The latest treatments

What it is:

Mastectomy is the surgical removal of the entire breast. It is usually teamed up with separate procedures on the lymph nodes in the armpit (called axillary nodes) to check if they have been affected. If breast cancer spreads, the cancerous cells often collect in the axillary lymph nodes. These lymph node surgery options are axillary dissection or sentinel node biopsy

How a mastectomy is performed:

• You'll likely go to the hospital early in the morning, have surgery, stay overnight and then be released the following morning. But you may spend more time in hospital, depending on your doctor's specifications and your condition after surgery.
• The surgery is performed under general anaesthetic and lasts approximately two hours.

Possible temporary side-effects:

• You may experience some nausea from the anaesthetic the day of the surgery, though your appetite usually returns by the next day. You may eat and drink what you wish.
• Your chest will be sore, tender, weak and even painful, depending on the extent of the surgery. The discomfort may last several weeks.
• Once home, you may experience post-operative fatigue, which usually lifts within a week. Otherwise you should be able to move around, fix light meals, read, sleep, watch TV, etc.
  
• You may feel well enough to return to part- or full-time work after several weeks, as long as your job doesn't require strenuous activity such as lifting.

Possible long-term side-effects:

• Scarring
  
• Post-mastectomy pain syndromes

For more information:

Order the Canadian Cancer Society's pamphlet called Mastectomy: What You Need to Know via e-mail or call 1/888/939-3333.

How you can cope:

• Because you may feel fatigue, nausea and pain, you won't be able to do housework for a week or more. Arrange for help with meals, child care and rides to and from appointments.
  
• Ask your family and friends to pitch in.
  
• Contact the Canadian Cancer Society and click on your province, or call 1/888/939-3333 to get help arranging for community services before you go in for surgery.

Routine follow-up :

• You'll visit your cancer specialist to receive the pathology report about two weeks after surgery. The report will tell you whether the cancer has spread and how aggressive it is. You'll also find out if the tumour is Estrogen Positive, which means that estrogen may have helped grow the cancer cells. If it is, you'll likely go on hormone therapy.
  
  
• At that same visit, or earlier, you'll have stitches or surgical "staples" removed from your chest.
  
  
• If you're to receive chemotherapy or radiation, treatment starts four to six weeks after surgery.
  
  
• If you're to receive chemotherapy and radiation, you'll start the chemotherapy first for three to six months and then undergo radiation for three to six weeks.
  
  
• After treatment there is wide variation with respect to follow-up appointments, where you'll have a physical examination and blood tests. Talk to your doctor about your schedule.
  
  
• Once a year you'll have a mammogram.