Building Your Team

Before choosing surgery, you build a breast cancer treatment team. You need surgeons, oncologists, anesthesiologist, and radiologist. If you're able, you are the leader of this team. You have to live with the choices made.

Breast surgeon - recommends and performs breast surgery such as mastectomy or lumpectomy under general anesthesia, and a sentinel node biopsy.

Oncologist - also recommends which surgical option is best. Recommends chemotherapies and follows treatment.

Anesthesiologist - usually on hospital staff, unless you want to choose your own.

Radiologist - performs the sentinel node biopsy (where 2-3 lymph nodes in the armpit or breast are surgically removed) is also on hospital staff.

Plastic surgeon - performs reconstruction if you want it, during or well after mastectomy.

Radiation oncologist - manages radiation therapy. Wait till after surgery to find.

First Breast Cancer Treatment: Surgery

Lumpectomy - usually recommended when there is a single, small lump. The lump and the margin around it are surgically removed under general anesthesia.

* Advantage: You have a small scar, usually.

* Disadvantages: You undergo radiation therapy afterwards; because radiation can cause lumps, you may have more biopsies in the future.

Mastectomy - removes breast tissue, comprised mainly of fat, under general anesthesia. Surrounding tissues are undisturbed.

* Advantages: You need no further biopsies on that side; you probably avoid radiation therapy if cancer is detected early.

* Disadvantages: You have asymmetry, and this may temporarily affect sex life or self-image. With psychological adjustment or reconstruction, these disadvantages can disappear.

Breast reconstruction - during/after a mastectomy using techniques such as DIEP, where abdominal fat and skin are transferred to the chest, to shape a new breast. This is not cosmetic surgery; it's part of treatment.

* Advantages: feeling and looking restored; getting a tummy tuck and a breast lift on the other breast.

Breast Cancer Treatment After Surgery

The oncologist considers the information from the various tests. The oncologist stages the cancer, and recommends various breast cancer treatments. The oncologist can refer you to a psychologist or support group to allay anxiety about treatment.

Radiation therapy - usually started after recovery from lumpectomy. It is precisely administered to the breast (and perhaps lymph nodes) in order to kill cancerous cells, while avoiding damage to the rest of the body. Sessions are a few minutes, once a day, 5 days a week, for 6 weeks.

* Short-term side effects: fatigue, breast soreness, redness, swelling.

* Long-term side effects: breast shrinkage, tanning, lumpiness.

Chemotherapy - started after all radiation is complete. Drugs which kill or disable cancer cells are given cyclically, with time off between treatments, for 3 to 6 months. The chemotherapy visit usually is outpatient, lasting 1 to 6 hours. Some drugs are taken orally at home, sometimes as a permanent regime.

* Side effects: hair loss, nausea/vomiting, nerve or muscle pain, infection, weight gain, fatigue, difficulty sleeping.

Hormone Therapy - taken orally at home; both treats and prevents recurrence in some cases.

Exercise, diet and lifestyle changes help recovery significantly.

Survival After Therapy

With 2 million breast cancer survivors in America, breast cancer is beatable. Breast cancer treatment requires internal fortitude to reach recovery. You emerge with relief, gratitude and hope.