Most doctors believe immediate operation following positive biopsy gives better results than closing the wound and operating again later. Psychologically it may be distressing to a woman to face a second operation.
There has been little improvement in the results of treatment of this condition over the last 30 years, despite enormous advances in treatment of other forms of cancer.
Operation remains the treatment of choice. In the past the operation was a radical mastectomy. This removed the affected breast, a large portion of overlying skin, the underlying muscles of the chest wall and the lymph glands under the arms.
The result is disfiguring and makes it hard to fit a prosthesis (breast substitute) under the clothes.
Despite arguments to the contrary suggesting lesser procedures, removal of the breast and the lymph glands is necessary. It is no longer considered necessary to remove the muscles of the chest wall.
Simple mastectomy (removal of the breast alone followed by radiation treatment to the glands under the arm) is advocated by some as an alternative.
Removal of the lump only, the so called lumpectomy, so as to leave a woman with her breast has, in my opinion, no part to play in the proper management of cancer of the breast. The risk of local recurrence is so high, about 60 per cent, that it is not justified.
Apart from operation there is often need for radiation treatment either in the initial treatment of breast cancer or in treatment of recurrences or spread of the tumor.



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