PARTIAL MASTECTOMY with or without
AXILLARY LYMPH NODE CLEARANCE

This is quite a common operation to be offered after discovering a breast cancer. The primary cancer is removed with an area of surrounding normal breast tissue. It may be quite a sizeable portion of breast tissue, or quite small, but we try to minimise any noticeable defect afterwards.

The axillary lymph node clearance involves the careful dissection of the little glands under the armpit. These are called lymph nodes, and they filter the fluid which leaks out through the small blood vessels or capillaries. They also usually catch any cancer cells before they spread to other parts of the body. Usually between 6 and 18 nodes are found, and we can see if any cancer cells have spread to this area. The pathologist "fixes and stains" these and looks at them under the microscope to determine if there are any signs of malignancy in the nodes.

After partial mastectomy you should have radiotherapy to reduce the risk of any tumour recurring. Chemotherapy or hormone therapy may be given to lower the risk also, especially of spread elsewhere.

Sometimes it may be advisable to take a little more tissue with further surgery if the pathologist thinks the margin is too close.

If a full mastectomy is required, immediate breast reconstruction can be performed at the same operation.

If you need a mastectomy then you should be offered reconstruction.

Without a reconstructive operation you will look like the lady pictured above, with it you will look like the left.

There are various reasons for a mastectomy:
More than one cancer in the breast.
A large lump > 4 cm
areas of ductal carcinoma in-situ
if you choose to have one

The entire breast tissue is removed from just below the collar bone to the upper abdomen. A simple mastectomy is when just breast tissue is removed. A modified radical mastectomy is when the lymph glands under the arm are also removed.

This operation takes 2-3 hours, and usually two plastic drains are left in the wound for 3 to 5 days, or for the time spent in hospital. Recoverey takes 3 to 6 weeks. The need for extra treatment is known after all the results are in.