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Possible side effects of mastectomy and lumpectomy include wound infection, hematoma (accumulation of blood in the wound), and seroma (accumulation of clear fluid in the wound).

If axillary lymph nodes are removed, a condition called lymphedema may develop which involves swelling and tightness of the arm on the affected side. This condition occurs in 25% to 30% of women who undergo removal of the lymph nodes in this area. Sometimes the swelling is temporary lasting only a few weeks. Sometimes, however, the swelling persists.

Other side effects may include temporary or permanent limitations in arm and shoulder movement, and numbness of the skin on the upper, inner arm (resulting from damage to the nerve that controls sensation in this area).

Breast Reconstruction

Some women are comfortable wearing a prosthetic to achieve a more natural appearance under clothing following removal of a breast. However, some prefer to undergo reconstruction of the breast which is a surgical procedure to rebuild the breast contour and if desired, the nipple and the areola.

Generally, breast reconstruction is completed in 3 stages over 6-8 months. This initial surgery forms the breast mound without a nipple. Further surgery refines the shape and size and creates nipples. Tattooing is used to create the appearance of the areola.

Breast reconstruction may be performed immediately after mastectomy (which may result in better cosmetic results) or can be delayed months or even years.

In general, there are two methods for performing breast reconstruction:

• Implants - Implants filled with saline or silicone are placed under the skin to provide shape and volume. The first step involves placement of a tissue expander under the chest muscles which are gradually inflated with saline over a period of weeks to gently stretch the skin and muscles. A later surgical procedure in performed to replace the expanders with implants. Implants are not permanent and must eventually be removed or replaced anywhere from 1 to 15 years after reconstruction.

• Muscle Flap - This procedure entails using skin and fatty tissue from the back, buttocks or abdomen to surgically recreate the breast. Because the procedure uses the person's own tissue, it feels and moves more naturally, however, the surgery is complex and requires significant recovery time. Additional surgery refines the breast shape and creates the nipple.

Radiation Therapy

Radiation therapy is treatment with high-energy rays that destroy cancer cells. This treatment may be used to destroy cancer cells that remain in the breast, chest wall, or underarm area after surgery. In some cases, the area treated by radiation therapy may also include supraclavicular lymph nodes (nodes above the collarbone) and internal mammary lymph nodes (nodes beneath the sternum or breast bone in the center of the chest).

Radiation therapy is usually recommended after mastectomy if:

• The tumor is larger than 5 centimeters
• The area around the tissue that is removed (margin) is positive for cancer
• Four or more lymph nodes are involved
• The cancer is present in more than one location within the breast

When given after surgery, radiation is usually delayed for several weeks to allow time for healing of the incision and surrounding tissues. Radiation therapy is usually delayed until chemotherapy is complete.