Breast cancer is the number one cancer among Singaporean women. It usually occurs when harmful (malignant) cells originate from the cells lining the milk ducts and glands. In advanced breast cancer, cancerous cells can spread through the breast to the rest of the body.
Breast surgery is part and parcel of cancer treatment and would be required at some point in time to remove cancer cells. Depending on the breast cancer stage, chemotherapy or radiation therapy would also be introduced alongside hormone therapy.
There are 2 main types of breast cancer surgery.
Breast-conserving surgery
Breast-conserving surgery could be a lumpectomy or wide local excision, where the tumor and a section of surrounding breast tissue is removed. It could also be a partial mastectomy, where part of the breast is removed.
In breast-conserving surgery, the amount of breast tissue that is removed will depend on the type of cancer, tumor size and its location in breast as well as the size of the breast.
An area of healthy breast tissue around the tumor will always be removed and tested for cancer via a biopsy The chances of the cancer returning is reduced when the healthy tissue does not show signs of cancer. More tissue may need to be removed from the breast if cancer cells are found in the surrounding tissue.
Radiation therapy usually follows after breast-conserving surgery to destroy any remaining cancer cells that may still be present. However, the sequence may also vary.
Mastectomy
A mastectomy is the removal of all the breast tissue to treat or prevent breast cancer. A sentinel lymph node biopsy is removed along with the breast if there are no obvious signs that the cancer has spread or metastasized. The sentinel lymph nodes are the first lymph nodes that the cancer cells reach if they spread and are a part of the lymph nodes under the arms. Lymph nodes will be removed if there are signs of cancer.
Breast Reconstruction
Breast reconstruction is surgery done to create a new breast shape to replace the breast that is removed. It is done after a mastectomy. A breast implant may be used or tissue from another part of your body can be used to create a new breast.
Lymph Node Surgery
A biopsy may be done on the sentinel lymph nodes to check if cancer has spread to them. The sentinel lymph nodes are the first lymph nodes that cancer cells reach if they spread and are a part of the lymph nodes under your arms. They are also called axillary lymph nodes.
The sentinel lymph nodes are examined for cancer cells and further surgery would be needed to remove here if cancer cells are found.
Hormone Therapy
Hormone therapy lowers the levels of oestrogen or progesterone hormones in your body and helps to shrink a tumour and make it easier to remove. Hormone therapy may be used as the only treatment for breast cancer if your general health prevents you having surgery. It is received for 5 years or more after surgery.
