You have a very small cancer in the breast, or there is something in your breast that may be one. The plan is to take out the diseased part of the breast with a clear rim of healthy breast. At the same time glands will be taken from your armpit (axilla). The glands are small clusters of cells that are connected to tiny draining pipes in the breast and axilla, called lymphatics. When cancer 'travels' and spreads through the lymphatics, the glands will be affected and will get bigger.
This is what is meant by a wide excision and axillary sample. Sometimes all the glands are taken from your armpit. This is called an axillary clearance. The two pieces of tissue are looked at under the microscope in the laboratory to see if the lesion in your breast is cancer or not and also to see if the cancer has spread to the glands of your axilla. Future treatment will be based on this important information.
Before your Operation
- You will be admitted on either the day of the operation or the day before.
- You will be asked to sign a consent form if this has not already been done.
- You may be asked to wear TED stockings. These help to prevent blood clots in your legs.
- You may receive a small injection which also helps to prevent blood clots. This is usually given twice a day.
- You will be asked to be nil by mouth for a few hours before your operation. You will be advised of when this will start.
- Wide Local Excision means that the breast lump is going to be removed along with some tissue surrounding it that looks healthy. This is then analysed after your operation.
- The doctors will then be able to tell you if they feel enough tissue has been removed.
- Occasionally, some people need to have a further operation if the disease has extended beyond the tissue that has been removed the first time.
- You may also be advised to have some or all of your lymph glands from your arm pit removed. This may be done with just the one incision in your breast or with a second one under your arm.
These risks include having an anaesthetic and wound infection. These will be discussed with you at the pre-operative assessment clinic, on the ward or with your own doctor.You will already have been advised about the possibility of surgery to your armpit. This will be either an axillary sample or clearance which is explained below.
Complications are minimal and seldom serious. If you think that all is not well, please ask the nurses or doctors. Bruising may be troublesome. Occasionally some old blood collects under the wound, but this can easily be removed. Occasionally the wound edge does not heal well in places. This always settles down but may take 2 or 3 weeks to do so. Infection is a rare problem and settles down with antibiotics in a week or two. Aches and twinges may be felt in the wounds for 4 to 6 weeks. The wound in your armpit is smaller than the one in your breasts, but may be much more uncomfortable. Occasionally there is a numb patch in the skin of the armpit and down the inside of the upper arm. This patch slowly lessens in size but may always be present.
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