In the most basic fashion, breast surgery treats cancer by removing breast tissue. However, in reality there are many different ways in which breast cancer is treated by surgery, with variable outcomes in the appearance of a woman’s breast following treatment (surgery). When you are faced with the recommendation of breast surgery to treat disease, you must ask several very specific questions:
• Is the purpose of the proposed surgery to diagnose cancer? To treat cancer? Or both?
• Is surgery the only form of treatment necessary?
• What are the likely physical outcomes to my health and appearance resulting from the recommended surgery?
• What alternatives do I have?
• What are my rights regarding the alternatives? Once you have answers to these questions, you likely will find yourself with many more questions. Among those questions, you must define a plan for your goals, and then enlist the medical specialists you need prior to any surgery to treat your breast cancer and achieve realistic goals for your health and your appearance. The key medical specialists to consult are a general or breast surgeon and a board-certified cosmetic surgeon.
• The breast surgeon will likely perform your breast surgery specific to treating disease
• The cosmetic surgeon will partner or consult with your breast surgeon in any surgery you undergo, so that you may benefit from reconstruction at the time of surgery to treat cancer, or other surgery that is planned for the future
But your agenda does not end with enlisting the right providers for your care: You must now pre-certify your breast surgery with your insurance company. During what may be a highly stressful time for you, insurers may, in fact, not be the most cooperative. They will likely require ample paperwork from any physician who you consult with or who will treat you. Take charge of administering exactly what they require in the same fashion you have taken charge of who will perform your breast surgery. You must be proactive. It is up to you to discover what is needed from each party and make sure that all of the insurance paperwork has been received from the physician’s office. Keeping good lines of communication open will maintain the momentum of this process. According to the National Institutes of Health and the National Cancer Institute, in 2004 approximately 140,000 women were diagnosed with breast cancer, two-thirds of which will be localized and will not have spread beyond the tumor in the breast.
No, breast surgery treats much more than breast cancer. Research data from the Institute of Medicine and the National Institutes of Health (NIH) state that roughly 80% of all breast lumps are benign (harmless), and some may be treated with surgery. These include benign cysts, tumors, and calcification. Additionally, breast surgery can treat blocked and infected milk ducts, and can also treat medical conditions that result from excessively heavy and large breasts, such as back and neck pain, breast pain, rashes and skin ulcers.
In some cases of tumor removal, including breast cancer, a lumpectomy, or breast conserving surgery may be prescribed. Lumpectomy means that only a portion of the breast is removed: the tumor and a small area of the surrounding healthy tissue (margin). With lumpectomy, as much healthy breast tissue as possible will be conserved. The goal of lumpectomy is minimal disfigurement and effective treatment. However, this does not mean that the procedure will not cause you any disfigurement. A lumpectomy can result in changes to breast size and shape. When a lumpectomy is followed by radiation, this is considered breast conserving surgery and is an alternative in some cases for a mastectomy (which is the complete removal of the breast). This is most often recommended when a breast tumor is considered to be invasive breast cancer, meaning that the cancer is outside the confines of the milk ducts, or for certain types of in situ breast cancer (cancer contained within the ducts).
The added radiation can cause skin discoloration in addition to the change in breast size or shape. If your goals are to look and feel whole again following any ablative breast surgery (removal of the breast), including lumpectomy, you should consult with a breast surgeon to determine if consultations with a cosmetic surgeon prior to the surgery to treat disease is warranted. Both will work together to provide you the best possible outcomes for your health, and for reconstruction if it is likely to be prescribed. A wide excision biopsy or quadrantectomy is sometimes confused for lumpectomy. These procedures do remove localized breast tissue. However, the wide excision biopsy is more often for diagnostic goals that may result in full or partial removal of possibly malignant tumors. A quadrantectomy is removal of one quarter or quadrant of the breast, and can be highly disfiguring.
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