Once you have been diagnosed with breast cancer, your cancer doctor will discuss treatment options with you. There are many types of breast cancer, and the treatments are generally tailored to the type of breast cancer. There are several surgical options.
Breast cancer treatments are tailored to the individual woman.
Some breast cancer treatments change the appearance of the breast.
Reconstructive surgery may help with how your breast looks after cancer surgery.
Breastfeeding is possible after breast cancer surgery. Breastfeeding during chemotherapy is not safe for the baby.
Plus, there is radiation therapy, chemotherapy, hormone therapy, targeted therapy, and immunotherapy to treat breast cancer. It’s important to know that your breasts can change during the treatments and after breast cancer, including if you are breastfeeding.
Breast changes with treatments
Some of the treatments for breast cancer can cause changes to the appearance of your breasts. Other treatments do not. Surgery and radiation do change the appearance of your breasts.
There are several types of surgery for breast cancer. One type of surgery does not remove the entire breast. This type of surgery removes only the area where the cancer is located and it has many names. They are:
- Breast-sparing surgery
- Partial mastectomy
A total or simple mastectomy removes the entire breast, the nipple, and the areola (the dark area around the nipple). Some lymph nodes may be removed and checked for cancer. This can be done at the same time as the mastectomy or it can be done later through a separate incision, closer to the armpit.
A modified radical mastectomy removes the entire breast like a total mastectomy, and most of the lymph nodes in your armpit are also removed.
2. Radiation therapy
Radiation therapy involves high-energy X-rays, protons, or other particles. Radiation therapy is delivered directly to the area where the cancer was removed during your lumpectomy. The radiation kills any remaining cancer cells and is often as effective after a lumpectomy as having a total mastectomy.
Radiation therapy can also be used in cases where surgery cannot be performed.
Chemotherapy is a therapy that uses drugs designed to kill or shrink cancer cells. There is a long list of medications for breast cancer. Some can be taken by mouth and others are injected into a vein (IV therapy). Chemotherapy is sometimes used to shrink the tumor before surgery.
4. Hormone therapy
Some types of breast cancer depend on the female hormones of estrogen and/or progesterone for growth. There are several types of hormone therapies. Most hormone therapies either reduce the amount of estrogen in your body or prevent estrogen from reaching the cancer cells, which stops the growth of the tumor.
Hormone therapy is usually taken after surgery for some time to prevent cancer from coming back.
5. Targeted therapy
Targeted therapy uses a variety of substances that target and attack specific cancer cells. These therapies are less harmful to non-cancer cells than some of the other breast cancer treatments.
Your immune system gets a boost or support to help fight cancer cells. Some of these therapies use substances that your own body makes, or they are made in a lab.
Changes to breasts after treatments
If you choose to have a lumpectomy you may notice only a small change in how your breast looks. There will be a scar and often a dent and there might be some dimpling around the scar. If the lumpectomy changes your breast shape significantly, you might consider reconstructive surgery. Plastic surgeons generally recommend waiting for at least a year to allow healing to be complete. During this time, the scarred area may fill in and reconstructive surgery might not be needed.
Some women are not concerned with their appearance after the area has healed and decide to stay flat. This is sometimes related to the size of the breasts before surgery. Some women choose not to have any further surgery and prefer to use a prosthesis that fills the bra and bathing suit.
There are many things to consider when thinking about reconstructive surgery whether following a lumpectomy or mastectomy.
You will have scars from both the original surgery and the reconstructive surgery. Tissue can be taken from your back, abdomen, and buttocks to create a new breast or fill in the lumpectomy scar. The areas where the tissue was removed may also create a scar and change the shape of that area.
The new breast will feel different because it is not made of breast tissue, but it will appear more like your original breast.
The skin may change color after radiation therapy. Sometimes it looks sunburned or may appear darker or have a blue or black tinge. The area must be protected from the sun. Clothing or a high-SPF sunscreen is recommended to prevent sun damage.
With a lumpectomy, much of the breast tissue remains and the effects of radiation can wear off over time. If the lumpectomy was well before your pregnancy, chances are good that you can breastfeed from the breast that had the lumpectomy. The remaining breast tissue might not produce as much milk as the other breast, but it will most likely produce colostrum, which is so good for your baby. If the breast with the lumpectomy does not produce much milk, you can breastfeed exclusively from the other breast.
For moms who previously had a mastectomy, you can breastfeed exclusively from one breast.
Breastfeeding and breast cancer treatment
It is not safe to breastfeed during chemotherapy and may not be safe during hormonal and other therapies. Check with your oncologist (cancer doctor) to see if you can pump and discard your breastmilk during this time and resume or start breastfeeding once your oncologist says it is safe.
Treatment for breast cancer can cause changes to your breasts, both during the treatment phase and afterward. If you have concerns, see your healthcare provider.