My operation in France: Mastectomy
When Sue Caroll, 57, moved to the Creuse in 2010 with husband Jim, 62, she was in remission from breast cancer. However, the cancer returned in 2014. Series by Gillian Harvey
I was first diagnosed with breast cancer in my right breast in 2006, after which I’d had a lumpectomy, chemotherapy and 18 months of Herceptin. I was formally discharged from the Royal Marsden Hospital in London in 2011.
However, in 2014, I noticed changes in my left breast – it was hard to the touch, and the nipple had become inverted.
I made an appointment for a mammogram, which identified a potential mass. Medical staff then carried out a biopsy on both sides, due to my history and symptoms, after which I was diagnosed with cancer in both breasts. I was told to find a gynaecologist to oversee my treatment.
As I hadn’t yet received my Carte Vitale, I panicked. Thankfully, I rang Cancer Support France who calmed me down and even provided a translator to support me.
The consultant at the hospital in Limoges told me that I’d need a mastectomy and removal of lymph-nodes on my right breast and a lumpectomy on my left.
However, before the procedure I was advised to have chemotherapy to shrink the tumour on the left side.
A tiny metal chip was injected into my breast to help attract the chemotherapy, and I went through six rounds of treatment over five months.
Once chemotherapy had finished, I was booked in for a lumpectomy and mastectomy. On the day of my operation, I was admitted at lunchtime and in surgery just a few hours later. The operation itself took about two hours, and I woke attached to a morphine drip, as well as three drains: two on my right side and one on my left.
The drains on the left side were taken off the following day, but those on the right stayed in for five days. After two days, I was taken off a morphine drip, but my pain was managed superbly.
Unfortunately, I developed a problem with my arm, which became hard to the touch. A scan to check for blockages came back clear and so I was given regular massages to improve my circulation.
A week after the operation, I was discharged. Before leaving hospital, I was given gel dressings to apply on my front and back, held on with a kind of “boob tube” dressing. I also had two weeks of daily blood-thinning injections and a blood test every five days for a month. After six weeks, I saw my surgeon.
One thing that surprised me was I wasn’t offered physio, which was standard in the UK. But I remembered exercises from last time... and started doing them in hospital!
Two months after the operation I began having daily radiotherapy on my left breast. This went on for six weeks, during which I’d see a doctor every week, and the consultant once a month.
After my treatment finished, I was told I would be monitored regularly. For the following two years, I saw a specialist (either the gynaecologist, the oncologist or radiologist) every four months and then my appointments became six-monthly. I was also prescribed Létrozole – an anti-oestrogen drug – for five years.
I hope to undergo reconstruction but have been advised to lose 15kg beforehand. I’m seeing a dietician for support and advice.
Cancer Support France supports English-speaking cancer sufferers and their families in France.
FACTS ON A MASTECTOMY by Dr Betty Lauratet, Gynaecologist/Obstetrician, Clinique Geoffroy Saint-Hilaire
When might a mastectomy, rather than a lumpectomy, be performed?
Lumpectomy is a less-invasive treatment for breast cancer; it should always be carried out with radiotherapy to avoid relapse. A mastectomy might be recommended for certain types of cancer. Mastectomy might also be the chosen course of action if the patient cannot undergo radiotherapy for health reasons, has already undergone a lumpectomy with radiotherapy, or if chemotherapy has had no effect. Mastectomies are also offered to women with the BRCA gene mutation.
How long does the procedure take?
A mastectomy operation lasts between one and two hours. It depends on the size of the breast and whether additional exploration is carried out.
What happens afterwards?
Recovery is straightforward. A patient is usually up and about within 48 hours. The length of time in hospital is usually between three and five days, after which the patient can return home. The dressing is changed every 48 hours by a nurse, until no longer necessary.
When is reconstruction offered?
Immediate breast reconstruction is sometimes offered: for example, with a small lesion, less than 1cm, together with negative lymph nodes, if the surgery is preventative or if radiotherapy has already been administered.
However, with some cancers, or if the nodes are affected, it may be necessary to carry out reconstruction later.
Are there any side-effects?
Some patients refuse reconstruction and as such have an altered body image. There is also the risk of scarring. Some patients suffer swelling of the arms, tingling sensations in the arm, or limited movement after lymph nodes have been removed.