Dr. Rosa E. Cuenca, MD

Recovery from mastectomy is not too difficult. That said, everyone has different responses to surgical pain. If your surgeon is only taking a sentinel node biopsy rather than all of the lymph nodes in the axilla, you can expect less pain. Most patients have good pain control with oral pain medications. Expect most of the pain in the inner arm and armpit which will get better every day. Some surgeons inject local anesthesia that lasts several days and this helps with pain as well. Some patients report using very little pilas for pain.

A closed biopsy is best, because it is an outpatient procedure, requiring local anesthesia, leaves a minimal skin opening, has less risk of infection, and does not damage the local lymphatic channels around the lump. This is important because we use those lymphatic channels to map out the test to check for tumor spread into your arm pit nosed, and this is crucial information in planning for cancer treatment. It also less expensive as open biopsy is a surgical procedure, often done in the operating room which costs much more.

The relationship between a patient and a surgeon is a very important one, as important as the one between medical oncologist and patient. The training, technical approach, and options for best procedure need to be fully discussed prior to proceeding with any surgery. It is also a time to ask questions about the surgery, assess the surgeon’s experience with cases such as yours, and what outcomes they report. It is a time to see how that surgeon’s OR works, what complications and recovery time can be expected, when to return to work, and to plan any pre-surgical testing that may be required. It is important to know what the outcomes of which surgery is done, so informed consent can be truly achieved. This is vital to the patient-surgeon relationship.
It is also time to interview that surgeon, see how they interact with you and your family, how their office works, and how they support you, as you will be seeing them frequently after your surgery.
What procedure you “need” when you have Breast Cancer is best decided with your surgeon, as the surgeon is trained to evaluate surgical treatments and their outcomes, and can best guide you through the current recommendations for these treatments. Often, there are options to avoid mastectomy, and Breast Conserving Surgery May be a better option for many reasons. If mastectomy is truly the best treatment, then options and timing for reconstruction should be discussed, as well. Only you and an experienced surgeon can make these critical decisions with full disclosure of risks and benefits. These discussions should be held with a surgeon rather than a medical physician.