastectomy or lumpectomy, removes just the cancerous tissue with a normal rim of tissue around to remove all microscopic disease, preserving as much of the breast as possible.
Patients with advanced breast cancer may only be candidates for total mastectomy, whereas early-stage disease may have all options.
The first important factor in tailoring decisions is the tumor size, specifically the amount of disease relative to your breast size.
We also consider the biology of your disease and the need for systemic therapy in addition to surgery. The need for chemotherapy also contributes to options for surgery.
We assess your genetic risk via a detailed family history and all indicated genetic testing. Genetic mutations may change recommendations for treating your current cancer and preventing future cancers.
The last factor, and most important, is your personal preferences.
I believe in shared decision-making for patients who have a choice between mastectomy and breast conservation therapy. I explain to them that both are highly effective, and then we discuss risks and benefits, considering life factors that allow for emotional recovery from cancer.
With breast conservation, you keep as much of your breast as possible, with almost all patients going home the same day.
Full recovery takes about two weeks, but you usually return to work and normal activities after a couple of days if they aren’t extremely strenuous. This surgery is paired with radiation in most patients to ensure the lowest chance of recurrence.
In a mastectomy, your breast is removed, and you face a longer recovery.
Many patients go home the same day due to advanced pain management strategies with drains that are removed once patients no longer need them. They should avoid vigorous activity until they fully recover in four to six weeks.
Reconstruction is always an option, but the timing depends on patient factors: some patients are candidates immediately, while others must be delayed due to other medical conditions.
My advice to patients is simple.
Start by being vigilant. Get your annual mammogram. If something changes in your breasts, talk to your provider. By catching cancer early, you give yourself more options for treatment.
If you are diagnosed with breast cancer, seek treatment from a surgeon who specializes in the disease. We can offer the latest procedures, including minimally invasive options.
Finally, know that you have choices. Talk to your surgeon about what is best for your specific needs and goals. Remember, we’re here not only to ensure your procedure goes well, we’re here to make sure it’s the right procedure for you.
Ashley Hendrix, MD, MBA, FACS, is a board-certified, fellowship-trained breast surgeon at Regional One Health’s Main Campus and East Campus. For appointments, call 901-515-HOPE (4673).
By Ashley Hendrix, MD, MBA, FACS