10 Things You Should Do Before Undergoing Breast Cancer Surgery

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  • 1. Stay Calm
  • Stay CalmThe diagnosis of breast cancer strikes most women like a “crisis”. However, you should resist the urge to treat it as an “emergency”. Having the cancer removed quickly may help your anxiety, but “rushing” to surgery will not improve your chances of surviving breast cancer or avoiding a recurrence. For the best possible outcome, it is critical that you learn about all of your treatment options before going to surgery so that you do not deprive yourself of treatment options or make hasty decisions that might compromise your outcome. It is completely safe to take a few weeks to figure things out.
  • 2. Avoid multiple unnecessary operations
  • Avoid multiple unnecessary operationsNearly 1 out of every 3 women who undergo lumpectomy for breast cancer requires more than one operation to successfully treat her breast cancer when only one operation is usually all that is necessary. Here are the three most common reasons that patients undergoing multiple operations: 1) the surgeon was surprised to find cancer after removing a lump that was thought to be benign, 2) incomplete removal of the cancer at the first operation, and 3) failure to evaluate the lymph nodes at the first operation in a woman with breast cancer. While it is not always possible for the surgeon to be successful in the first operation, following this “10 Things Guide” will greatly increase the chances that your first breast operation will be successful.
  • 3. Consider a Second Opinion
  • Consider a Second OpinionChoosing a surgeon to treat your breast cancer is among the most important decisions you will make in your fight against breast cancer. This decision will not only influence how you emotionally handle your cancer diagnosis, it will also greatly affect the kinds of treatments you are offered, the success of your breast cancer operation, and the kinds of side-effects you will deal with after breast cancer surgery. Even if you are happy with your current surgeon, obtaining a second opinion will make you a smarter consumer and reassure you that you are on the right path to recovery. Second opinions may also help you identify more effective or safer options that might have not been offered to you. Don’t be ashamed to ask for a second opinion. It is your right as a patient.
  • 4. Insist on a Needle Biopsy Before Surgery
  • Insist on a Needle Biopsy Before SurgeryIf you have a new breast lump, abnormal mammogram, or abnormal ultrasound, please resist the urge to have it removed as the first step to finding out what it is—even if your surgeon recommends removal as the first step. Instead of surgery at the first step, please insist on a needle biopsy first to allow a portion of the abnormality to be removed for a diagnosis. Finding out what the abnormality or lump is before having it surgically removed will greatly improve the chance of successful removal, reduce the chances of unnecessary surgery, and provide you the opportunity to fully consider your treatment options (e.g., lumpectomy, mastectomy, reconstruction, lymph node biopsy, second opinion, clinical trials) before you burn any bridges that can’t be crossed again. Commonly, the only difference between successful cancer surgery and unsuccessful cancer surgery is whether or not a needle biopsy was performed first.
  • 5. Ask Your Surgeon To Obtain Wide Surgical Margins
  • Ask Your Surgeon To Obtain Wide Surgical MarginsWhile the idea of losing extra breast tissue might seem unsettling, it is essential that your surgeon remove a generous rim of normal tissue along with your cancer. We call this rim of normal tissue the surgical margin or safety margin. The safety margin is important because cancers are often larger than they appear on mammogram or ultrasound. So the surgeon must remove the cancer with a safety margin (surgical margin) to increase the chances of successful removal in case the cancer is larger than expected. Even small cancers can be a challenge to remove because they cannot be felt. To aid removal of small cancers, surgeons usually have localizing wires or needles temporarily inserted into the breast by the radiologist prior to surgery to mark the location of the cancer. Although many surgeons use only 1 localizing wire inserted right through the center of the tumor, ask your surgeon to consider using 2 wires (one on either side of the tumor) to ensure removal of your cancer along with a wide surgical margin. While placing multiple localizing wires prior to surgery might be an inconvenience to you, your surgeon, and to the radiologists, it is not nearly as inconvenient as having to return to surgery a second time because the cancer was not adequately removed.

Read more about preparing for breast cancer surgery

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