Breast Surgery

Dr Donaldson and Dr Ng are part of a team of specialists at St Andrew’s Hospital involved in the multidisciplinary management of breast cancer patients. This team includes oncologists, radiologists, pathologists, breast care nurses and allied health professionals who are all dedicated to achieving the best outcome for each patient.

Every case is discussed at a multidisciplinary team meeting and each specialist is able to provide up-to-date recommendations in their field of specialty. This approach facilitates communication between the different specialties and has been shown to improve patient outcomes. Your surgeon will inform you of the formal recommendations that have been discussed at these meetings.

Surgery to remove breast cancer has evolved dramatically in the past few decades. It can involve either a wide local excision (breast-conserving surgery) with subsequent radiation to the remaining breast or removal of the entire breast (mastectomy).

Each approach can be accompanied by a variety of reconstructive techniques to achieve safe oncological results and excellent cosmetic outcomes. The decision on which approach to undertake varies significantly from patient to patient and your surgeon will be able to discuss the available options with you during your consultation.

If breast cancer spreads, it usually involves the lymph nodes in the armpit first. At the time of surgery, some or all of the lymph nodes may need to be removed depending on your circumstance.

Removal of the first draining lymph nodes in the armpit is known as a sentinel lymph node biopsy. You will be required to undergo a specialised scan (lymphoscintigraphy) prior to your operation where a radiolabelled dye is injected into your breast. This will allow reliable identification of the lymph nodes that require removal during your operation.

In some cases, where there is known cancer within the lymph nodes, an axillary clearance may be required during which all the lymph nodes within the armpit are removed.

Some women will require or choose to have a mastectomy as part of their breast cancer treatment. This can be confronting for the woman and her family. Research has shown that breast reconstruction after a mastectomy has a positive impact on patient outcome and can be done either at the time of the mastectomy (immediate) or at a later date (delayed) after post-operative treatment has been completed.  

Breast reconstruction can be performed using a prosthetic device (permanent implant or tissue expander) or your own tissue (autologous flap). More information can be provided by your surgeon during your consultation.