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10 Questions to Ask Your Surgeon About Breast Cancer Surgery

Know Your Options and Make Your Best Choice

By

Updated July 09, 2009

You will need surgery to remove cancer from your breast. Before the lumpectomy procedure was developed, and when doctors made all the decisions for you, a mastectomy was the only surgery offered for breast cancer. Since the mid 1970s, patients have been offered more choices and a more active role in making their treatment decisions. Even so, that doesn't make this decision easier. Here are 10 questions to help you choose the breast cancer surgery that is right for you. You may want to print this out and bring it to discuss with your surgeon.

1. What are my options for surgery?

Once you have a comprehensive diagnosis, and know the size of your tumor, whether or not the cancer has spread, how aggressive it is, and your chance of recurrence, it's time to decide on surgery. You'll want to consider other treatments you may need because chemotherapy and radiation can affect the timing of surgery and reconstruction. Ask your surgeon what your options are. Here are some more specific questions to ask:

2. Which procedure do you recommend for me?

If your surgeon favors one particular type of breast cancer surgery, this is the time to find out. You should be offered a choice, unless your cancer has spread beyond your breast, or you have multiple tumors, or an aggressive cancer. Follow up your surgeon's recommendation by asking:
  • Why do you recommend this procedure?
  • Can I talk with someone who has already had this surgery?

3. Will my lymph nodes be removed and tested?

Sometimes cancer cells break away from the tumor and travel through the lymph system to other parts of the body. It is important to remove some of the lymph nodes closest to the tumor, and test them for cancer cells. This helps your doctor determine the possibility of metastasis, and influences your other treatment decisions. Be sure to ask your surgeon:
  • How many lymph nodes may be removed?
  • How likely is it that I will develop lymphedema?
  • Will I need to take special care of my arm after surgery?

4. What are my odds of recurrence after this surgery?

What you're asking here is how much tissue has to be removed to reduce your risk of a recurrence. Your surgeon can't give you a gold-plated guarantee that any particular surgery will protect you from more breast cancer. But a good surgeon should be able to help you weigh the risks and benefits of your chosen surgical procedure.

5. What will my cosmetic result be?

After surgery to remove breast tissue, you may no longer be symmetrical. There are techniques to cope with, repair, or reconstruct a breast. Your results will vary, depending on the size of your breasts before surgery, the size and extent of your tumor, and the type of surgery you choose. It's better to be prepared for your post-surgical appearance, than to face an unexpected result. To help you envision your future appearance, you might ask:
  • How much breast tissue will be removed?
  • Where will my scars be and what will they look like?
  • What are my options for prostheses, repair, or reconstruction?

6. How long will this surgery take and what kind of anesthesia will be used?

You will receive anesthesia to put you to sleep during breast surgery. The more complex your procedures are, the longer you will be under anesthesia. It's important that your surgeon and your anesthesiologist work together to guard your safety and manage your pain during your surgery. Ask:
  • What kind of anesthesia will I have?
  • What risks are associated with this kind of anesthesia?
  • Will I be intubated?
  • Can I be pretreated for nausea?

7. What should I expect to feel like during recovery?

You will need to plan on some time to rest and recovery after surgery. Don't return to normal activities right away, and do let someone else help you with tasks until your strength returns. You may want to ask:

8. Will I need special exercises during recovery?

After breast surgery, especially mastectomy, you may have less motion in your arm and shoulder. Some women have pain in the shoulder, or they develop a frozen shoulder. Special exercises have been developed to help prevent these problems. Here are some useful questions to ask about exercise:
  • Will I need special exercises to help regain full motion and strength in my arm and shoulder?
  • Would you refer me to a physical therapist or a Reach to Recovery volunteer who can show me how to do the exercises?

9. Am I a good candidate for reconstructive surgery?

Women who have a mastectomy may want to look into breast reconstruction. Several kinds of surgery can recreate your breast, from implants to tissue flap procedures. Not everybody has enough spare tissue to create a reconstructed breast. So you may need to ask:
  • If I have a mastectomy, am I a good candidate for reconstructive surgery?
  • What kinds of reconstruction options do I have?
  • Is a skin-sparing mastectomy a good idea for me?
  • How soon can I have breast reconstruction done?
  • Would you recommend a plastic surgeon for me?
  • Would you connect me with other patients who have had breast reconstruction?

10. Would I be eligible for balloon catheter radiation?

After a lumpectomy, you may need radiation treatments. External breast radiation usually takes six weeks, but a balloon catheter device delivers radiation from within the breast in 5 to 7 days. This device is temporarily placed in your lumpectomy cavity, and radiation is given with great effectiveness and fewer side effects. If you can tolerate this device, you can have it implanted during your breast surgery. Ask about different kinds of devices:

Sources:

What You Need to Know About Breast Cancer – Treatment. National Cancer Institute. Updated: 11/01/2007.

Surgery for Breast Cancer. American Cancer Society. Last Revised: 05/13/2009.

  1. About.com
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  6. Breast Cancer Surgery - Decisions About Breast Cancer Surgery

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