Life After Breast Cancer: Navigating Mastectomy, Breast Reconstruction Surgery, and Insurance Support in Recovery
According to the GLOBOCAN[1], breast cancer accounts for 32.9% of newly diagnosed cancer cases in Malaysia.
It is important to comprehend the many forms, signs, phases, therapies, and recovery processes associated with breast cancer. Being armed with the necessary knowledge makes it possible to discover breast cancer early, increasing the chance that treatment will be successful.
We discuss mastectomy as a treatment for this disease, including types, importance, risks, costs, and how insurance can help women with breast cancer.
What is a mastectomy?
A mastectomy refers to surgery used to remove one or both of the breasts. In addition to it being a treatment for breast cancer.
A bilateral mastectomy removes both breasts, whereas a unilateral mastectomy removes just one breast.
Lumpectomy vs mastectomy
Most breast cancer patients can select between two treatment options: mastectomy or a lumpectomy (breast-conserving surgery) with radiation therapy.
A lumpectomy preserves most of the breast by removing only the tumour and a small margin of healthy tissue around it. It is just as successful as a mastectomy for women with localised breast cancer, a tumour less than 4 cm in size, and clean margins (no cancer cells in the tissue around the tumour).
Radiation therapy that is usually used in combination with a lumpectomy has some adverse effects and usually necessitates daily visits to a treatment centre for 1 to 6 weeks. After a mastectomy, some women will require radiation therapy, but the majority won't. If you decide against radiation therapy, ask your doctor for advice.
The doctor or oncologist will discuss the options by taking into account the following:
-
The tumour size.
-
The breast cancer’s location.
-
Whether cancer has spread to several areas.
-
Breasts size.
-
Overall wellbeing.
From the experiences of breast cancer survivors in a study[2], mastectomies are linked to a lower incidence of post-surgical side effects and a lower frequency of chronic pain compared to lumpectomies.
However, mastectomies are associated with poorer levels of cosmetic satisfaction, whereas lumpectomies provide good cosmetic results.
The National Library of Medicine[3] found that it is common for young women with breast cancer to undergo mastectomy treatment in Asian countries. Nonetheless, patients treated with breast-conserving surgery for early breast cancer appear to survive as well as those undergoing mastectomy.
Is mastectomy a major surgery?
Yes, mastectomy is a major surgery as it involves the permanent removal of either one or both breasts. The surgery may take up to four hours, depending on the extent of the malignancy, and the patient will be under general anaesthesia.
Depending on their recovery rate, patients may require a few days in the hospital due to the intense nature of the surgery.
Types of mastectomy
The options for mastectomy surgeries vary depending on the type of cancer.
-
Total (simple) mastectomy involves removing the whole breast, including the nipple, areola, and some overlying skin. The muscle beneath the breast remains intact.
-
Modified radical mastectomy removes the breast together with the nipple, areola, and underarm lymph nodes (axillary lymph nodes).
-
Radical mastectomy involves removing the chest wall muscles behind the breast, the whole breast, and the axillary lymph nodes.
-
Skin-sparing mastectomy removes all breast tissue, nipple, and areola while preserving healthy breast skin and breast reconstruction is performed immediately after following mastectomy.
-
Nipple-sparing mastectomy is the removal of all breast tissue but spares the nipple, areola, and overlying skin. It is similar to a skin-sparing mastectomy, but in this procedure, the nipple and areola are left in place.
-
Double mastectomy removes both breasts and is done as a prophylactic precaution against breast cancer.
Why would a woman get a mastectomy?
Women undergo a mastectomy for various reasons, including the treatment of breast cancer.
Breast cancer is a common female cancer; learn more about cancers that affect women - its types, symptoms, treatments, and help for recovery.
To treat breast cancer
A mastectomy is the most promising therapy option to remove breast cancer cells.
Reasons why women should get a mastectomy:
-
Tumour size.
-
The tumour affects many breast areas.
-
Radiation treatment is not recommended.
Surgery is the main suggested course of treatment if a woman has:
-
Infiltrating ductal carcinoma.
-
Infiltrating lobular carcinoma.
-
Triple-negative breast cancer.
-
Inflammatory breast cancer.
-
Paget’s disease of the breast.
Besides surgery, simple, healthy lifestyle choices can also contribute to cancer prevention efforts, in the sense that they may lower the risk of breast cancer.
What stage of breast cancer requires a mastectomy?
A key consideration when choosing a course of treatment for breast cancer is its stage. The diagnosis of non-invasive ductal carcinoma in situ (DCIS) is known as stage 0, whereas invasive breast cancer is classified into stages I through IV.
A mastectomy may be necessary for Stage II or beyond when breast cancer has spread widely. However, the decision to undergo a mastectomy is influenced by tumour size, location, the presence of multiple tumours, and the women’s preferences and general health.
Does mastectomy remove all breast cancer?
Mastectomy removes some or all of breast tissue. The tumour and a surrounding margin of healthy tissue are removed to lessen the chance of leaving cancer cells behind.
What happens during a mastectomy?
General anaesthesia is used during a mastectomy. The surgeon removes the breast tissue by making an incision around the breast. Extra breast tissue, such as the nipple and axillary lymph nodes, may also be removed, depending on the kind of mastectomy.
After surgery, the incision is sealed with stitches or staples. At a follow-up session, it may occasionally be necessary to remove the stitches.
What happens after a mastectomy?
Following the procedure, you'll be taken to the recovery room. The staff will monitor your blood pressure, respiration, oxygen saturation, heart rate, and body temperature. Doctors may prescribe medications to relieve pain and discomfort.
Initially, the area will be swollen, bruised, and stiff. The healing process for most wounds takes 2-3 weeks, but it might take many months for your arm and chest to completely heal. You will most likely have to stay in the hospital for a few days after the surgery.
Risks & complications of a mastectomy
Some risks and complications linked to a mastectomy include the following:
-
Temporary breast swelling.
-
Breast soreness.
-
Hardness resulting from the formation of scar tissue at the incision.
-
Wound infection.
-
Removed lymph nodes causing swelling (lymphedema) in the arm or chest.
-
Pain felt in the breast after removal (phantom breast pain).
-
Blood clot.
-
Psychological affect.
-
Fluid accumulation (seroma) in the surgical area.
Life after a mastectomy
Life following a mastectomy involves physical recovery, emotional adjustment, and possible decisions about breast reconstruction.
-
Physical recovery: You will have to adhere to the postoperative care guidelines provided and be referred to physical therapy to restore strength and mobility.
-
Emotional adjustment: It might be challenging at first to glance at your physique after surgery. Feelings of being unfeminine or ugly may arise, affecting your confidence and self-esteem.
-
Breast reconstruction: Some individuals may decide to undergo breast reconstruction to restore their breast's appearance.
A study[4] found that all women after mastectomy assessed their health as poor and experienced depression, dejection and sadness.
What is breast reconstruction surgery?
Breast reconstruction surgery restores the shape and appearance of the breast after a mastectomy.
The surgery can be performed during a mastectomy (immediate reconstruction) or at a later date (delayed reconstruction). A delayed reconstruction may occur months or even years later after the mastectomy.
In the final phase of breast reconstruction, a nipple and areola may be recreated on the reconstructed breast.
Types of breast reconstruction surgery
There are several types of breast reconstruction surgery.
-
Implant reconstruction: Reconstructed using saline or silicone gel implants.
-
Autologous tissue (flap) reconstruction: Uses the patient's tissue from other body parts.
Occasionally, a combination of autologous tissue and implants is employed, allowing for increased volume or contouring with an implant.
How long does it take to recover after breast reconstruction?
Depending on the type of reconstruction, the patient's general health, and any extra operations required, the recovery period might differ significantly. However, most women are able to resume their jobs and engage in regular activities after six weeks.
Breast reconstruction surgery cost
Breast reconstruction surgery can cost anywhere from RM12,000 to over RM50,000 in Malaysia.
However, the cost can vary depending on the type of reconstruction, extra services or procedures included in the treatment plan, and other variables. Speak with medical institutions or plastic surgeons directly to receive a precise cost estimate.
Insurance for breast cancer
Health insurance is essential in providing financial support and access to necessary medical care for individuals diagnosed with breast cancer.
PRULady is a personalised critical illness insurance for women that covers female-related needs such as illnesses including treatment for breast cancer. You can be rest assured that you have access treatment without having to worry about your finances, allowing you to focus on your recovery.
Conclusion
It's crucial for individuals facing this decision to discuss their alternatives thoroughly with their doctor or a specialist to make informed decisions based on their specific circumstances.
Check out Prudential's wide range of insurance solutions and financial products such as Medical Insurance | Critical Illness Insurance | Investment-linked Life Insurance | Insurance for Parents | Insurance for Mom & Children
For more on cancer, read:
[1] Breast conserving surgery versus mastectomy: the effect of surgery on quality of life in breast cancer survivors in Malaysia. Available at https://gco.iarc.fr/today/data/factsheets/populations/458-malaysia-fact-sheets.pdf
[2] Choosing Mastectomy vs. Lumpectomy-With-Radiation: Experiences of Breast Cancer Survivors. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555933/
[3] Breast-conserving surgery versus mastectomy in young women with breast cancer in Asian settings. Available at https://pubmed.ncbi.nlm.nih.gov/30734015/
[4] Quality of Life in Women after Mastectomy. Clinical and Social Study. Available at https://pubmed.ncbi.nlm.nih.gov/33813445/