Where can you find information? Who should be on your “team?” A mastectomy vs. the less invasive lumpectomy? What are lymph nodes and why are they important?
These are a few of the most important questions you will face when diagnosed with breast cancer. McLeod Breast Cancer Surgeon Dr. Amanda Turbeville offers these insights:
Here are highlights of Dr. Turbeville’s comments:
There are a couple of important things that a woman should think about when she is facing breast cancer surgery.
First, gather all of the information about breast cancer that you can. There are websites with the American Cancer Society, Susan G. Komen, as well as McLeod Health that are great resources. McLeod Health also has a cancer specialist (that you can find on the website www.McLeodHealth.org) to answer specific questions.
You need to pull together your treatment team. Generally, it is headed by your surgeon, but you will also want to include a nurse navigator, your oncologist and (if you’re considering reconstruction) a plastic surgeon. In addition, you will want to pull together your emotional team — family, friends, church members and pastors, whoever you lean on for support.
You need to understand that you are going to be faced with a lot of decisions and not all of the answers are going to be clear cut. Don’t panic because you are going to have time to make an educated decision. While you don’t want to delay, you don’t need to rush into anything.
Under certain circumstances people with breast cancer can choose between a mastectomy or a lumpectomy, which is considered breast conservation therapy. A lumpectomy is almost always followed by radiation. It is as effective as a mastectomy for a woman that has cancer in one side of the breast or a tumor less than 4 cm (1.5 inches). You do need “clear margins” for a lumpectomy, which means the tissue surrounding the tumor has to be completely free of cancer. Radiation therapy after a lumpectomy can affect the reconstruction timing and also the type of reconstruction available to the patient.
Some people have anxiety related to a breast cancer diagnosis. For those people, there is an option of a mastectomy to completely remove the breast, alleviating fears of breast cancer coming back. Many women with a mastectomy have reconstruction at the same time as surgery.
Your lymph nodes are a filter that drains your body’s lymphatic system. This is why lymph nodes are likely to catch or filter out cancer cells that might be floating in the fluid as it drains away from the cancerous area of the breasts. And those under your arm — the axillary lymph nodes – are relatively easy to get to during surgery. It is very common to remove all or some of these lymph nodes.
The sentinel lymph node dissection is a newer technique. It offers an option to axillary lymph node dissection, where we remove all the lymph nodes under the arm. In some women, a sentinel node procedure can spare them more invasive surgery. However, the sentinel lymph node biopsy is not appropriate for everyone. It has its own limitations and has to be performed by a surgeon who has experience with this technique.
The sentinel lymph nodes are the first to filter the fluid draining away from the area of the cancer. If the cancer cells are breaking away from the tumor, they will be filtered by these lymph nodes first. Removal of one to two lymph nodes under the arm can help assess the lymph node status and if you have a small breast cancer or don’t have any abnormal lymph nodes before surgery, this can be a good technique for you.
Have a question? Ask a Cancer Specialist.