“I have been told that the lump in my breast is cancer this morning. My doctor told me that I should get operated immediately or else my cancer will spread. Surgery has been scheduled for tomorrow. I am worried that it might spread by then”

Date :31/08/18 Writen By : Dr. Selvi Radhakrishna

This kind of knee jerk reaction surgery happens very commonly in our Country.

While we cannot afford to lose too much time to decide and plan treatment, there is no urgency in removing the lump or the breast in an unplanned fashion.

The diagnosis has to be ascertained by tests that will include mammogram, breast ultrasound and a core biopsy from the lump. Mammogram and ultrasound are useful tests that help us in diagnosis and planning of surgery. A well done mammogram and ultrasound should map out the extent of the disease to plan complete or partial removal of the breast and the need for axillary lymph node clearance. Sometimes a breast MRI is also done to add to information.

In very young people or patients with strong family history, we may consider genetic testing at this time. The results of this test also influence the management of the disease.

Additional tests may be required to assess general health and to stage the disease. These tests take a few days to organize. Besides the window of time available is useful to get as much information as possible and understand the options of treatment available. Repeated visits with your consultant doctor and specialist nurse will be required to clarify doubts and then go ahead with the treatment.

The clarity in diagnosis and available options of treatment helps the patient to choose and accept the treatment and its outcomes. It is definitely easier to cope with treatment with a complete understanding of what’s going on.

An unplanned surgery often spoils the chance to preserve the breasts and axillary lymph nodes. Removal of all the lymph nodes when it is not necessary may add to the risk of arm swelling after treatment. Reoperations may become essential adding to stress, time and money.

In most developed countries, there is usually a waiting time to get appointments to see a doctor, schedule tests and arrive at a plan of action. Sometimes this can be distressing when it is too long a wait but generally within reasonable time everything gets sorted out. In our country, especially in private practice the specialist’s access is quick and everything gets done in a frenzy with a sense of panic. This situation creates chaos and also does not allow a systematic reasoning and understanding of the disease and its management. The fears and doubts persist when inadequately addressed and cause enormous stress for a long time.

A well-organized private practice in our country can comfortably provide all the information and a plan with a couple of rounds of discussion in about a week to 2 weeks. And it is perfectly safe without the risk of cancer spreading elsewhere in this time frame.

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