Our Detailed Approach to a Breast Cancer Patient…
Whether you have a breast-related complaint or not, you have been examined by a breast surgeon experienced in breast cancer. The doctor listened to you, examined you, and then requested some radiological tests. I have tried to explain the subsequent process to you below as simply as possible:
- As radiological tests, ultrasound or mammography was primarily requested, appropriate for your age.
- You brought the radiological results to your doctor. Your doctor requested a biopsy from a suspicious area seen in the radiological tests. The biopsy is usually in the form of a closed method, which is a fine-needle or core-needle biopsy.
- The pathologist evaluated the biopsy result and gave it to you to convey to your doctor.
- When your doctor sees the cancer diagnosis, they will inform you about the stage of the disease and possible treatments.
If your doctor deems it necessary, they will submit your case to a multidisciplinary breast cancer board for evaluation in terms of diagnosis and treatment, and will share the result of the evaluation with you. In addition, in some cases, your doctor will invite you to the meeting and allow you to ask questions and share the most appropriate treatment method with you. Breast cancer can present in 3 different stages.
What are the possible complications after breast cancer surgery?
1 – Early Stage Breast Cancer
Early-stage breast cancer refers to cases where the tumor in the breast is small, and there is no spread to the axillary (armpit) lymph nodes, or there is very limited spread. The early-stage breast cancer process:
- If it is an early stage, your doctor will primarily recommend breast surgery. In such a case, breast-conserving surgery will most likely be performed, and the axillary lymph nodes will also be sampled (biopsied). If there is cancer involvement in the axillary lymph nodes, the surgical intervention in that area may need to be extended.
- After this surgery, your breast is in good cosmetic condition.
- Subsequent additional treatments will be determined at a meeting with your doctor and the relevant oncology branches (such as chemotherapy, radiotherapy, hormone therapy).
- Your follow-up will be done by your doctor/doctors every three months for the first three years after surgery, every six months for the next two years, and then once a year for life.
2 – Locally Advanced Breast Cancer
For us to diagnose locally advanced breast cancer, the tumor in the breast must be large, or the axillary (armpit) lymph nodes must be involved with the disease, or both situations must be present. The locally advanced breast cancer process:
Treatment usually begins with drug therapy (chemotherapy, hormone therapy, targeted therapy, etc.). If there is a regression in the disease, an appropriate surgical intervention is performed. These interventions are:
- Breast-conserving surgery
- Oncoplastic surgery
- Mastectomy
- Axillary surgery
Your doctor will inform you in detail about these surgeries.
If breast-conserving or oncoplastic surgery is performed, the cosmetic appearance of your breast will be good. In the case of mastectomy, if the outer skin of the breast is preserved and the inside is emptied and replaced with a breast prosthesis or tissue from your own body, the appearance will be good.
Additional treatments (radiotherapy, hormone therapy, etc.) will be applied after surgery.
Your follow-up will be done by your doctor/doctors every three months for the first three years after surgery, every six months for the next two years, and then once a year for life.
3 – Metastatic Breast Cancer
In this stage, the disease has spread to other organs outside the breast. Therefore, a systemic condition exists. In treatment, the priority is on non-surgical options (such as chemotherapy, radiotherapy, hormone therapy). The process in metastatic breast cancer:
- Treatment primarily begins with systemic drug therapy and/or radiotherapy. The aim of this is to regress the disease throughout the body.
- If sufficient regression is achieved in the disease, surgical application to the breast becomes an option.
- A limited surgery to the breast or a mastectomy is performed.
- In the surgery to be performed, the armpit is not intervened on unless necessary.
- Additional treatments will be required after surgery, depending on the type of tumor.
- Postoperative follow-up will be done more frequently and with more tests.
Emotional Process
The first feelings experienced when a breast cancer diagnosis is first made are usually anger, pessimism, depression, fear of death, and fear of facing reality. After a few days, the person begins to accept the illness, decides to fight the disease, and starts to discuss treatment and quality of life with the doctor in a calmer manner.
At this point, it is very valuable for the patient’s situation to be discussed in a board (multidisciplinary meeting), and if possible, for the patient to be included in this discussion. It will positively affect the patient if the breast surgeon offers surgical recommendations that will best maintain the patient’s quality of life.
Changes in Family Life
Breast cancer affects not only the patient but also their close environment and family. Husbands try to help their wives with household chores. Family members become more careful and sensitive about health issues. Life and time become more valuable for the person who is ill.
Expectations:
Patient’s expectations:
- To overcome the disease.
- To be able to continue their life in a healthy, long, and high-quality way.
- For the family to be strong and support them.
Family’s expectations:
- To see the patient happy and relaxed.
- For the most effective treatment to be applied.
- For the patient to have a long, healthy, and high-quality life.
