Results vsrisks of the procedure

Results

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 of the cancer, how aggressive it is (grade) and whether it’s already spread to your lymph nodes or beyond (stage). Other important factors are whether the cancer is receptive to hormones oestrogen and/or progesterone and the biological marker HER2.

Today, breast surgery combined with newer, more effective treatments which have significantly reduced the risk of dying from breast cancer. Breast cancer has a >90% survival rate over 5 years.

If you have hereditary breast cancer as a result of carrying a breast cancer gene, a mastectomy will reduce the risk of developing another cancer. If you haven’t developed cancer, a preventative mastectomy will reduce your risk of developing a gene-associated breast cancer by over 95%.

Another treatment that can help prevent breast cancer in patients at very high risk is decreasing hormone levels. This can be achieved through medications or surgically through removal of your ovaries and fallopian tubes (hysterectomy with salpingo-oophorectomy).

Risks

As with any medical procedure there are potential risks. The chance of complications depends 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 (armpit) 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.

Lymphoedema

This is swelling of the soft tissue due to collection of lymphatic fluid. It may happen in your arm, hand, breast 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, or targeted, lymph node removal, your risk of lymphoedema is 5–17%. After axillary lymph node removal, it can be between 20–50% 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 slightly lower.

Lymphoedema can occur days, months or even years after breast cancer surgery. Early treatment from a lymphoedema specialist can help. Management can include education, skincare, manual lymphatic drainage and compression therapy. The two most important preventative actions you can take are maintaining a healthy weight and doing regular exercise that includes arm movements.

Cording

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 targeted dissection, 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 treat it faster.

Infection

This is normally treated with antibiotics.

Bleeding

Excessive bleeding is rare. It may require a return to the operating theatre to control.

Problems with wound healing

Sometimes there’s a build-up of 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

Lumpy scar tissue can form where your breast tissue was removed. This can alter the shape of your breast or chest wall. This often resolves with time but 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.