Wide local excision for DCIS: the operation

Most women had surgery shortly after diagnosis. For many, this was the first time they’d had any kind of surgery. Several felt anxious beforehand and found it difficult to sleep, especially the night before. Some said they took extra care of themselves before surgery, eating healthily and exercising in order to be as fit as they could be beforehand. A few women said they prepared themselves psychologically and emotionally by using complementary approaches, including meditation and Neuro-Linguistic Programming.

Before surgery, Carol stopped drinking, cut down on smoking, ate healthily and walked several…

Age at interview 51

Gender Female

Age at diagnosis 51

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Some women said they were worried about having a general anaesthetic. One was anxious about waking up during surgery. Another, who lived alone, wondered whether she’d be able to cope alone at home after having had anaesthetic. One woman, who’d had problems with general anaesthetic before, said she was worried she’d have problems again. Very few women actually do have any serious problems and only one woman we spoke with said she had worrying side effects afterwards

Sandy stayed with a friend after surgery, and that turned out to be just what she needed.

Age at interview 58

Gender Female

Age at diagnosis 58

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Elizabeth, a nurse, said it was only when she developed painful symptoms that she found out she’d…

Age at interview 50

Gender Female

Age at diagnosis 49

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A doctor explains why most women have no need to worry about general anaesthetic.

Gender Male

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At the hospital

Most women said they took a friend, partner or family member, such as a daughter, with them to the hospital. At the hospital, they had a procedure called ‘localisation’, either the day before surgery or on the day of surgery itself, before the operation. Because DCIS can’t be felt, localisation is used to pinpoint the exact area to be removed. A fine wire is inserted into the breast under local anaesthetic using either mammography or ultrasound to make sure that the wire is accurately positioned where the microcalcification is in the breast. This usually takes about half an hour and should not be any more uncomfortable than having a mammogram. Once the wire is in place, it is covered with a comfortable padded dressing and left there until surgery.
Many women talked about their experiences of localisation. A few found the procedure painful, uncomfortable or unpleasant. Several said that they felt anxious afterwards because they had to wait in the hospital for several hours before surgery with a wire in their breast. Having not eaten or drunk anything all day, they were glad to be finally taken to theatre. One woman said that the procedure took longer than expected because the machine broke down, another that several attempts were made to get the wire in place. Some said they would have liked more information beforehand about what would happen in hospital, including information about localisation.

After localisation, Jane waited over an hour to have surgery. She was on her own in a private…

Age at interview 50

Gender Female

Age at diagnosis 49

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Waiting to have surgery made Agnes even more anxious and she had a headache. She would have liked…

Age at interview 54

Gender Female

Age at diagnosis 53

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Hilary hadn’t known anything about localisation beforehand and found it painful.

Age at interview 57

Gender Female

Age at diagnosis 50

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Most women had localisation in the same hospital as their surgery, though two people said they had localisation in one hospital and surgery in another.

Sue felt fine on the day of surgery and was taken by ambulance from the local clinic to the…

Age at interview 50

Gender Female

Age at diagnosis 49

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Sandy had to arrange her own transport from one hospital to another. She said waiting to have…

Age at interview 58

Gender Female

Age at diagnosis 58

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After coming round, although some women said they felt very tired and groggy because of the anaesthetic, most felt well. Only a few were sick and one woman who reacted badly to the anaesthetic said she felt dizzy and disorientated. Another said she had a severe reaction to the drugs she’d been given only after she got home.

Agnes would have liked to know beforehand that shaking and shivering were possible reactions to…

Age at interview 54

Gender Female

Age at diagnosis 53

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Carol was desperate to go home where she could sleep properly. She had vomited because of the…

Age at interview 51

Gender Female

Age at diagnosis 51

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Most women said that, although they were attached to drains at first and needed to take care when moving, they were in no pain at all after coming round, several saying they had very little need for painkillers.

Sue was discharged from hospital a few hours after surgery and had no pain at all. She was back…

Age at interview 50

Gender Female

Age at diagnosis 49

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Some women were on a ward with breast cancer patients, while others were in a mixed ward with men and women who’d had various kinds of surgery. Several said they found the ward noisy, so sleep and rest were often difficult. A few women who had private health care had their own room. One of these women, though, said she asked to have a bed on the ward after surgery because she preferred the company of other patients.

Agnes had very little pain after surgery but was unhappy on the ward. She found it noisy and felt…

Age at interview 54

Gender Female

Age at diagnosis 53

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Because a WLE is a relatively short operation, most women were discharged from hospital either on the same or following day.