Too often, even after deciding to undergo surgery for breast cancer, women still feel left in the dark about how to prepare emotionally and physically.
In this third episode of our five-part series, we feature insights from Mrs. Jill McNeely, a retired breast nurse navigator. We explore crucial factors such as choosing between lumpectomy and mastectomy, the importance of family history and genetic testing, recovery timelines, and post-surgical bras. While relying on your healthcare team is essential in your decision-making and recovery, knowledge can help alleviate anxiety and give you a sense of control.
Mastectomy vs. Lumpectomy: Making Your Choice
Ultimately, the decision between a lumpectomy and mastectomy is yours. However, working with and listening to your healthcare team is essential. If you have the option, Jill recommends considering these key points:
- Will you be overly concerned about cancer recurrence with a lumpectomy?
- Are you prepared for potential radiation therapy after a lumpectomy?
- Does the chosen surgery align with your lifestyle and personal preferences?
Understanding the Procedures
Lumpectomy
A lumpectomy is a breast-preserving surgery where the surgeon removes the cancerous tumor without removing all the unaffected breast tissue. According to the Cleveland Clinic, there are different types of lumpectomy procedures:
- Excisional biopsy: The surgeon removes the tumor as part of a biopsy, and a pathologist tests the tissue to determine whether the tumor is cancerous or benign.
- Wide local excision: The surgeon removes the tumor plus a small margin of nearby healthy tissue. A pathologist tests the margin to ensure there are no cancer cells. If no cancer cells are found, the surgery is considered successful.
- Quadrantectomy: The surgeon removes about a quarter of the breast, including the tumor, a margin of healthy tissue, and the area containing milk ducts.
- Re-excision of margins: This follow-up procedure is performed if cancer cells are found in the margin after a wide local excision. The surgeon reopens the site to remove more tissue and ensure all cancer cells are gone.
Mastectomy
A mastectomy involves the surgical removal of all breast tissue, typically as a treatment or preventive measure for breast cancer. According to the American College of Surgeons, there are different types of mastectomy surgeries:
- Simple Total Mastectomy: Removes all breast tissue, including the nipple, areola, and some overlying skin, leaving a scar across the site.
- Skin-Sparing Mastectomy: Removes all breast tissue but leaves as much healthy skin as possible, often used when breast reconstruction is planned.
- Nipple-Sparing Mastectomy: Removes all breast tissue but leaves the nipple, areola, and overlying skin intact.
- Modified Radical Mastectomy: Removes all breast tissue, including the nipple, areola, and axillary lymph nodes.
Though these options may seem overwhelming, your care team should guide you in selecting the best option based on your diagnosis. If preserving your nipple(s) is important to you, advocate for it with your healthcare team or seek a second opinion. If you are unable to keep your nipple(s), note that 3D tattoo artists can recreate them for patients who lose them in surgery.
Family History & Genetic Testing
Genetics can influence your choice between a lumpectomy and mastectomy. Getting genetic testing while considering surgery options can provide crucial information about your overall risk of developing breast cancer or having a recurrence. Over the past few years, genetic testing has become much more affordable and is something to consider if you're unsure about your options. Reach out to your care team or nurse navigator to help you schedule an appointment and navigate insurance coverage for genetic testing.
Recovery Time: Lumpectomy vs. Mastectomy
Lumpectomy:
- Typically an outpatient surgery, allowing you to go home the same day.
- Usually, no drains are required.
- Your mobility shouldn't be restricted, but avoid heavy lifting for the first few days.
- Most patients can return to work within five days, but it's important to take more time off if needed.
- Be sure you haven't taken any pain medications at least 24 hours before driving.
- Having a supportive post-surgical bra like the Resilience Bra is important. Insurance will likely cover part or all of your post-surgical bra if you visit a mastectomy boutique before your procedure.
Mastectomy:
- More mastectomies are becoming outpatient surgeries, but some hospitals may require a 1-2 night stay depending on the outcome.
- You will likely have drains. Depending on the surgery, expect anywhere from 1-6 drains, with 2-4 being most common.
- Your hospital and care team will guide you through measuring your drain output and color during recovery.
- Your mobility will be restricted for 6-8 weeks, and you should avoid raising your arms or lifting heavy objects during this time.
- You probably won't be able to shower for the first few weeks post-surgery, except for using a handheld showerhead for rinsing off or washing your hair.
- You'll need a caregiver for the first four weeks to help monitor your drain output, pain medications, and overall recovery.
- When you can return to work depends on your recovery and the type of job you do. If there are no complications and your job is desk-based, you may return to work within 3-4 weeks. For physically demanding jobs, you'll need to wait 6-8 weeks.
- Wait at least a few weeks after surgery before driving, and ensure you haven't taken any pain medication for at least 24 hours beforehand.
- Wearing a supportive post-surgical bra like the Resilience Bra is crucial. Insurance will likely cover part or all of your post-surgical bra if you visit a mastectomy boutique before surgery.
Getting a Post-Surgical Bra BEFORE Surgery is Critical
While hospitals usually provide a post-surgical bra, these are often minimal and may not fully meet your needs. Finding a high-quality post-surgical bra like the Resilience Bra before surgery is critical to your recovery. If you're willing to pay out of pocket or submit a claim to your insurance, you can buy the Resilience Bra online. Alternatively, you can visit a local mastectomy boutique for a fitting. The boutique will handle insurance reimbursement, or you can purchase the bra directly if you don’t have insurance.
The Resilience Bra
The Resilience Bra includes features that benefit patients after a lumpectomy or mastectomy. Lumpectomy patients appreciate its adaptability, allowing the bra to tighten or loosen for the right level of support. Mastectomy patients love the drain management system, which keeps drains secure and tucked away. Once drains are removed, the bra transforms into a sports bra that can be used for other activities or procedures.
Resilience Bra Features:
- Soft, breathable fabric for 24/7 comfort.
- Adjustable Shoulder Straps that adapt to your body shape and size.
- Drain Pocket Holders to manage up to 3 drain bulbs on each side.
- Drain Tubing Holders to secure tubing against the body.
- Interior Pockets with removable pads or space for prostheses or ice packs.
- Extended Pockets to support swelling spots or compression pads for lymphedema.
- Insurance Reimbursable Medicare and most insurance providers cover part or all of the cost.
For more information about Three Strands Recovery Wear, including retail locations, online purchasing options, and ambassador opportunities, visit threestrandsrecoverywear.com. For questions, email info@threestrandsrecoverywear.com. To purchase the Resilience Bra, use the store locator to find a retailer near you or buy it online here for 15% off your first purchase.
Please note that while this series provides valuable insights and personal experiences, it is not a substitute for professional medical advice, diagnosis, or treatment. Viewers are encouraged to consult their physicians or healthcare providers for any medical concerns.