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Malignant breast tumor is the most prevalent cancer among women in the Western world . In Spain 25,000 new cases are diagnosed each year; 30% of the tumors detected correspond to breast cancer. Viewed another way, 1 in 8 women will have breast cancer at some point in her life. The incidence in Spain is low when compared with the cases registered in countries like the United States or Canada, although similar to areas like Portugal or Ireland. Advances in medicine have managed to significantly reduce mortality in cases of breast cancer and the prognosis is usually quite hopeful , especially if the detection is carried out early, in the most initial stages of the disease.
There are two techniques to remove the malignant breast tumor: mastectomy, which is more effective, and lumptectomy, less invasive . The main difference lies in the removal or not of the entire breast, an aspect that worries many women due to the psychological implications it has. In addition to the physical sequelae, the appearance of the breasts after removal can cause emotional sequelae that slow down postoperative recovery. Hence, when choosing one or the other, not only the opinion of the physician but also of the patient herself is taken into account.
How Breast Cancer Is Diagnosed
Fortunately, the breast cancer prevention programs established in practically all the autonomous communities of our country have favored early diagnosis, better control and treatment of this disease. The protocol, with annual or biannual check-ups in women over 50 years of age , makes it possible to diagnose breast cancer in its initial phase. If detected in the first instance, the probability of surviving the disease is very high.
Diagnostic tests that are performed preventively usually consist of a physical examination and a mammogram or x-ray of the breasts , which is the most effective method for making an accurate and reliable diagnosis. Despite being a common and simple test, it is often uncomfortable for the patient. The specialist, after observing the resulting image and comparing it with the previous mammograms that appear in the patient’s history, will make a report with the possible cysts, masses or tumors that are visible. Mammography makes it possible to locate lesions in very early stages, when they are not yet detectable by examination nor have they spread to other nodes or even other organs.
If the result of the mammogram is positive, the doctor will assess the characteristics of the tumor and suggest a treatment . In the first instance, the patient will have to undergo surgery to remove the tumorous mass. Following removal, radiation therapy may need to be completed , especially if healthy nodes in the breast were preserved during surgery.
Doctors often recommend that patients do regular self-examinations as a preventive method. In contrast, this method is unreliable: only 50% of tumors can be detected by physical examination.
Lumpectomy vs. Mastectomy
Lumpectomy is a surgical intervention that consists of removing the tumor located in the mammary glands and part of the healthy tissue around it . This guarantees a margin of safety, so that all cancer cells, even the most incipient ones, will have been removed. Unlike a lumpectotomy, a mastectomy involves removing the entire breast .
Mastectomy has a great psychological impact on women and reduces their quality of life. The loss of a breast affects the perception of their own image and deteriorates their social relationships, especially those of a couple. That is why oncologists recommend opting for lumpectomy whenever the necessary conditions exist. This technique is only effective when the malignant tumor is small (less than 4 centimeters) and localized. The chances of it being a recurrent tumor or even metastasizing are greater in women who undergo a lumpectomy and thus preserve the breast .
Advantages and disadvantages of lumpectomy
The main advantage of lumpectomy is that the woman can preserve the breast , although sometimes its appearance is different from that of a healthy breast. In these cases, the patient can undergo a cosmetic surgery operation that improves her appearance. In addition, another advantage is that being a simpler surgery, recovery is faster and easier than if you underwent a mastectomy .
But not all are advantages . On the contrary, it is very likely that the oncologist will determine a radiotherapy treatment for a couple of months, to increase the guarantees of elimination of all tumor cells . Faced with this situation, the woman who plans a cosmetic surgery operation to equalize the appearance of her breasts will have to delay it until the end of the radiotherapy treatment.
In addition, the risk of developing a new malignant tumor or even metastasizing is higher in women who opt for a lumpectomy than in those who decide to remove the entire breast with a mastectomy.
Postoperative and recovery after a lumpectomy operation
Returning to a normal rhythm of life after an operation requires time and patience. In the postoperative period, the relief of having passed the operation as well as the attention of the doctors and nurses will reduce anxiety and help regain strength.
Lumpectomy, despite being a less invasive operation than mastectomy, requires anesthesia . After the operation, the medical team will monitor vital signs to monitor the effects of anesthesia and detect any complications that may arise in the most immediate postoperative period. Infections, although not common, are one of the most frequent problems after an operation. If they are not treated properly, they can even put the patient’s life at risk. When the effects of anesthesia have worn off, if there have been no complications, they will probably determine the advisability of continuing recovery on the ward.
During the first days, health professionals will prescribe medications to mitigate pain and stop possible infections . In a few days you will be discharged, if everything has gone well. Of course: you will return home with a bulky bandage that you will have to maintain for almost two weeks, a time it will take for the stitches to heal. The doctor or nurse will call you after fifteen days for the first post-operative check-up. At that checkup, they will finally release her from the bandages, remove the stitches, and remove the drainage tubes as well.
As in any postoperative process, it is important to maintain good hygiene and follow the instructions of healthcare personnel . In addition, a good rest accelerates recovery, so you should try to sleep as much as you can. Stitches and drainage can be uncomfortable, and improper movement can cause pain. In general, it is advisable to sleep on the opposite side of the surgery. In any case, you have to see which position is more comfortable. You can use herbal teas or natural remedies to promote sleep. Let’s not forget to consult with the specialist before resorting to any medication .
Regarding underwear, we must avoid the use of underwired bras, not only because it can be painful but also because of the risk of damaging the suture. On the market there are countless sports bras and even specific products to promote recovery after a mastectomy or lumpectomy. We bear in mind that we must wear a bra day and night, in order to reduce any inappropriate gesture or movement that causes pain.
Throughout the recovery process, we will consult with the oncologist and the rest of the healthcare team for any questions or concerns. Within hours of the operation, the doctor will recommend starting to do some simple exercises to tone the muscles of the arm and shoulder. These exercises will vary as recovery progresses.
One of the most frequent negative consequences of breast cancer treatment is lymphedema or abnormal accumulation of fluid in the soft tissue due to the obstruction of the lymphatic system . Being a chronic and progressive disorder, the specialist doctor will remain alert to detect the problem as soon as possible and establish the appropriate guidelines for its treatment. Prevention happens by being constant in performing the exercises recommended by the gynecologist or oncologist. Once lymphedema is diagnosed, treatment usually consists of preparing an exercise table by a physiotherapist, aimed at slowing the development of the disease and reducing the possible discomfort it causes.
In addition to going to regular check-ups, we may need to share the experience and answer questions with other women who have gone through the same process. There are various associations and organizations at the national and local level that support women facing cancer. Whether we face a mastectomy or a lumpectomy, we will never walk alone!
Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.