Breast cancer is a malignant disease characterized by an uncontrollable growth of the cells in the breast, which mostly affect women. The exact causes for the development of breast cancer are not known, but investigators identified gene mutations that can be either inherited or acquired and cause the disease. Therefore, having direct family members who suffered from breast cancer increases the probability of suffering from it as well, while there are numerous other risk factors.

Depending on the form of the disease and on the patient’s characteristics, treatment options include surgery and radiation, which are known as local treatment since they aim to treat the cancer without damaging other parts of the body, or chemotherapy, hormone therapy, targeted therapy and bone-directed therapy, which are systemic treatments that reach cancer cells anywhere in the body. The two most common types of surgery for patients with breast cancer are mastectomy, which is the full removal of one or both breasts, and breast-conversing surgery.

Breast-Conserving Surgery Procedure for Patients with Breast Cancer

Unlike in a mastectomy, during breast-conserving surgery, the entire breast is not resected, but only the tumor and part of the normal surrounding tissue. The patient is asleep under general anesthesia and an incision is made in the chest to reach the affected area. Then, part of the breast is removed, and in some cases, the surgeons will also remove some lymph nodes under the arm, and part of the chest wall lining. After the surgery is completed, a pathologist uses a microscope to analyze the tissue removed and look for cancer cells at the edges. If no cancer edges are found, then the pathologist declares that it has negative or clear margins. If there are still cancer cells in the edges, or positive margins, it means that some cancer cells may have been left. In this case, a re-excision is needed, during which the surgeon will go back and remove more tissue.

The procedure is performed in an outpatient surgery center, and patients usually don’t need to stay overnight at the hospital and will be able to return to their normal activities in two weeks. There are many names given to breast-conserving surgery, including lumpectomy, breast preservation surgery, partial mastectomy, re-excision, quadrantectomy, or wedge resection. In the case of partial mastectomy, the removal is larger, while quadrantectomy refers to the removal of a quarter of the breast. For most women, the treatment does not consist of surgery alone, but radiation therapy before or after the surgery is particularly common. Hormone therapy or chemotherapy combined with breast-conserving surgery are also options to decrease the risk of cancer recurrence.

Benefits and Risks of Breast-Conserving Surgery for Breast Cancer Patients

“After observing several relevant protocols, we found very high frequency of mastectomy vs. BCS, despite the fact that stage of disease was low. We also found only 20% of absolute contraindications for BCS. Most frequent contraindication for BCS [breast-conserving surgery] was multicentricity of the tumor (with micro calcifications), especially in ductal in situ carcinoma,” concluded the authors of the study “Criteria and Procedures for Breast Conserving Surgery” regarding the use and effectiveness of the procedure. “BCS followed by radiation therapy with tumor-free edges is standard procedure in treatment of T1 and small T2 breast cancers. This approach implies higher risk of local recurrence (LR), although local recurrence is low (1% per year), with rates of survival similar to radical procedures.”

Despite the encouraging results, like any other surgery, there are risks and potential side effects. The most common side effects after a breast-conserving surgery include pain or tenderness, temporary swelling, the formation of hard scar tissue in the surgical site, nerve (neuropathic) pain in the chest wall, armpit, and/or arm that doesn’t go away over time (called post-mastectomy pain syndrome or PMPS), and loss of sensation in part of the breast. One of the problems that most of the times occur is that patients end up with breasts that do not exactly match in size and shape since breast tissue was removed during surgery. However, breast reconstruction may be discussed with the cancer care team. In addition, there are risks associated with all surgeries like bleeding and infection at the surgery site. In cases where the axillary lymph nodes are also removed, patients may also suffer from lymphedema.

Note: Breast Cancer News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Inês holds a PhD in Biomedical Sciences from the University of Lisbon, Portugal, where she specialized in blood vessel biology, blood stem cells, and cancer. Before that, she studied Cell and Molecular Biology at Universidade Nova de Lisboa and worked as a research fellow at Faculdade de Ciências e Tecnologias and Instituto Gulbenkian de Ciência. Inês currently works as a Managing Science Editor, striving to deliver the latest scientific advances to patient communities in a clear and accurate manner.
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Inês holds a PhD in Biomedical Sciences from the University of Lisbon, Portugal, where she specialized in blood vessel biology, blood stem cells, and cancer. Before that, she studied Cell and Molecular Biology at Universidade Nova de Lisboa and worked as a research fellow at Faculdade de Ciências e Tecnologias and Instituto Gulbenkian de Ciência. Inês currently works as a Managing Science Editor, striving to deliver the latest scientific advances to patient communities in a clear and accurate manner.
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