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Some considerations
Effectiveness of the treatment
Research (statistics) and medical opinion indicate that women
who have breast conserving treatment that includes radiation
therapy live as long as women who have a mastectomy. However,
in some circumstances (such as when there is more than one
cancer in the breast) your surgeon may recommend a mastectomy
as being more effective.
Experts do not recommend breast conserving treatment without
subsequent radiation therapy. Leaving out radiation therapy
significantly increases the chances of the cancer returning.
Appearance
Breast conserving treatment aims to keep the look, shape
and feel of your breast as much as possible. However, your
breast may look different after the operation. A mastectomy
cuts away the whole breast. Unless you have a breast reconstruction
you will not be able to wear low cut dresses.
The size and shape of your breasts will also impact the result.
Ask to see photos showing the results for women with similar
size breasts to yours, whose tumour was a similar size and
in the same position.
Sometimes, because of the amount of the breast that needs
to be removed and the likely appearance of the breast afterwards,
breast conserving treatment is not possible or will not give
a good result. This can also be the case if the tumour is
too close to the nipple. The size and position of the tumour
will also affect the appearance of the result. The experience
of your surgeon will also impact appearance, particularly
of the scar, which can be straight or puckered.
If you have a mastectomy, you can have a breast prosthesis
or breast reconstruction if you want. There are a number of
options for reconstruction. Occasionally women will have both
breasts removed and reconstructed for appearance.
Tumour size and position
Sometimes, the size and position of the cancer, whether there
is more than one cancer in your breast and the size of your
breast may mean that mastectomy will be a more appropriate
treatment (breast conserving treatment may result in a deformed
breast- this is most likely where the tumor is large or at
the top of your breast or there are multiple tumours). Always
ask to see photographs of the result of surgery where the
tumour (s) is a similar size and position to yours.
Radiation therapy
If you choose breast conserving treatment, you will need
radiation therapy to kill any remaining cancer cells. This
may involve significant cost and time away from home where
there is no local treatment centre. Radiation therapy will
cause (usually) slight changes to the appearance and feel
of your breast, such as a slight redness and a firmer feel.
Some women decide to have a mastectomy to avoid travel or
excessive cost or too much time away from their children.
Others decide the hassle of radiation treatment (which requires
daily treatments for six weeks) is not worth the benefit to
them.
Risk
Where a woman considers she has a high risk of the cancer
returning in the breast she may choose a mastectomy to avoid
future problems. Some women who have a high risk through familial
breast cancer may decide to have a mastectomy in both breasts.
To get more information from websites and books to enable
you to make your decision, use this link- helping
to decide.
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