Breast Cancer Surgery at North York General

On the day of your surgery, the first place you'll be asked to go is Patient Registration which is located on the ground floor and is just behind me. All patients are required to go here first. After you register at Patient Registration you'll be asked to come up here to Day Surgery and you'll be given all the information that you need. You'll also be helped to prepare for your surgery by changing into any gowns and directed to the waiting area. When a woman is diagnosed with breast cancer commonly the first modality of treatment would include an operation and there are really two common operations that we would do. The first would be a lumpectomy which is where we take the lump with healthy tissue around it, and the second would be a mastectomy. And a mastectomy would be in a situation where the lump might be more extensive in the breast or there may be other circumstances where we feel it's appropriate to recommend a mastectomy. On the day of my surgery I arrived early in the morning as planned and met with the team who were going to be responsible for a lot of my care that day . at the time to identify for the surgeon where the tumor was the radiologist who had performed my biopsy was here to assist with that. The time came for my surgery and I was wheeled out into the hall and I met the anesthetist whose extremely helpful, explained what was going to be happening, what I would likely feel, what I'd feel like after, etcetera. Then my surgeon came out, spoke with me, made a note on my arm so she knew exactly what size she'd be dealing with, introduced me to the nursing team who would be in the operating room with me and away we went. When I woke up in Recovery, my husband was there. The staff in the Recovery Room were extremely attentive, made sure I was warm, comfortable and eventually after not nearly as long as I thought it would take I was well enough to head back home to begin my recuperation. Most women with breast cancer would have to have a procedure to have their lymph nodes checked and the most common technique nowadays is called a sentinel node biopsy. If the cancer has not spread to the first lymph nodes it's unlikely to have gone beyond that. So we use a dye technique where we inject the breast on the day of the surgery. And the dye helps us isolate the first lymph nodes and we would take out only those lymph nodes and test them to see if there's cancer there. That procedure offers a lot less risk than the previous technique where we took out many more lymph nodes and gives us a lot more specific information about the patient's cancer in the lymph nodes. In patients in whom we recommend a mastectomy we counsel them as well as to the option of reconstruction. We can offer reconstruction at the same time as the initial mastectomy in many cases. We also can offer patients delayed reconstruction. Sometimes it's not appropriate to be done at the time of the initial surgery depending on what the patient's treatment might be in terms of chemotherapy or radiation. I had a mastectomy done here. That was a little painful at first to see. Initially it is and after that it's not because again when the news came back and they had got all the cancer out I just forgot all about that part of my my breast because I know too, talking with the doctor there's so much they could do now to build your breast back up in different surgeries. So that you know too is something you look forward to and you just forget about the flat part. Our patients would go home the same day in many cases. Then they are followed up in the office. In my practice I would see them about 10 to 14 days after their surgery and at that point we would have the pathology back. So I would, on that first visit, assess their wound, make sure that everything is healing appropriately. And then I would have a preliminary review of the pathology and give them an indication of what I thought the likely treatment would be. Usually I have already organized an appointment with one of our oncologists so that follows shortly thereafter and a more detailed discussion about their pathology and their options for treatment would occur on that occasion. After you've seen the surgeon, you will likely be referred to the medical oncologist. Sometimes that happens before the actual surgery takes place. Most often it happens after the surgery is completed, whether that be a lumpectomy or a mastectomy. When you meet the medical oncologist, he or she will review the pathology either from the biopsy or from the lumpectomy or mastectomy and many of those features that we get from the pathology that helps us determine the likelihood of recurrence, how aggressive or not the cancer appears to be behaving and that helps us make treatment decisions around whether or not you will require chemotherapy radiation therapy and/or hormonal therapy.