Q: My breast cancer was diagnosed early, but my physician says that I need surgery. Which operation is better - lumpectomy or mastectomy?
A: Although lumpectomy (removal of the tumor and its margins) - combined with radiation therapy - has gained favor as a treatment for early breast cancer, there are some important instances in which mastectomy is a better option. For example, if the tumor lies directly behind the nipple, it may be difficult for the surgeon to remove without significantly altering the shape of the breast. If this is the case, mastectomy may be a better alternative when followed up by breast reconstruction. In addition, women with small breasts may achieve better cosmetic results with mastectomy followed by breast reconstruction.
Q: Does it matter when I have surgery?
A: If breast cancer has been diagnosed and surgery is proposed, it certainly is advisable to have the operation sooner rather than later. But breast cancer is rarely a surgical "emergency." So it is better to explore surgical options and get a second opinion before scheduling a procedure. Such leeway will permit you to make a more informed decision about your surgery; such as having breast reconstruction at the time of mastectomy, rather than during a separate operation.
Q: What will my chest look like after breast surgery?
A: Many women worry that they will have a "hollow" chest after breast cancer surgery. Fortunately, the operations that are performed these days are not likely to produce that kind of disfigurement. If you have a lumpectomy, you will probably have a small indentation in your breast. If you have a modified radical mastectomy or a simple mastectomy, your chest will be flat on the side where the breast was removed. Depending upon the location of your tumor, the scar on your chest wall may be horizontal or diagonal.
Q: My breasts are droopy. Can this be fixed?
A: Breast droop or Ptosis is usually surgical correctable by either a mastopexy (skin tightening and lift) or augmentation or both. Choosing the correct option is very important. Your surgeon will discuss this with you.