Frequently Asked Questions for Surgery
Women facing breast surgery are often frightened and have many questions. Here are some of the most common questions along with answers from UH surgeons.
Q. Are there advantages to going to a breast surgeon as opposed to a general surgeon? How will I know if the doctor is a breast surgeon?
A. Breast surgeons are generally more up-to-date on the current literature and techniques used in breast cancer treatment and work with a multidisciplinary team. Patients should ask the surgeon how much of his/her practice is devoted to breast surgery. Also they should ask if they do close follow-up on women who are high risk.
Q. Is a mastectomy better than a lumpectomy?
A. The cure rate is the same whether you have a mastectomy or a lumpectomy. A lumpectomy involves less surgery and results in a quicker recovery with the preservation of the breast. Radiation is often needed with a lumpectomy. A mastectomy is typically suggested if you have a large cancer or if you cannot tolerate radiation.
Q. Why do I need radiation therapy if I have a lumpectomy?
A. Radiation therapy reduces the risk of the cancer returning to the breast. There is between a 15 to 25 percent chance of the cancer coming back after a lumpectomy. If radiation is completed after a lumpectomy, the risk is reduced to five percent.
Q. Why do I need to have my lymph nodes removed? What is a sentinel lymph node biopsy?
A. Invasive cancers can spread to the lymph nodes under your arm. The surgeon removes lymph nodes to check for spreading of the cancer and to prevent it from growing further. By checking lymph nodes, the doctor can also stage the cancer and identify how aggressive it is. Identifying the stage of the cancer helps the oncologist decide if chemotherapy is needed and what kind will be the most effective. Most people do not have lymph node involvement.
A sentinel node biopsy allows doctors to remove just a few lymph nodes to see if the cancer has spread. A patient does not need to have all of his/her nodes removed unless he/she has cancer in the sentinel nodes.
Q. Please explain the possible “defect” in the breast after a lumpectomy.
A. When a surgeon removes the section of breast tissue where the cancer is located, the tissue is often wedge- or round-shaped, depending on the location of the cancer. When the swelling in the breast goes down following surgery, this area tends to sink and is sometimes called the “defect.”
Q. Why are so many women having bilateral mastectomies when a lumpectomy is recommended?
A. Because of fear of cancer recurrence, many women are deciding that it is better to have both breasts removed. However, research shows there is no survivor benefit.