In breast-conserving surgery, the cancer and some of the tissue around it are removed, allowing you to keep (conserve) as much of your breast as possible. Breast reconstruction can be done at the same time as surgery. Surgery is also used to check the lymph nodes under the arm for cancer spread.
Reconstruction is available for women who need a total mastectomy or whose partial mastectomy leaves an unacceptable deformity. Reconstructive surgery can be delayed or performed immediately, and uses either breast implants or autologous tissue. The most commonly used autologous tissue is the TRAM (transverse rectus abdominis myocutaneous) flap. The latissimus dorsi muscle also can be used. In some cases, free flaps are used.
Reasons for undergoing reconstruction include inability to wear clothes, dislike of the external prosthesis, and weariness of the mastectomy deformity. Many women choose not to have reconstruction.
Women tend to be satisfied with the result of reconstruction when it is delayed months or years after mastectomy. Additionally, chemotherapy or radiation therapy will not interfere with the reconstruction. Immediate reconstruction is more convenient for patients, less expensive, and limits exposure to anesthesia risk. The aesthetic results tend to be better and the patient does not have to live with a deformity, even temporarily.
Risks for any surgery are:
- Reactions to medications
After breast conserving surgery, a pathologist will look at the breast tissue and lymph nodes that have been removed. The results will help the woman and her doctors decide what other treatments are best. If there are cancer cells in the surgical margin around the breast cancer, the woman may need more surgery. For some women this may mean having a mastectomy.