Breast Cancer Surgery: Procedure, Recovery, Cost, Risk & Complication

Surgery is a common procedure when it comes to treating breast cancer, as the main objective is to remove the cancer cells as much as possible. There are different types of surgery for breast cancer, depending on your medical history and the type and stage of cancer that you are suffering from. The two main types of surgeries are:

• Lumpectomy, which is also known as partial or segmental mastectomy. This surgery involves removing only that part of the breast where cancer has been detected, along with some normal tissues surrounding it. The portion of breast that is removed depends on factors such as the size and location of the cancerous tumor.
• Mastectomy, which involves the removal of the entire breast, including all breast tissues and at times even the nearby tissues. In some cases, patients may also undergo double mastectomy, where both the breasts are removed.

A breast cancer patient may require a surgery in the following conditions:

• If one is in a locally advanced stage of breast cancer
• Suffering from Paget’s disease (cancer cells form in/around the nipple)
• Multiple tumors in different areas of the breast
• Recurring of the cancer in the breast even after radiation
• A connective tissue disease such as lupus or scleroderma, where the side effects of radiation cannot be tolerated by the skin
• The patient is pregnant and radiation may affect the unborn baby

Pre Procedure

The following preparations need to be taken before undergoing a surgery for breast cancer:

• Have a detailed discussion with your surgeon as well as your anaesthetist regarding the complete procedure of the surgery. You can ask questions to your doctor and clear your doubts, if you have any.
• If you wish to have a breast reconstruction at the same time, you will also have to meet and discuss the same with your plastic surgeon before the surgery
• Inform your doctor regarding the medicines, supplements and the vitamins that you are taking
• Discontinue taking medicines that may increase the risk of bleeding in the course of the surgery, like blood thinners and aspirin
• You have to stop eating or drinking anything 8-12 hours prior to the surgery. Your doctor will instruct you in this matter.

During Procedure

The surgery is normally performed by administering general anaesthesia. An incision is made around the affected breast. The tumor and the surrounding tissues are then removed. There are different procedures by which the surgery can be performed:

• Axillary node dissection where several lymph nodes are removed from the armpit on the side where the tumor was located
• Sentinel lymph node biopsy where only one or two lymph nodes are removed and then tested if they have cancerous cells in them
• Total mastectomy which involves removing of the entire breast
• Skin-sparing mastectomy where all the breast tissue, nipple and areola are removed but not the breast skin
• Subcutaneous mastectomy, which is removal of the breast tissue only, and not the skin, nipple and areola

Once the surgery is completed, the incision is stitched back that gets dissolved or has to be removed later. There may be plastic tubes placed in the surgical area for draining any fluid that may accumulate post surgery. The tubes will be sewn in place, with the other ends being attached to a small-sized drainage bag.

Post Procedure

After the completion of the surgery, you will be shifted to the bed and your pulse, breathing and blood pressure will be monitored by your doctors. There will be a dressing over your surgery site. You may feel numb, pain or a pinching sensation in your underarm area. You will be prescribed pain medications for it.

Before you are discharged from the hospital, you will be provided proper instructions regarding care at home, how to take care of your incision and drainage, recognising and informing your doctor if you see any sign of infection. There may also be some restrictions in your daily activities initially. You can also consult your doctors to have a clear knowledge when you can resume wearing a bra or breast prosthesis.

A breast cancer surgery can have the following risk or complications:

• Bleeding from the incision site
• Infection in the area of surgery
• Temporary swelling
• Pain and stiffness of the shoulder
• Hard scar tissue formation at the surgical site
• Hematoma, where there is a build-up of blood in the site of the surgery
• A feeling of numbness, especially under the arm, if the lymph nodes have been removed
• Change in the appearance and shape of the breast, especially if a large portion has been removed.

You will have to go for follow-up appointments so that the doctors can monitor your progress of recovery after the surgery. You may have to go for radiation therapy if the tumor was a large one, there were several lymph nodes that were cancerous, if the cancer had spread in the nipple or skin, or there are any cancer cells remaining even after the surgery. In case your cancer is found to be sensitive to chemotherapy, you can discuss other modes of treatment like hormone therapy with your oncologist. Apart from that, involving yourself with a counsellor or support group can help you recover fast emotionally. A healthy lifestyle with good food habits, along with cutting off tobacco and alcohol, will ensure a faster recovery and a healthy life ahead.

The cost of a breast cancer surgery may be approximately Rs. 3, 23,350 – Rs. 4,52,700.