Your surgeon will discuss with you the most appropriate type of surgery, depending on the size and any spread of the cancer. Before any operation make sure that you have discussed it fully with your surgeon. Remember, no operation or procedure will be done without your consent.
For many women it is now possible to have a smaller operation to conserve the breast rather than a mastectomy. This is known as breast conserving surgery. All breast surgery, however, will leave some type of scar, and the cosmetic effect depends on the technique used. You may like to discuss with your doctor or nurse beforehand what your breast will look like after surgery.
Segmental excision/wide local excision
This is the removal of the breast lump together with an area of surrounding tissue. The axillary lymph nodes are also removed. Radiotherapy is given to the breast following recovery from the procedure.
For some women, the most appropriate treatment is still a mastectomy (removal of the breast). A simple total mastectomy removes only the breast tissue.
Sentinel lymph node biopsy
This test is called a sentinel node biopsy. The procedure involves injecting a small amount of radioactive material and a dye that identifies the first (sentinel) node to receive cells from the tumour. Sometimes there are 2 or 3 nodes at this point together, if so they are usually taken out together.If the sentinel lymph node/s have cancer cells in them or are positive, it is usual to have all the lymph nodes removed (axillary clearance).
If this node is clear, it usually means that the other nodes are clear. With this procedure, removal of all the lymph nodes under the arm can be avoided for those patients whose sentinel nodes are clear.
Lymph node removal
Removal of all the lymph nodes or axillary clearance is usually done when there has been a biopsy confirmed diagnosis of cancer spread in the lymph nodes in the armpit. For most women this operation can be performed without causing serious difficulty with shoulder movement, or arm swelling.
It is often possible for women who have had a mastectomy to have breast reconstruction. Sometimes this can be done at the same time as the mastectomy, but often it is done some months, or even years after the original operation.
If you would like to consider breast reconstruction, discuss it with your doctor before surgery so that he or she can tell you about the different methods available. For a free copy of our booklet Understanding Breast Reconstruction, download a copy here or call the National Cancer Helpline on Freefone 1800 200 700.
After your operation
You will be encouraged to get out of bed and start moving about as soon as possible after your operation. You may have one or two drainage tubes in place from the wound. These will usually be removed a few days after the operation by the nurses on the ward.
The length of your stay in hospital will vary according to the type of surgery you have had. Following local excision your stay will probably be quite short; after a mastectomy your stay could be several days.
After your operation you may experience some pain or discomfort which can continue for several weeks. There are various types of painkilling drugs available which are very effective. If you do have pain, at home or in hospital, it is important to tell your doctor or nurse so that effective pain killers can be prescribed.
The surgeon may have removed the lymph nodes from under your arm, in which case your hand and arm will be more vulnerable to infection. Even a small cut or burn or graze can sometime lead to a condition called lymphoedema which is a swelling of the hand and arm. For further information, see the section on Avoiding Lymphoedema. Take care of your hand and arm on the operation side, particularly when gardening or when using sharp knives. Always wear rubber gloves when washing up and use oven gloves when cooking.
If you do get any sign of swelling, pain or tenderness, ask your doctor’s advice.
Before you leave hospital you will be given an appointment to attend an outpatient clinic for your post-operative check up. This is a good time to discuss any problems you have after your operation.
When you get home, do take things easy for a while. You may feel physically and emotionally exhausted. Try to have long rest periods and eat a well balanced diet – the hospital dietician can provide guidelines if you wish. You will probably be advised not to lift or carry anything heavy nor to drive for a few weeks.
Our Survivors Supporting Survivors programme provides peer-to-peer support to people who have recently had a cancer diagnosis. The programme works on the principle of personal contact between the patient and Survivors Supporting Survivors volunteer - someone who has come through their own cancer journey. Carefully selected and fully trained volunteers are available to provide practical information and reassurance at a time when a woman is most in need of both.
For more information on Survivors Supporting Survivors, or Irish Cancer Society-affiliated support groups in your area, call the National Cancer Freefone Helpline on 1800 200 700 or follow these links:
Call our National Cancer Helpline
Freephone 1800 200 700 to talk to a specialist cancer nurse
It's open Monday-Thursday from 9am to 6pm and Friday from 9am to 5pm