MED0001664328 This website contains imagery which is only suitable for audiences 18+. Any surgical or invasive procedure carries risks. Read more here
MED0001664328 This website contains imagery which is only suitable for audiences 18+. Any surgical or invasive procedure carries risks. Read more here
At Gold Coast Breast Centre, we approach breast cancer surgery with a compassionate and patient-centred philosophy. Dr Maree Kekeff understands that breast cancer diagnosis and surgery can be an emotionally and physically challenging experience for patients. Our focus is on providing a supportive environment where patients feel heard, understood, and fully informed about their options. We aim to provide personalised care using the most appropriate surgical methods tailored to each patient’s specific needs and medical condition.
Our philosophy is based on transparent communication throughout the process, from initial consultation to recovery. We prioritise the patient’s health and well-being while considering the long-term implications of the surgery. Our team ensures that every patient has a clear understanding of the procedures involved and the steps that follow. We work collaboratively with a multidisciplinary team including oncologists, radiologists, pathologists and other healthcare professionals to develop a treatment plan that aligns with the patient’s goals and ensures the most appropriate approach to managing the cancer.
We understand that breast cancer surgery is not just about the physical aspects but also about managing the emotional and psychological effects. Our aim is to provide a holistic approach to treatment that respects the patient’s needs, ensuring that they are fully supported at every stage of their journey.
Breast cancer surgery refers to any surgical procedure aimed at treating or managing breast cancer by removing tumours or affected tissue. Surgery is often the first step in treating breast cancer and is typically followed by other treatments like chemotherapy, radiation, or hormone therapy. The type of surgery performed depends on the size, location, and stage of the cancer, as well as the patient’s overall health and preferences. Surgical options may include Lumpectomy, also known as Wide Local Excision (removal of the tumour and some surrounding tissue), Mastectomy (removal of the entire breast in different techniques) and commonly Lymph Node Procedures to assess possible tumour spread.
Some of the surgeries are essential for patients who have breast cancer or for those at a significantly high risk due to genetic factors, such as having a BRCA1 or BRCA2 gene mutation. For risk reducing or prophylactic surgery, a patient should be carefully counselled, informed and given the option to attend genetic counselling before committing to any major procedure.
Breast cancer surgeries are tailored to each individual case, with the approach determined by various factors, such as the tumour’s size, its spread to nearby tissues, and the patient’s personal goals. For some, a lumpectomy may be enough to remove the cancerous cells, while others may need a more extensive Mastectomy procedure. In some instances, reconstructive surgery may be performed during the Mastectomy to reshape the breast, although the primary goal of breast cancer surgery is to remove cancerous tissue and lower the risk of recurrence. Post-surgery treatments, such as chemotherapy or radiation, may be necessary to ensure that any remaining cancer cells are targeted and eliminated.
There are several types of breast cancer surgeries, and the choice of procedure depends on the specific needs of the patient and the nature of the cancer. The most common procedures include:
A Lumpectomy, also known as breast-conserving surgery, involves the removal of the tumour and a small margin of surrounding tissue, leaving most of the breast intact. This procedure is suitable for early-stage cancers that have not spread extensively and allows for a more conservative approach. The goal of a Lumpectomy is to remove the cancerous tissue while preserving as much of the breast and its shape. Additional treatments, such as radiation therapy, may be recommended after surgery to reduce the risk of recurrence.
This procedure usually accompanies a Lumpectomy. It allows the use of the patient’s own fat/skin nearby to fill in the space the Lumpectomy has left. This gives the patient more options to conserve their breast with larger tumours.
A Mastectomy involves the removal of the entire breast tissue, sometimes including the nipple and areola. This procedure is typically recommended when the cancer is widespread or when there is a high risk of recurrence. There are different types of Mastectomies, including Simple (total) Mastectomy, Nipple Sparing Mastectomy and Skin Sparing Mastectomy. These procedures usually involve the removal of lymph nodes.
If a breast cancer has the potential to spread to the lymph nodes, though no imaging or examination has demonstrated spread, this procedure is used to sample 1-3 nodes (sometimes more) to rule out any spread on the same side as the breast cancer. This can change further treatment and the stage of the cancer.
In some cases, when the cancer has been confirmed to have spread to the lymph nodes under the arm we perform an axillary lymph node dissection, this is removing a group of lymph nodes from the armpit area to assess the nodes and determine how many are involved.
Each of these surgical procedures is performed based on the stage and location of the cancer, as well as the patient’s overall health and preferences. The goal is to remove the tumour and surrounding tissue as completely as possible to prevent the cancer from spreading further.
Total Mastectomy, also known as Simple Mastectomy, involves the removal of the entire breast tissue, along with the skin and commonly the nipple and areola. This procedure is typically performed when the tumour is large or cancer has spread throughout the breast tissue. This method is commonly recommended when a more conservative surgery would not effectively remove all cancerous cells. For some patients, Total Mastectomy may also be part of a treatment plan that includes chemotherapy or radiation therapy to address any remaining cancer cells after surgery.
Nipple-Sparing Mastectomy involves removing the breast tissue while preserving the skin, nipple, and areola. This method is typically used for patients with breast cancer where the skin/nipple is not involved. It is also commonly performed in risk reducing procedures. It is an increasingly popular option as it offers a more natural look, especially when reconstruction is planned immediately. Nipple-sparing mastectomy can be a good choice for patients who wish to maintain the appearance of their breasts after the procedure.
However, not all patients are suitable candidates for Nipple-Sparing Mastectomy. This method requires careful evaluation of the patient’s health and the location and size of the tumour. For patients at higher risk of cancer recurrence, this method may not be appropriate. Additionally, patients should be aware that while the nipple and areola may be preserved, they may not have full sensation in the area following the procedure.
In some cases, patients may opt for a Skin-Sparing Mastectomy, where the skin over the breast is preserved, allowing for immediate breast reconstruction. The nipple and areola are sacrificed. This can be for multiple reasons. It can be used if the nipple/areola is involved or if the patent’s breasts are too large or sag too much to allow for an implant reconstruction. This allows for a reduction in the skin and lifts the breast for a safer implant reconstruction.
Immediate implant reconstruction is the common approach performed by Dr Maree Kekeff. A more complex procedure can be considered called an autologous reconstruction (patient’s own tissue) or DIEP (Deep Inferior Epigastric Perforator) flap surgery. This procedure is done alongside a microscopic Plastic and Reconstructive surgeon.
The latter procedure if far more complex and lengthier and requires a review and consult with the other surgeon before it can be considered.
After breast cancer surgery, recovery time and aftercare vary depending on the type of surgery performed and the patient’s overall health. Following a Lumpectomy or Mastectomy, patients will need to rest and avoid strenuous activity for several weeks to allow the body to heal. For mastectomy patients, drains may be placed to help with fluid drainage from the surgical site, and patients may be instructed to wear a compression garment to help reduce swelling. In cases of lymph node removal, patients may also need to manage any swelling or discomfort in the arm or chest area.
Post-operative care includes regular follow-up appointments to monitor the healing process and address any complications that may arise, such as infection or excessive swelling. Patients will also be guided on the most suitable approach for resuming normal activities, including when to return to work, exercise, or other physical tasks. Breast cancer surgery is a major procedure that requires time and patience for recovery, with gradual adjustments to daily activities. Ongoing support from the medical team plays an important role in the healing process, which may include follow-up care, counselling, or rehabilitation services if needed.
After a Mastectomy, patients can expect a recovery period that includes monitoring for infection, managing pain, and addressing any complications. The recovery process typically involves staying in the hospital for one or two days after the procedure, although some patients may recover on an outpatient basis. Following all post-operative care instructions is essential, including keeping the surgical site clean and avoiding activities that may stress the area.
If breast reconstruction is part of the treatment plan, recovery times may vary depending on the type of reconstruction used. Your medical team will provide detailed guidance on physical activity restrictions and timelines for returning to work or other regular activities.
As with any surgery, there are risks associated with breast cancer surgery. These include:
These risks are considered during the planning and consultation stages, with Dr Maree Kekeff ensuring that patients are well-informed about potential complications. While these risks are present, following the recommended aftercare and attending follow-up appointments helps to manage and minimise these issues.
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