Lumpectomy is a surgery where a cancerous or benign tumour is removed from a breast along with some surrounding tissues. The amount of tissue removed varies according to the nature of the tumour. It is a form of breast-conserving surgery. It is also called a partial mastectomy.

Lumpectomy is the first option of treatment for women diagnosed with early-stage breast cancer.

What is the goal of lumpectomy?

Lumpectomy aims to remove the cancerous cells from the breast and at the same time maintaining the appearance of the breast. Studies have proved that for early stage breast cancer, lumpectomy is as effective as mastectomy (complete removal of the breast).

Doctors may recommend lumpectomy to remove precancerous cells as well.

Pre lumpectomy measures-

If you are under any other medication or if you suffer from allergies, inform your doctor. Other pre-surgery measures include-

  Stop taking aspirins or any pain relieving medication

  Your doctor will recommend you to not drink or eat anything 8-12 hours prior to the surgery.

The procedure:

A mammogram and a biopsy reveal the exact location of a tumour. Lumpectomy is performed under general anaesthesia. The surgeon makes a small incision over a tumour to extract the cancerous cells and the surrounding tissues. Sometimes doctors have to perform sentinel lymph node surgery or axillary node dissection.

The surgeon then closes the incisions with sutures. The sutures may dissolve over time or may have to be extracted later by a doctor.

If you have undergone lumpectomy and sentinel node biopsy, you will be discharged on the same day as the surgery as soon as your blood pressure stabilizes.

However, after lumpectomy with axillary node extraction, you may have to stay in the hospital for 2-3 days.

Therapy after lumpectomy

Your oncologist will recommend a follow-up radiation therapy to destroy the mutated cells that may have remained in the area where a tumour had developed. Radiation reduces the risk of breast cancer recurrence.

You might also have to undergo hormone therapy. Some types of breast cancer need female hormones like estrogen and progesterone to grow. Hormone therapy inhibits the development of cancerous cells by not allowing these hormones to reach the cells.

Your doctor will advise you to avoid strenuous physical activities for at least a month after the surgery.

Lumpectomy is a safe surgical procedure that can root out tumours or precancerous cells from the breast without deforming the shape of it.

Breast Lumpectomy - All You Should Know!

Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer   breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.

Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.

Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.

    A lump in either of the breasts or armpits
    Change in size, shape, or contour of either breast
    Redness of your breast or nipple
    Discharge of clear or bloody fluid
    Thickening of breast tissue or skin that lasts through a period
    Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
    One area on the breast that looks very different from the other areas
    Hardened area under the breast skin

Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.

Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.

    Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
    Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
    Age: Women over 50 are at higher risk of developing breast cancer.
    Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
    Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
    Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
    Obesity and alcohol abuse are also likely to increase a woman s chances of developing breast cancer.

Stages: Starting from stage 0, higher stages indicate advanced disease.

    Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
    Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
    Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
    Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
    Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.

Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.

    Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
    In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
    Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
    Ultrasound screening can also be given in addition to mammograms.
    Breast MRI is another way to screen for breast cancer if the risk is greater.

Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.

    Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
    Tamoxifen is used in women who are at high risk for breast cancer.
    Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
    In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).

Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.

Breast Cancer - Know More to Say 'No' More!

Once the reality of the positive pregnancy test sets in, dreaming about the yet-to-arrive begins. Curiosity about gender, options for names, ways to manage, shopping ideas, etc., begin to get discussed. And then totally out of the blue the news comes that there is a miscarriage. This is one of the most depressing phases. It is very important for the family to be around and support each other. While the entire family is upset and hurt over the news, the mother needs most care as there is just not emotional but a huge physical component also to the episode. On the other hand, remember that miscarriages are extremely common, and is no indication of a fertility issue.

The first step would be to diagnose and confirm the miscarriage. After that, depending on whether it was complete or incomplete, some medical intervention might be required. In most cases, medications like misoprostol are given to expel the uterine contents. These help by clearing out the contents in about a couple of days' time. In some cases, a D and C might be required if your doctor suspects that medication will not suffice. This also helps identify if there is any issue in the uterus that could have caused the miscarriage.

While the above take care of the physical part, the emotional component also requires cautious management. Needless to say, this is trickier than the earlier one.

Mourn to your heart's content - When you have nursed a life within you and have lost it, it is very normal to cry for its loss. There would be a mix of emotions - shock, denial, confusion, anger, grief, depression, etc. Take some solace from that fact that this is nature's way of removing unhealthy fetuses.

Get someone to talk to - Need not be your husband, but anybody whom you can talk to without having to watch words. A sibling, a good friend, a close relative - your choice. Make sure you don't pick ones who will judge and sympathize with you. More than sympathy, you need someone understanding and knowledgeable.

Socialize more - As you would have kept to yourself post your positive test, use this time to socialize more and meet friends whom you have not regularly been in touch with. Close family members, your children (if you already have), society groups, movie groups, etc., help to a great extent.

Formal medical counseling: If you are not able to cope with your regular circle of family and friends, try seeking professional advice from counseling.

Spirituality - Whether you believe in temple or churches, spend some time there. Involve in some religious activity if you would like, this helps very often.

As much as it is painful and traumatic, it is not very uncommon or unnatural. Get back on your feet, the sooner you do, the better.

Miscarriage - Ways To Recover

With the recent number of breast cancer cases on the rise, it is important that we should get the examination done on a regular basis as a preventive measure. Even if someone is suffering from it, it is important that we should make an effort and learn about.

If you have breast cancer then a surgery will be part of your treatment. Based on the condition, surgery will be carried out due to any of the following reasons:
1. To remove the cancerous tissues from the breast
2. To reconstruct the breast once the cancer is removed
3. To check whether the cancer has spread to the lymph nodes below the arm
4. To treat symptoms of cancer that has progressed to an advanced stage

Breast cancer surgery may be classified into two types
1. Mastectomy: Mastectomy involves removing the entire breast; tissues in the adjoining region may also be removed. A double mastectomy is a procedure where both the breasts are removed.
2. Breast-conserving surgery: In this surgery, only parts of the breast affected by cancer are removed. The area of the breast that is to be removed will depend on the severity of the cancer. Some healthy tissues may also be removed in this surgery.

Usually, if a woman is in the initial stages of cancer then she may opt for the latter as it entails removing parts of the breast. They may also undergo radiation therapy along with these surgeries.
For checking if the cancer has spread to the lymph nodes below the arm, the lymph nodes are removed from the body. Once they are removed, they are studied under a microscope to check if it has spread, if yes then the extent of their damage. This procedure is carried out along with the surgery to remove the cancer.

Once the mastectomy procedure is completed, you can opt for a breast reconstruction surgery to rebuild the area. You may opt for this procedure at the time of breast cancer removal or at a later stage. If you are considering breast reconstruction surgery then you should discuss it with your surgeon.

Surgery is sometimes not used to treat cancer, but in slowing the progression of cancer or even reducing its symptoms.It is important you talk to your surgeon before the procedure to understand the goal of the surgery.

Surgical Procedure for Treating Breast Cancer

A breast lump is a restricted swelling, projection, lump or knot in the breast that doesn't feel like a breast tissue. There are diverse reasons why breast lumps occur.

Not all lumps are cancer. These can also be breast conditions that are not harmful and which can be easily curable.Knots that feel harder or are not the same as the rest of the breast need to be checked. This kind of irregularity might be an indication of breast cancer.

A self-examination should be your starting point. This is how you can detect a lump on your own:

Step 1: Begin by taking a look at your breast in the mirror. Keep your shoulders straight and your arms on your hips.

This is what you need to search for:

    Breasts that are their typical size, shape, and shading
    Breasts that are uniformly formed without distortion or swelling

In the event that you see any of the changes mentioned below, convey them to your doctor:

    Dimpling, puckering, or protruding of the skin
    A nipple that is not in its initial position
    Redness, rash or swelling

Step 2: Now, raise your arms and look for the changes mentioned above.

Step 3: While you're in front of the mirror, search for any indications of liquid or blood discharge from the nipples.

Step 4: Next, examine your breasts while resting.Use Your right hand to feel your left breast and use your left hand to feel your right breast. Cover the whole breast from your collarbone to the highest point of your mid-region, and from your armpit to your cleavage to search for any lumps.

Step 5:Examine your breasts while either standing or sitting. Many women find that the easiest approach to examine their breasts is when their skin is wet, so this step could be done while taking a bath as well.

Diagnosis:

    Mammogram: Mammography is a technique using X-rays to diagnose and locate tumours of the breasts.
    Breast ultrasound: Breast ultrasound utilises sound waves to create pictures of the breasts from the inside.
    Breast MRI:This involves using an effective and attractive field, and radio frequency pulses to create photos of the insides of the breasts.
    Ultrasound-guided biopsy: During this sort of biopsy, utilising ultrasound imaging to discover the bump, a radiologist will give you anesthesia and afterward insert a needle into the lump to evacuate some tissue for assessment under a magnifying lens. Stereotactic biopsy and an X-ray-guided biopsy may also be used.

Possible treatments:

    In case the knot turns out to be cancerous, surgery is typically performed.
    You may have a few discussions with different doctors for additional treatment, including radiation treatment and chemotherapy or hormone treatment.

What You Should Know About Breast Lump Detection

The incidence of pain and lumps in the breast is on the rise. Breast cancer has grown in incidence over the years. More women are getting diagnosed with it, and the age at which they are being diagnosed has reduced too. Therefore, preventative checks and screenings have gone up significantly. The number of women diagnosed with small lumps has gone up drastically. The good thing is that since these are diagnosed in the early stages, the treatment is simpler and the prognosis far better than women who get diagnosed much later in life.

In a majority of cases, once a lump is identified the most preferred treatment is removal. This is known as lumpectomy. However, before a final decision is made to remove the lump, there are certain tests that are run by the doctor to confirm the diagnosis and extent of spread.

A thorough breast exam to identify if this is an isolated lump or if there are more lumps in either breast. The exact shape and size of the lump also need to be identified so that treatment can be planned accordingly.
Imaging to see if the lymph nodes have been involved. In most cases, there could be spread to the lymph nodes in the armpits which also need to be removed if required. If the lump is too big or too many in number, then a mastectomy may be required instead of a lumpectomy. This requires removal of the entire breast tissue on one or both sides (rarely) along with involved lymph nodes.
Pre-surgery: Once the diagnosis is confirmed, then the doctor will plan treatment. Prior to the surgery,

Talk to your doctor about your other medical conditions and medications and allergies, if any
Gynecologic history is very important to be discussed in detail
Blood thinners have to be stopped prior to the surgery
Post-surgery care needs to be planned, including a caretaker for a few days and postop care
During surgery:

Lumpectomy or mastectomy is often done under general anaesthesia
This requires hospitalization and carries the risks associated with anaesthesia
The outlined breast tissue or complete breast and surrounding lymph nodes will be removed. The area will be closed using sutures and bandaged
Post-surgery:

The wound needs to heal, and so postop care is very important
For the first few days, painkillers and antibiotics are used to control pain and infection
As a follow-up, some women may require radiation therapy to contain the suspicious tissue that may be left behind after lumpectomy
If extensive breast tissue was removed, some women may prefer to have reconstructive surgery done
Remember that lumpectomy is not a definitive procedure, and there could be cases that require a repeat operation
Advantages:

Less invasive compared to a mastectomy
The appearance of the breast is minimally affected, and symmetry is maintained
Disadvantages:

May not ensure complete removal
May require additional radiation therapy
May require repeat surgery

Surgical Treatment For Pain And Lumps In Breasts Of Women!

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