Surgeries: Types

Surgery on the Breast

After being assessed at the combined clinic, your doctors will recommend one of two procedures on the breast.

Breast Option 1 – Mastectomy

Removes the whole breast, including the nipple and surrounding area.
Muscles supporting the breast stay.
A drain is always used after the operation to remove extra blood/fluid.
Sometimes a reconstruction is performed with a mastectomy with either implants or a patient’s tissue (Goldilocks Mastectomy or Flap)
In very select cases, especially when reconstruction is an option, the skin and nipple of the breast may be spared if it is safe

Breast Option 2 – Lumpectomy

Takes out the cancer lump & a bit of normal tissue around (about 1-2 cm).
Often no drain is needed but this may vary from patient to patient.
The pathologist will analyze the lumpectomy to make sure all the cancer is removed
Sometimes, 1 in 8 people might need another operation if the cancer is too close to the edge of the first one.
ALL patients undergoing a lumpectomy will require radiotherapy afterward to make sure we limit the risk of the cancer re-occuring.

When will my surgery take place?

You will be given a letter with a date to meet your surgeon and get ready for surgery. This may not be your admission date in all cases but the day that you are prepped and consented for your operation. Your admission will be confirmed on this date.
Take this letter with you when you are admitted and give it to the doctor at the hospital where you are having the operation.
Please report to the indicated hospitals at 08h00 in the morning unless being told otherwise

Surgery to the Armpit (Axilla)

All breast cancer surgeries also involve surgery to the axilla to make sure the lymph nodes have not been affected by the cancer. This is important when making decisions about other treatments you may need. Your doctors will decide on one of two procedures to check or remove your lymph nodes:

What are lymph nodes?
Lymph nodes are like small filters in your body that clear it from harmful cells. The ones under your arm are important in breast cancer as they may be affected by the cancer cells.

1. Removing Many Nodes

Axillary Node Clearance – ANC

Take out most of the nodes under your arm.
Done during mastectomy or separately if you’re having a lumpectomy.
About 15-20 nodes are usually removed.
A drain is left to remove extra blood or fluid.
This procedure is needed if they have already confirmed before your operation that there may be lymph nodes affected

2. Removing Specific Nodes

Sentinel Lymph Node Biopsy – SLNB

Take out 2 to 3 nodes under your arm connected to where the breast cancer is.
Before surgery, you get an injection near the cancer site. A day later, a blue dye may also be injected near the nipple when you are asleep
These help the surgeon find the specific nodes. The blue dye might be visible on the nipple but usually fades.
If cancer is found in these nodes, more nodes under the arm may be removed like in axillary node clearance.

Your Hospital Bag – What to Pack

A clean dressing gown or pajamas (those with buttons may be easier to put on and take off), personal toiletries, slippers or comfortable shoes;
Any medicines or inhalers you are taking/ using, in their original packaging
Something to occupy your time, e.g. book or newspaper
A bra or a comfortable-fitting camisole to wear when you are discharged.
Bring your correct contact telephone numbers and for your next of kin.