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Comprehensive Breast Care - July '07

Breast Surgery: Several options available to patients

Anita Leininger, MD

After being diagnosed with breast cancer, patients face the tough decision of what course of treatment to pursue. The decision is very personal and depends upon each patient’s individual situation. The University of Toledo Medical Center offers several treatment options for breast cancer patients, one of which is surgery.

According to Anita Leininger, MD, assistant professor of surgery and surgical director of the Center for Breast Care at UT Medical Center, the decision to undergo surgery, as well as which type of surgery, is ultimately up to the patient. “The patient’s personal history, support system, level of anxiety and risk of developing a subsequent cancer are all under consideration,” she says. “It’s important for the patient to be part of her treatment plan. She needs to be educated and make the decision that is best for her.”

Several forms of surgery
There are several forms of surgery for breast cancer:

• Radical mastectomy – which is rarely performed anymore; consists of the removal of the entire breast, the chest wall muscles and lymph nodes under the arm.
• Modified radical mastectomy – the removal of the entire breast, lymph nodes under the arm and the lining over the chest muscles.
• Total or simple mastectomy – the removal of the entire breast.
• Partial mastectomy or lumpectomy – the removal of the part of the cancerous breast and some of the surrounding tissue.

Lumpectomy is usually an outpatient procedure, whereas mastectomy requires an overnight hospital stay. Most patients return to work within four to six weeks with many able to return as early as one week.

The right to choose
“The key is educating patients about getting the appropriate surgery for the right reasons,” says Dr. Leininger. “The worst feeling is never having been given the choice. Most patients can live with the outcome if they made the decision, but if someone else made it for them, they may feel resentment or regret for the rest of their life.” The patient’s decision for which surgery is best, may be guided by her interdisciplinary care team and the results from testing such as pathology, genetics, MRI and PET/CT.

Breast reconstruction an option for most patients
Surgery is typically conducted within six weeks of diagnosis. During the time before surgery, patients opting for a mastectomy are able to meet with a plastic surgeon to discuss breast reconstruction, which is an option for most patients. “I believe there is an advantage for the patient both psychologically and medically with immediate reconstruction,” says Dr. Leininger. “The patient wakes up with something there rather than a flat area on her chest. With delayed breast reconstruction, the plastic surgeon has to build a three-dimensional breast on a flat surface, which can be difficult.”

Interdisciplinary care enhances patient experience
At UT Medical Center, a team approach is used to offer patients comprehensive care. “Many times this makes it possible for patients to meet all of the doctors involved at one appointment,” says Dr. Leininger. “When a case is diagnosed, all of the disciplines come together and review patient history, slides and films. This allows for discussion of treatment options that can be presented to the patient as a united front.”

For more information about surgical treatment for breast cancer, call 877-451-2299.