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Mammography | Radiotherapy

  Subcutaneous Mastectomy | Benign breast lumps


Breast cancer is rare in young women, and most often strikes over-sixties. The causes are not yet completely understood, but there does seem to be certain women at a slightly higher risk. These include women with a family history of breast cancer, also women who either have no children, or have had them late in life. There is also some evidence to suggest that women who eat a diet high in animal fat may be running an increased risk. However, whatever your circumstances or age, doctors recommend careful breast self-examination.

Examining your breasts for lumps is therefore an important part of looking after yourself. Radical mastectomies are rarely performed today - instead, most women have a combination of treatment.

For many, the treatment consists of a lumpectomy to remove a lump up to 4cm (1 in) across, together with removal of the lymph glands under the arm, plus a low-dose radioactive implant into the breast for 48 hours and then five weeks of daily radiotherapy as an outpatient.

New methods of treatment mean that some women - and it always depends on the individual case - do not have to go through this tiring course of outpatient therapy following treatment. 

Instead they are given a five-day high-dose radioactive implant immediately after surgery, plus chemotherapy for pre-menopausal women or tamoxifen for post-menopausal women if the cancer has spread to the lymph glands. Healing is usually very good after a lumpectomy, with no noticeable scarring. 

Wound infection is also uncommon.  If the cancer is treated early, the outlook is optimistic: either a complete cure or years of good health can be expected. If the cancer recurs, it can sometimes be controlled for years by drugs, radiotherapy, and in some cases further surgery.

  • Mammography is a technique for taking pictures of the breast using a low dose of X-ray. It can show tiny changes in the breast tissue: sometimes these may be the only signs of cancer. 

  • A mammogram (breast X-ray) can also show up other breast problems which are not cancer. Mammograms are available free to all women aged 50 and over. 

  • If you are under 50 you will not be invited to attend for a mammogram, and must continue to check your breasts regularly. Your risk of breast cancer may be greater, however, if you have a close female relative who has had breast cancer.

  • The other way is to have a screening - usually with ultrasound, which is more efficient in younger women - before the age of 50

  • Radiotherapy is a process which uses harmful radiation to destroy cancer cells. It is normally given in a number of small treatments so that your healthy cells are able to recover.

  • Usually you will be treated for a few minutes a day, up to five times per week, and for a period of two to six weeks, but the number of treatments prescribed bears no relation to the seriousness of the cancer. 

  • Age, your general state of health, and the site and type of cancer being treated are all taken into account when your course of radiotherapy is being planned by a specialist.

  • Where possible, your doctor may prescribe a course of radiotherapy to destroy a tumour and hopefully cure your disease, but radiotherapy is also given to relieve symptoms and lessen pain.  This is called palliative treatment, and is usually only given over a short period of a few days.

  • Total body irradiation is often given to patients who are having a bone marrow transplant, for example for leukaemia.  A large single dose of radiation., or six to seven smaller ones, is given to the whole body to destroy the cells of the bone marrow.  The new bone marrow then takes its place.

 For internal radiotherapy, which is administered with an injection or a drink, you may have to become an inpatient for a few days.

Subcutaneous Mastectomy

The type of breast surgery your consultant recommends will depend entirely on the nature and position of any malignant tumour. Where a subcutaneous mastectomy is offered, an incision is made under the breast and internal breast tissue is removed, leaving most of the skin intact. 

  • The nipple is not involved, but the milk ducts leading to it are cut. 

  • In the past, silicone implants were put in at a later stage, but now more and more doctors are offering immediate insertion of the implant, so that by the time you wake up from you operation, your breast's appearance will already have been restored.

  • Subcutaneous mastectomy is a treatment for breast cancer.  One-third of women who have full (radical) mastectomies suffer from the psychological after-effects of losing a breast, and the subcutaneous mastectomy relieves many of these potential problem.

  • After the operation, you will have bruising and a loss of feeling in the `new` breast.  The feeling will gradually return and the bruising will fade after about six weeks.

  • It is important to seek professional advice about exercise: stretching exercises will ease any discomfort in your shoulder (the breast tissue is attached to the muscles in the shoulder), and mobilize the breast and prevent it from sticking up like a mountain when you are lying on the beach!

Benign breast lumps
  • Most benign breast lumps are fibro adenomas - round, fibrous, painless tumours which feel firm to the touch and movable under the skin.

  • A typical Fibroadenoma is between 1-3cm (5/8-1 1/4in) in diameter. They are most common in women under 35, and multiple lumps may occur in one or both breasts. Removal is recommended because of the small risk of cancer, and once the lump has been analyzed this risk can safely be ruled out.



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