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Choosing Treatment for Early-Stage Breast Cancer

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  • Women who have lumpectomy go home from the hospital the same day as their surgery. For a week or 2 after surgery, they must rest and avoid sports, swimming and heavy lifting.
  • Women who have mastectomy stay in the hospital for 1 to 2 days after surgery. If they also have breast reconstruction, they might stay a day or 2 longer. They go home with drains that must be emptied twice a day. After about 2 weeks, the surgeon takes the drains out in the office. If more fluid or blood builds up after the drains come out, the doctor will drain it with a needle in the office. During the draining process and for a few weeks more, women who have a mastectomy must rest and avoid sports, swimming, or heavy lifting. Even after they recover, women who have mastectomy will not have normal feeling in the chest. Women who have mastectomy can have the breast that was removed reconstructed right away or later.
  • Regardless of which surgery you have, you will probably need to have biopsies of your lymph nodes. This part of the surgery usually does not cause problems. But in some cases it can cause arm swelling, pain, or stiffness; shoulder pain or stiffness; or a nerve injury. If any of these happen to you, you might need to do special exercises or have physical therapy (work with an exercise expert) to get back to normal.

  • How do I work with my doctor to make a decision? " ” Tell your doctor how you feel about the different treatment options. If there is something specific that worries you, tell your doctor about that, too. Then listen to what your doctor has to say about his or her experiences with women who had situations similar to yours. Together you can decide which treatment option is right for you. When you choose your treatment, you can find out more details about that option. ‚  
    All topics are updated as new evidence becomes available and our peer review process is complete. ‚  
    This topic retrieved from UpToDate on: Nov 04, 2014. ‚  
    Topic 16242 Version 9.0 ‚  
    Release: 22.8 - C22.208 ‚  
    ‚ © 2014 UpToDate, Inc. All rights reserved. ‚  


    figure 1

    Lymphatic system in women

    This figure shows the organs of the lymphatic system, which include the bone marrow, thymus, spleen, and lymph nodes. These organs are connected by lymph vessels.

    Graphic 86801 Version 1.0

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    Lymphatic system in women

    This figure shows the organs of the lymphatic system, which include the bone marrow, thymus, spleen, and lymph nodes. These organs are connected by lymph vessels.

    Graphic 86801 Version 1.0

    View Original
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    table 1Choosing between mastectomy and lumpectomyView Largetable 1Choosing between mastectomy and lumpectomy

    Mastectomy

    Lumpectomy

    How will I look?

    If you decide not to have your breast reconstructed, you will have a scar where your breast used to be. If you do have your breast reconstructed, you will have a new breast made of an implant or out of skin, muscle, and fat taken from other parts of your body. Reconstructed breasts do not have as much sensation as breasts that have had a lumpectomy.

    Your breast will have a scar and might have a dent or dimple where the tissue was removed. The treated breast might be a little smaller than the other breast. Still, it will feel more like a real breast than a reconstructed breast and have more sensation.

    What will my recovery from surgery be like?

    You will stay in the hospital for 1 to 2 days (or a little longer if you have reconstruction done, too). You will go home with drains that must be emptied twice a day and that stay in for about 2 weeks.

    Your recovery will take 4 to 6 weeks. During that time you will need to rest and avoid sports, swimming, and heavy lifting. You might need physical therapy.

    You will go home from the hospital the same day as your surgery, and your recovery will take 1 to 2 weeks. During that time, you will need to rest and avoid sports, swimming, and heavy lifting. You might need physical therapy.

    What are the risks or side effects of this surgery?

    Mastectomy is usually safe, but it can sometimes lead to bleeding, infection, or fluid build-up. Plus, the surgery can sometimes damage the skin on the chest. (This is more common in women who smoke.)

    Lumpectomy is usually safe, but it can sometimes lead to bleeding, infection, or fluid build-up where the cancer was removed.

    Will I need more than 1 surgery?

    Possibly, if you decide to have your breast reconstructed later.

    Possibly, if the cancer comes up to the margins and the surgeon has to take more tissue.

    Will I need radiation therapy?

    Probably not. But some women who have mastectomy do need radiation.

    Yes. After lumpectomy, most women must have radiation therapy 5 days a week for 3 to 6 weeks.

    What are the chances that cancer will come back in the same area?

    Cancer can still recur after mastectomy because all the breast tissue cannot be totally removed. About 5 out of 100 women who have a mastectomy will have cancer come back on the chest wall after mastectomy.

    Fewer than 10 out of 100 women who have a lumpectomy will have cancer recur.

    Graphic 61056 Version 2.0


    figure 2

    Lumpectomy and mastectomy to treat breast cancer

    Women who have a mastectomy have the whole affected breast removed. Women who have a lumpectomy have the tumor and a small part of the surrounding healthy tissue removed. In most cases, women who have a lumpectomy must also have radiation therapy after their surgery. Women who have a mastectomy can usually decide if and when to have their breast reconstructed. The type of reconstruction shown here is just one way surgeons can reconstruct a breast.

    Graphic 73172 Version 6.0

    View Originalfigure 2

    Lumpectomy and mastectomy to treat breast cancer

    Women who have a mastectomy have the whole affected breast removed. Women who have a lumpectomy have the tumor and a small part of the surrounding healthy tissue removed. In most cases, women who have a lumpectomy must also have radiation therapy after their surgery. Women who have a mastectomy can usually decide if and when to have their breast reconstructed. The type of reconstruction shown here is just one way surgeons can reconstruct a breast.

    Graphic 73172 Version 6.0

    View Original

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    This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.The use of UpToDate content is governed by the UpToDate Terms of Use. ‚ ©2014 UpToDate, Inc. All rights reserved. ‚  

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