Patients & Visitors

Breast Unit

Surgery


Surgery is often the first treatment offered, however chemotherapy or endocrine therapy is sometimes offered before surgery for some patients.

If you are offered surgery first then usually a date for this will be discussed with you as soon as you and your surgeon have decided on the correct operation for you. This date should be within 31 days following an agreement with you on the type of operation.

You may not be able to decide at the first appointment, especially if complicated information is given to you, for example for those patients opting for breast reconstruction. If so, another appointment will be made for you to be seen in clinic again to discuss the options available.

Consent for the operation may be taken in clinic or on the day of surgery.

Before your operation

Before your operation, an appointment will be sent to you to be seen by our preoperative assessment nurses. At this appointment, your fitness for surgery will be assessed. This may include blood tests, x-rays and/or an ECG.

If your operation is being combined with a sentinel lymph node biopsy, then you will be required to have a scan to identify the lymph nodes that will be removed. This is called a lymphoscintigram. This is either done on the day before surgery or on the day of surgery. You will be told a time and date at your breast clinic appointment. If the scan is done on the day before surgery, you are not required to stay overnight.

On the day of surgery

On the day of surgery you will have had instructions to go to the admissions suite or SSSU. There, the surgeon, anaesthetist and breast care nurse will see you.

If you are having a localisation wire placement prior to surgery, you will be collected and taken down to the breast unit. If you are required to have a lymphoscintigram on the day of surgery you will be taken to the department of nuclear medicine.

You will be given an approximate time to expect your operation but please be aware that this time can change significantly dependant on many factors.

Following your surgery you will go to recovery before going back to the ward.

Recovery and discharge

If your surgery is a day case procedure then you will be assessed to ensure that you are fit for discharge.

If you are discharged with a drain, our breast care nurses will explain how to look after this and will discuss a time for the drain to be removed in the breast clinic.

When you are discharged home we would encourage patients be gently walking during the day rather than lying in bed. This is to reduce the risk of deep vein thrombosis, which can occur after surgery. For patients who have had breast conserving surgery, including a wide local excision or therapeutic mammoplasty, we would encourage them to wear a comfortable non wired support bra day and night until they are seen in clinic.

Aftercare

Very occasionally patients have complications following their surgery. Occasionally patients bleed causing a collection of blood in the wound. The breast then becomes swollen and bruised. If this happens at home then we suggest you ring our breast care nurses within working hours or seek medical advice out of hours. If you have had a bleed resulting in a large collection of blood in the wound, we would usually recommend that this be removed under a quick general anaesthetic.

Also patients can have a wound infection following surgery. The wound or breast may be red, tender, swollen or you may just feel not quite right. This would need assessment and possible treatment with antibiotics. Again we suggest you ring our breast care nurses within working hours or seek medical advice out of hours.

Follow-up treatment

Following surgery the tissue removed is analysed by our pathologists (histology). This information will guide us to ensure that you have the appropriate further treatment for your breast cancer, which may include further surgery, chemotherapy, radiotherapy and endocrine treatment. This decision is made at a multidisciplinary team meeting (MDT) with surgeons, pathologists, radiologists, oncologists and breast care nurses.

Important histological features, which guide further treatment, include

  1. The size of the tumour as measured under the microscope
  2. For breast conserving surgery, if the margins around the excision are free from breast cancer cells (i.e. no tumour cells at the cut edge of the specimen)
  3. The grade of the tumour
  4. The number of lymph nodes containing breast cancer cells
  5. If the tumour is ER positive or negative
  6. If the tumour is HER 2 positive or negative

You will be seen approximately 2 weeks following surgery, in clinic with these results and a subsequent plan for your treatment. This may include further surgery, chemotherapy, radiotherapy and/or endocrine therapy.

Also See:


Surgery

Radiotherapy

Chemotherapy

Endocrine Treatment

Care after treatment

Breast Cancer Support Groups








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