Breast cancer surgery reduces the risk of breast cancer spreading within your breast and to other parts of your body.
The success of treatment depends on several factors including your age, the size and grade of the cancer and whether it has already spread to your lymph nodes or beyond. Another important factor is whether the cancer is receptive to the hormones oestrogen and/or progesterone.
Today, breast surgery combined with newer, more effective treatments has significantly reduced the risk of dying from breast cancer. Breast cancer has a 90% 5 year survival rate.
If you have hereditary breast cancer as a result of carrying the BRACA1 or BRACA2 gene, a preventative mastectomy will reduce your risk by over 95%.
Another surgery that can help prevent breast cancer in women at very high risk is removal of your ovaries and fallopian tubes (hysterectomy with salpingo-oophorectomy).
As with any medical procedure, there are some potential risks. The chance of complications depend on the type of procedure you’re having and other factors including your general health.
Common conditions that may affect the result include diabetes, obesity and infection from the procedure. Smokers are also at a higher risk of complications following surgery, especially with breast reconstruction or mammoplasty. You won’t be able to smoke during your hospital stay so this could be a good time to quit. The free HCF Quit Smoking app can help you kick the habit.
The most common complications of breast surgery are:
Pain and restricted mobility at the shoulder joint
This can occur after axillary (underarm) surgery. A physiotherapist will advise you on exercises to improve the range of motion in your arm and shoulder.
Tingling and numbness
You may notice tingling and/or numbness along your incision site or in your upper arm. This is more likely if you’ve had lymph nodes removed and nearby nerves were disturbed during surgery. This should improve over several months but can sometimes be permanent. If it persists, your doctor can prescribe medication to help.
This is swelling of the soft tissue due to collection of lymphatic fluid, which may happen in your arm, hand, breast, trunk or abdomen. The swelling may be accompanied by heaviness, tightness, numbness, pain and sometimes infection. It’s a common complication after lymph node removal and increases with the number of lymph nodes removed.
After sentinel lymph node removal, your risk of lymphoedema is 5% to 17%. After axillary lymph node removal, it can be between 20% and 50%, depending on the number of lymph nodes removed.
Having radiation therapy instead of axillary lymph node removal can also lead to lymphoedema, but the risk is lower.
Lymphoedema can occur days, months, or even years following breast cancer surgery. Early treatment from a lymphoedema specialist can help. Management can include education, skincare, manual lymphatic drainage and compression therapy.
You may feel an uncomfortable pulling sensation, like there’s a tight cord running from your armpit down your arm, sometimes extending to your palm. It may be a side effect of sentinel lymph node biopsy or axillary lymph node dissection. This can occur weeks to months after your surgery but usually resolves with time. Physiotherapy, warm packs and massage can help it to treat it faster.
This is normally treated with antibiotics.
Excessive bleeding is rare but if you’re having extensive surgery, such as a double mastectomy, you may want to consider donating blood in case you need a blood transfusion.
Problems with wound healing
Sometimes there’s a build-up of blood or clear fluid in the wound, called a seroma. It can feel uncomfortable. A seroma may resolve by itself, or your surgeon may use a syringe to drain it. Sometimes healing of the incision is delayed because the blood supply has been reduced by the surgery.
Painful, numb or stiff scar tissue
A lump of scar tissue can form in the hole where your breast tissue was removed. This can end up altering the shape of your breast. You may need physiotherapy or further surgery if it doesn’t resolve.
Ask your surgeon about the results and risks associated with your procedure. Also ask about their own rates of patient satisfaction and the rate of complications following the procedures they’ve performed.