Treatment Options
with Sandy Fogel, MD
What is the recovery time for breast conservation surgery?
Breast cancer treatment used to mean getting a mastectomy - losing your breast, and possibly your self-esteem. But today, there are other options. According to Sandy Fogel, MD, General Surgeon at GMBC, many women are having breast conservation surgery instead. “Women treated for breast cancer usually don’t need a mastectomy. The vast majority of women who have any kind of breast cancer are candidates for breast conservation,” he says.
Breast conservation surgery, or lumpectomy, does not require a total removal of the breast, and achieves better cosmetic results. It is equally as successful as other procedures and the survival rates are just as good, but not all patients consider it an option. “I still run across some women who think they are making a compromise and that they’ll do better if they have a mastectomy,” says Dr. Fogel.
Breast conservation surgery is done on an outpatient basis and patients spend significantly less time in the hospital. The surgery can be done under local anesthesia with sedation and can take less than hour to complete. The surgeon may need to do a needle localization to find the area that needs to be treated. “It’s basically putting a needle in the breast that acts as an arrow, pointing at the cancer,” says Dr. Fogel. “An incision is made and the tumor and the area around it, including a margin of healthy tissue around all sides of the cancer, are removed.”
Every effort is also made to give the patient the best cosmetic results possible. “We use plastic surgery techniques that won’t leave divots or a misshapen breast,” says Dr. Fogel.
Once the patient goes home, recovery normally takes about 24 hours. “People can usually go back to work, drive a car and do anything they want the next day, if they are comfortable enough,” says Dr. Fogel. If a woman has her lymph nodes removed, however, recovery may take slightly longer.
A woman recovering from breast conservation surgery needs to wear a comfortable bra for about a week after the procedure to keep the breast in its normal shape and help alleviate tension the weight of her breast may put on the stitches. “After breast conservation surgery, the patient will see a radiation therapist,” says Dr. Fogel. Radiation treatment usually lasts about six weeks. After that, the patient needs to schedule regular follow up appointments with their physician.
Although many women choose breast conservation surgery for cosmetic or emotional reasons, there are some cases when it is not an option. “If the tumor is too large in relation to the breast to allow a reasonable cosmetic result, breast conservation surgery doesn’t make sense,” says Dr. Fogel. “The main reason for breast conservation is for the cosmetic results. It’s not that it’s a better cancer procedure; it’s an equal cancer operation with a better cosmetic result.” A woman with multiple tumors would not be a candidate for conservation surgery because the cosmetic results would also be very poor.
According to Dr. Fogel, there are other reasons to avoid breast conservation as well. “Someone with certain diseases involving the skin may not be able to tolerate radiation therapy after surgery, so they shouldn’t have conservation,” says Dr. Fogel. “Someone who has skin involvement with the tumor in the breast would also probably do better with a mastectomy.”
When it comes to choosing breast conservation surgery, even geography may play a role. “Radiation therapy treatments are required,” says Dr. Fogel. “It is five days a week for six weeks. If a patient lives too far away and can’t get to a radiation center then they shouldn’t have breast conservation.”
The most important thing for a breast cancer patient to know is that there are options. “For the vast majority of people, the chances of having a successful cancer treatment are the same with mastectomy as they are with breast conservation,” says Dr. Fogel. “So if the odds are the same, then the woman gets to choose.”
