Surgery

The breast cancer treatment types can vary, but we have surgery as healing therapy, but it is not, necessarily, the first option. Depending on the patient’s clinical state, radiation therapy is recommended, as part of the palliative treatment, complementary to the surgery treatment or even to decrease the symptoms related to this disease. The systemic treatment is also recommended, which can be complementary and comprised by the anti-Her2 therapy, radiation therapy and hormone therapy methods. 

When the tumors are relatively small, surgery is the first healing therapy option, removing the tumor with a cancer-free margin. Depending on the breast and tumor size, a mastectomy (which is the complete removal of the breast, followed or not by a reconstruction surgery) can be recommended, or even a quadrantectomy (only 25% of the breast is removed). Taking into consideration the importance of the breast, it is always preferable to preserve it as much as possible, having a conserving surgery.

The quadrantectomy starts, in some situations, with the neoadjuvant treatment, which can shrink the tumor, instead of having the mastectomy. When there is the possibility that the tumor expands to the axillary ganglion, it was common to dissect the ganglion on the armpit of the same side too, besides operating the breast. 

Through a pathologist analysis of one ganglion, it can find whether it is cancer-free or not, avoiding dissecting another ganglion and the development of a lymphedema, causing the arm to swell, feel pain and increasing the infection risk. When it is proved that the disease has spread to another axillary ganglion or when the sentinel lymph node is impaired, at least 10 armpit ganglia will be dissected. 

Published data from early 2011 suggests that in specific cases, patients with up to two impaired ganglia could be saved from being emptied, without compromising the prognosis. But this could not be considered as a standard procedure.

After surgery, either mastectomy or quadrantectomy, the breast reconstruction can be performed so the breast has the aesthetic looks as the patient desires. The post-implant recovery can last until 2 weeks. The patient can be discharged in 6 days, depending on the type of surgery, and can be home carrying one or more drains.