| Lumpectomy and axillary clearance |
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| Written by Administrator |
| Wednesday, 28 January 2009 17:15 |
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GENERAL INFORMATION A lumpectomy and axillary clearance means the removal of the part of the breast containing the cancer as well as removal of the lymph nodes from the axilla. No muscles are removed. This operation is done when it is possible to treat breast cancer without removing the whole breast and when it is the patient's choice not to lose her breast. (It is also known as wide local excision). It is usually followed by irradiation to the breast. DIAGNOSIS A biopsy may have been done by removing a small piece of breast tissue either with a needle or an open biopsy. Or it may be suggested by your doctor that a biopsy will be done while you are asleep under anaesthesia. The pathologist comes to the theatre and examines the tissue while you are asleep. If he finds that the lesion in your breast is a cancer, the operation proceeds. PRE-OPERATIVE PREPARATION * Make sure your doctor knows what medicines you take, especially medicines which may affect blood clotting. * Your doctor may decide to do some special tests before the operation. * Do not eat or drink anything for 6 hours before the operation. * Your doctor will explain when you need to be admitted. * You may be given sedation before being taken to the operating theatre. OPERATION * You will be asleep for the operation. * The operation is done through 2 separate incisions and usually takes about 2 hours. * The breast specimen and lymph nodes will be removed and be sent to the laboratory to be examined by a pathologist. POST OPERATIVE CARE * You will wake up in a recovery room. * When your blood pressure, pulse and breathing become stable,you will be taken to your regular hospital room. * You will have a thin plastic tube coming from the axillary wound that will drain any fluid into a plastic bottle or bag. * There will only be moderate pain which can usually easily be controlled. * You will be able to eat normally. * Your doctor would have discussed with you how long you need to stay in hospital. * Arrangements will be made by your doctor for removal of the drain and the stitches. HOME CARE * You may walk about as you wish. * You may eat as you did before the operation. * You would have been given instructions on arm movements by your doctor or the physiotherapist. * Your doctor would have instructed you regarding bathing or showering. * You will have been told when the dressings may be removed. * You will be given instructions as to when the stitches need to be removed. * Your doctor would have explained to you when you may drive again. * Your doctor would have explained when you may return to work. * You will usually need to have follow up radiotherapy treatment. Chemotherapy treatment or hormone treatment will depend on the results of the pathological examination of the specimens which were removed. Your doctor will discuss this with you. COMPLICATIONS * Complications are infrequent after a lumpectomy and axillary clearance but are possible. You must be aware of the following possible complications. * The small sensory nerve to the inner aspect of the arm is usually divided during the operation. This may lead to some numbness on the inside of the arm. * Two important nerves run through the axilla and supply muscles around the axilla. Your doctor will attempt to avoid injuring these nerves during the operation. You must be aware of the fact that injury to these 2 nerves is possible. * A bleed or haematoma does sometimes occur, even in spite of a drain having been left in. If this happens your doctor will decide how to manage this. * These wounds very rarely becomes infected. If this happens, it may necessitate dressings or other active management. * Sometimes lymphatic fluid accumulates under the skin and may need to be aspirated by your doctor. * The cosmetic result of this operation is usually very good. You must remember however that sometimes the appearance of the breast after this operation is not entirely normal. * If you don't work hard with arm exercises, you may end up with some limitation of shoulder movement. * Systemic complications like venous thrombosis and pulmonary embolism are rare, but possible after any operation or anaesthetic. |
| Last Updated on Sunday, 08 February 2009 16:26 |