Breast Cancer Surgery
A biopsy specimen that proves to be malignant means radical surgery – that is, complete removal of the breast, and of adjacent lymph nodes near the armpit and collarbone, and sections of the arm and chest muscles beneath the breast. The surgeon cannot take chances. He must get all of the malignancy to save and prolong his patient’s life.
In the two to five-hour operation, the surgeon usually makes an ellipticallyshaped incision and removes the breast and surrounding tissue in a single bloc. This technique is considered less likely to disturb and spread loose cancer cells and it also entails less disfigurement than some of the older procedures.
With sutures and skin grafts, the surgeon is able to close the “window” or incision with a minimum of scarring. As in other surgery, the pink lines of incisions become smoother and paler with the passage of time.
It would be fatuous to minimize the seriousness or complexity of this operation. Patience, delicacy, and great skill are essential. But let the apprehensive woman realize that it constitutes the removal of an external organ only, one which she can forfeit without major organic change or injury to her health or general well-being. The operation is literally superficial (by definition, “on the surface”). No major cavity of the body is invaded or affected .
After Surgery
Following the operation, most surgeons advise treatment of the chest area with x-rays, or one of the new anti-cancer drugs, or both. The purpose of this is to kill any stray cancer cells that might be too deep-seated to be discoverable by any sort of inspection. The whole area where the tumor existed is suspect and no chances are taken.
The so-called “magic bullet” which could destroy cancer cells wherever they hide without harming the normal cells of the body is still a hope of the future. But we do possess drugs which show heartening results against some cancers, notably of the prostate, uterus, and breast . Female breast cancer is classified as a “hormone dependent” type – that is, the rate of growth of existing breast cancer is affected by female hormones, although this is not to say that hormones incited the cancer in the first place. Similarly, cancer of the prostate is affected by male sex hormones. Use of antagonistic hormones (male hormones in breast cancer, female hormones in prostate cancer) or hormone doses and removal of hormone producing organs by castration, has proved to be of considerable palliative benefit in appropriate cases, but is not to be looked upon as a cure, and never as an alternative to recommended surgery.
Unhappily, there are cases of “inoperable” breast cancer disease so far advanced or so widespread that surgery cannot be curative. But even in these cases, drugs now available can usually relieve pain, delay cancer spread, prolong comfortable and useful life. Among such drugs are nitrogen mustard, thiotepa, 5-fluorouracil, and a number of others well known to doctors, and promising new ones emerge from time to time from a vast cancer chemotherapy research program which to date has screened more The left side of the drawing shows lymph channels of the breast area with lymph nodes in the armpit, neck, inner and upper chest areas. The right side of the drawing shows directions of drainage that may carry cancer cells to other parts of the body if treatment of localized breast cancer is delayed. than 75,000 anticancer compounds in animal cancer experimentation.
In some cases, one or another of available drugs has made possible the more effective use of surgery and radiotherapy. Medical journals are filled with case history reports of marked improvement when certain drugs are used with certain
breast cancer patients. Each patient’s needs are of course different and meticulous medical teamwork is necessary in order that the individual patient may have the best therapies in the light of present knowledge.
Tags:biopsy specimen, breast cancer surgery, cells of the body, chest muscles, malignancy, pink lines skin grafts