Breast Cancer Surgery: Types of Operations and the Recovery Process

Breast cancer surgery is the primary treatment method that ensures the safe removal of cancerous cells and at-risk tissues in the breast from the body. These operations are specially planned according to the stage of the disease, the biological characteristics of the tumor, and the patient's general health. The right surgical interventions applied during the early diagnosis phase not only extend patients' survival but also maximise their quality of life.

• The scope of the surgery is determined by the size of the tumor and the condition of the underarm lymph nodes.
• There is no difference in survival rates between breast-conserving surgery and the complete removal of the breast (mastectomy).
• The hospital stay usually ranges from 1 to 3 days, depending on the surgical technique used.
• The need for post-operative chemotherapy or radiotherapy depends entirely on the tumor's structure, not on whether the breast was removed.
• The recovery process is highly individual; most patients can return to their daily routines within 3 to 4 weeks.

What is Breast Cancer Surgery?

Breast cancer surgery is the surgical removal of tumor tissue in patients diagnosed with cancer. As one of the most critical steps in treating the disease, this surgical intervention aims to prevent the cancer from spreading to other parts of the body. It is vital for every woman over the age of 20 to perform regular breast self-exams and to have an annual mammogram starting at age 40 to catch the disease in its early stages. In cases detected early, surgical interventions can be kept much more limited.

As we highlighted in our article Breast Cancer Awareness Month: Early Diagnosis and Screening Guide, early detection is the most important life-saving factor. The main goal in modern surgery is not only to clear the cancer but also to preserve the patient's bodily integrity and psychological well-being. Therefore, surgical planning is tailored for each patient with a multidisciplinary approach based on the tumor's specific characteristics.

What Are the Types of Breast Cancer Surgery?

In the past, the only accepted surgical treatment for breast cancer was the complete removal of the breast and the underarm lymph nodes. However, thanks to advances in medical science, this approach has completely changed. Different surgical options are evaluated based on the extent of the disease and the location of the tumor.

Breast-Conserving Surgery

Breast-conserving surgery (lumpectomy) is the procedure of removing only the cancerous tumor and a small margin of healthy tissue surrounding it. For about 80 to 85 percent of patients, there is no need to remove the entire breast. If the cosmetic appearance of the remaining breast tissue is within acceptable limits after the tumor is removed, this method is safely applied. Scientific research has proven that breast-conserving surgery performed with the right techniques is no different from complete breast removal in terms of patient survival. Therefore, preserving the breast also contributes significantly to the patient's psychological recovery.

Mastectomy Surgery

Mastectomy is the surgical removal of the entire breast tissue. It is preferred when the tumor has spread over a very wide area in the breast, is found in multiple foci, or is very large relative to the size of the breast. The common belief among patients that "if my entire breast is removed, I will be completely cured of the disease and live longer" is medically incorrect. There is no scientific data showing that patients who undergo a mastectomy live longer. Many patients who request a mastectomy under the influence of early trauma may say "I wish we had listened to you" in the following months. For this reason, patients should not be deprived of the chance to live with their own organs unless it is a medical necessity.

How is the Surgery Decision Made? (Evaluation Process)

After a breast cancer diagnosis, a detailed evaluation process is required to decide on the type and timing of the surgery. The size of the cancerous tissue, its sensitivity to hormone therapies, the division rate of the cells, sensitivity to smart drugs like Herceptin, and whether it has spread to the underarm lymph nodes directly affect this decision. As we emphasised in our article Breast Cancer Risk Factors: Uncontrollable and Modifiable, the biological characteristics of a tumor vary from person to person.

Another common misconception is the belief that chemotherapy will not be necessary if the entire breast is removed. The decision for chemotherapy is not based on the extent of the surgery, but on the tumor profile obtained after 5-7 days of examination in the pathology laboratory. During this process, general surgery, medical oncology, radiation oncology, and pathology specialists come together to map out the most appropriate treatment plan for you.

Pre-Operative and Post-Operative Process

The success of the surgical intervention depends on the meticulous execution of pre-operative preparation and post-operative care. Your doctor will inform you in detail at every stage of this process.

Pre-Operative Preparation

In the days leading up to the surgery, blood thinners must be stopped, and necessary blood tests and ECGs must be performed for anesthesia approval. You will be asked to stop eating and drinking at least 8 hours before the operation. During this period, stress management and psychological support are just as valuable as physical preparation.

Breast Cancer Surgery Recovery Process

The hospital stay after surgery is usually between 1 and 3 days. Thin tubes called "drains" may be placed in the area to remove fluids accumulating in the surgical site. When fluid drainage decreases, these drains are usually removed painlessly during an outpatient clinic check-up within a few days. Avoiding heavy lifting in the first few weeks after discharge and regularly doing the arm exercises prescribed by your doctor will speed up recovery. Most patients can return to their normal daily activities within 3 to 4 weeks.

Possible Complications and Risks

As with any surgical procedure, there are some risks associated with breast cancer surgery. Bleeding, infection, or fluid accumulation (seroma) in the surgical area can occur, though rarely. In cases where underarm lymph nodes are removed, there is a risk of swelling in the arm, known as lymphedema.

Some rules you should follow to minimise the risk of lymphedema include:

• Avoid carrying heavy objects with the arm on your operated side.
• Take care not to have blood drawn or blood pressure measured from that same arm.
• Do not wear tight-fitting clothes or jewelry that constricts your arm.
• Wear protective gloves when gardening or cleaning.
• Regularly perform the recommended lymphatic drainage exercises.

When Should You See a Doctor?

During the recovery process at home after surgery, you need to closely monitor your body's reactions. While mild leakage or slight pain is considered normal, some symptoms may require immediate medical attention.

If you experience any of the following situations, you should go to the hospital without delay:

• A high fever exceeding 38 degrees Celsius (100.4°F) that does not come down,
• Sudden excessive redness, increased warmth, or foul-smelling discharge in the surgical area,
• Sudden and severe swelling in the arm where underarm lymph nodes were removed,
• Shortness of breath, chest pain, or a feeling of palpitations,
• Severe pain that cannot be controlled despite painkillers.

In such emergencies, please dial 112 immediately or visit the nearest emergency room. Our Emergency Medicine department at BHT CLINIC İstanbul Tema Hastanesi is also by your side 24/7 with its expert staff.

The Process at BHT CLINIC İstanbul Tema Hastanesi

At the General Surgery clinic of BHT CLINIC İstanbul Tema Hastanesi, breast cancer surgery is performed at international standards and with a multidisciplinary approach. From the diagnosis of your disease to treatment planning, from surgical intervention to post-operative psychological support, all processes are meticulously managed by our expert medical staff. Our experienced surgeons aim to preserve the natural appearance of the breast while clearing the cancerous tissue using oncoplastic techniques.

Our hospital's operating rooms, equipped with advanced technology, and comfortable patient rooms are designed to ensure you get through your recovery process in the most comfortable way possible. To start your treatment planning and consult with our expert physicians, you can easily book an appointment through our website.

Frequently Asked Questions

How many hours does breast cancer surgery take?

The duration of the surgery varies depending on the surgical technique to be applied. Breast-conserving surgeries, where only the tumor is removed, generally take 1.5 to 2 hours, while surgeries involving mastectomy and simultaneous breast reconstruction can be completed in 3 to 5 hours.

Will there be pain after surgery?

It is normal to feel mild to moderate pain in the surgical area for the first few days after the surgical intervention. This pain can be easily controlled with standard painkillers prescribed by your doctor.

When can I return to normal life?

The vast majority of patients are able to take care of their personal hygiene within 2-3 days after surgery. Returning to desk jobs usually takes 2-3 weeks, while it may be necessary to wait 4-6 weeks for jobs requiring heavy physical activity.

If my entire breast is removed, won't I need chemotherapy?

This is a very common misconception. The decision for chemotherapy is not related to whether the breast is completely removed or not; it is related to biological characteristics such as the type and size of the tumor, its hormone receptor status, and whether it has spread to the lymph nodes.

Will the shape of the breast be deformed after breast-conserving surgery?

Thanks to modern oncoplastic surgical techniques, the breast tissue is reshaped after the tumor is removed. In this way, the natural appearance of the breast is largely preserved, and cosmetically satisfying results are achieved.

This article is for informational purposes only; please consult your doctor for diagnosis and treatment.