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Surgery Choices for Women with Early-Stage Breast Cancer
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    Posted: 10/22/2004



Introduction






Step 1: Talk with your surgeon






Step 2: Learn the facts






Step 3. Find out about your surgery choices






Step 4: Compare your choices






Step 5: Think about what is important to you






Step 6: Make your choice






Resources to Learn More



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Step 2: Learn the facts

Stages of Breast Cancer

Doctors talk about stages of cancer. This is a way of saying how big the tumor is and how far it has spread. If you are unsure of the stage of your cancer, ask your doctor or nurse. Here are the stages of breast cancer discussed in this book:

  • Stage 0: This means that you either have DCIS or LCIS.
    • DCIS (Ductal Carcinoma In Situ) is very early breast cancer that is often too small to form a lump. Your doctor may refer to DCIS as noninvasive cancer.
    • LCIS (Lobular Carcinoma In Situ) is not cancer but may increase the chance that you will get breast cancer. Talk with your doctor about treatment options if you are diagnosed with LCIS.
  • Stage I: Your cancer is less than 1 inch across (2 centimeters) or about the size of a quarter. The cancer is only in the breast and has not spread to lymph nodes or other parts of your body.
  • Stage IIA:
    • No cancer is found in your breast, but cancer is found in the lymph nodes under your arm; or
    • Your cancer is 1 inch (2 centimeters) or smaller and has spread to the lymph nodes under your arm; or
    • Your cancer is about 1 to 2 inches (2 to 5 centimeters) but has not spread to the lymph nodes under your arm.
  • Stage IIB:
    • Your cancer is about 1 to 2 inches (2 to 5 centimeters) and has spread to the lymph nodes under your arm; or
    • Your cancer is larger than 2 inches (5 centimeters) and has not spread to the lymph nodes under your arm.
  • Stage IIIA:
    • No cancer is found in the breast, but is found in lymph nodes under your arm, and the lymph nodes are attached to each other; or
    • Your cancer is 2 inches (5 centimeters) or smaller and has spread to lymph nodes under your arm, and the lymph nodes are attached to each other; or
    • Your cancer is larger than 2 inches (5 centimeters) and has spread to lymph nodes under your arm.

About Lymph Nodes

Lymph nodes are part of your body's immune system which helps fight infection and disease. Lymph nodes are small, round, and clustered (like a bunch of grapes) throughout your body.

Axillary lymph nodes are in the area under your arm. Breast cancer may spread to these lymph nodes even when the tumor in the breast is small. This is why most surgeons take out some of these lymph nodes.

Lymphedema is a swelling caused by a buildup of lymph fluid. You may have this type of swelling in your arm if your lymph nodes are taken out with surgery or damaged by radiation therapy. Here are some facts to know:

  • Lymphedema can show up soon after surgery. The symptoms are often mild and last for a short time.
  • Lymphedema can show up months or even years after cancer treatment is over. Often, lymphedema develops after an insect bite, minor injury, or burn on the arm where your lymph nodes were removed. Sometimes, this can be painful. One way to reduce the swelling is to work with a doctor who specializes in rehabilitation or a physical therapist.

Sentinel lymph node biopsy is surgery to remove as few lymph nodes as possible from under the arm. The surgeon first injects a dye in the breast to see which lymph nodes the breast tumor drains into. Then, he or she removes these nodes to see if they have any cancer. If there is no cancer, the surgeon may leave the other lymph nodes in place. This surgery is new and is under study in clinical trial (research studies with people who have cancer). Talk with your surgeon if you want to learn more.

For ways to find out more about lymphedema, look in "Resources to Learn More."

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