Your Treatment Options Dictate Your Surgery Choices

Breast cancer is difficult to face, especially knowing the possible damage that a surgical procedure or treatment could cause. Two main types of breast-cancer surgery exist: a mastectomy, or removal of an entire breast, and a lumpectomy, in which only the cancerous portion of a breast is removed. Depending on which type of surgery is performed and when, different treatments are available.

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The combination of surgery and treatments can help determine what type of reconstructive surgery and breast implant options are available, and when is the most effective time to pursue them.

Radiation Therapy

Radiation therapy works by using focused X-rays to target and kill cancer cells, with the goal of eliminating any remaining cancer cells after a lumpectomy. This reduces the likelihood of the cancer reappearing by about 50 percent. Women who undergo a mastectomy generally do not require radiation therapy. Radiation therapy can be harmful in certain situations, such as if the woman is pregnant at the time of the therapy.

In relation to breast implants, women with any kind of implants (e.g., saline or silicone) are still considered candidates for radiation therapy, even though the implants may complicate the planning and execution processes. The radiation therapy may eventually cause scarring and harden areas of the implant, creating a less natural look and feel to the affected breast. Breast reconstruction after a mastectomy and radiation therapy is also an option, but should be discussed with your oncologist before pursuit.

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Chemotherapy

Chemotherapy is a treatment option for almost every kind of breast cancer, operating through drugs that kill or disable cancer cells in the body. The application of chemotherapy is generally determined by the stage of the tumor, the characteristics of the tumor, and the overall health and age of the person who is receiving the therapy. In the early stages of cancer, chemotherapy is given after a surgical procedure but before radiation therapy (if applicable). Chemotherapy may also be given before surgery to reduce the need for a mastectomy to a less invasive lumpectomy. Chemotherapy patients are still candidates for reconstructive surgery, but depending on the body’s reaction to the chemo, patients may need to wait for up to several months after the therapy before undergoing the surgery.

Brachytherapy

Brachytherapy is a type of radiotherapy that is administered externally, and can affect both healthy tissue and cancer cells, causing an increased possibility of side effects. Since brachytherapy can be applied to only a small portion of the breast, it is usually used in conjunction with a lumpectomy, reducing the amount of tissue that is surgically removed. Several scientific studies have determined that women who undergo brachytherapy are still healthy candidates for reconstructive surgery.

Most modern forms of cancer treatment allow for reconstructive surgery as a possibility, though the timing of each is somewhat different. Depending on what type of surgery you undergo and what treatment(s) you pursue, you may need to consider reconstructive surgery before, immediately after, or several months after your treatment.