Surgery for Locally Advanced Breast Cancer
Surgery is planned with systemic treatment and radiotherapy, according to tumour extent, subtype and response.
The key things to know
- Extent, response and subtype guide the operation.
- Radiotherapy can influence reconstruction choices.
Surgery within a treatment sequence
Many locally advanced cancers receive medicines first, followed by reassessment for an operation. Some situations allow surgery earlier. Stage, receptors, skin involvement and lymph nodes determine the sequence; tumour size alone is not the only consideration.
Selecting the operation
Mastectomy may be required, while selected patients may become eligible for breast conservation after a response. Inflammatory breast cancer has distinct considerations and is not managed like an ordinary localised lump. The surgeon explains lymph-node surgery, margins and possible additional procedures.
Skin, reconstruction and radiotherapy
Affected tissue must be removed with a safe wound-closure plan. Skin condition and planned radiotherapy influence reconstruction type and timing; delayed reconstruction may be appropriate. Discuss the likely appearance, aesthetic flat closure and later options before the operation.
After the operation
Pathology shows residual disease, margins and nodes, helping guide subsequent treatment. Recovery includes wound care, shoulder movement and monitoring for arm problems. A favourable surgical result does not automatically remove the need for other planned treatment; each step is reviewed for benefit.
Take these questions to your appointment
- Why is mastectomy or breast conservation best for me?
- Is immediate or delayed reconstruction more appropriate, and why?
Sources & review
This is original educational content based on the sources below, not reproduced textbook material. Website supervisor: Dr. Nizar Ismail. Individual medical review of this article is pending.
This information cannot replace diagnosis or a personal treatment plan. Consult your care team about symptoms or decisions about your treatment.