BREAST SURGERY
Lumpectomy with Sentinel Lymph Node
A lumpectomy is a surgery done to remove a cancerous lump from the breast while leaving the rest of the breast intact. A sentinel lymph node biopsy is a procedure that may be done at the same time as the lumpectomy. It allows your surgeon to find and remove the first lymph node or nodes under the armpit that receives the lymph drainage from the cancer in the breast, thus preventing the spreading of cancer to the rest of the body.
Mastectomy
A mastectomy is an operation to remove the entire breast. It is usually used as a treatment for breast cancer. It may also be used as a way to reduce the risk of cancer developing in the breast. This is known as a prophylactic mastectomy and is an option for those with an increased risk of developing breast cancer.
Lumpectomy with Sentinel Lymph Node
Lumpectomy with Sentinel Lymph Node
Overview
A lumpectomy is a surgical procedure for removal of a cancerous lump from the breast. A sentinel lymph node biopsy is a procedure that may be done at the same time, which involves your surgeon locating and removing the first lymph node or nodes under the armpit that receives the lymph drainage from the breast. These lymph nodes are called the sentinel lymph nodes. By removing the sentinel lymph nodes, your oncology team can tests whether or not the cancer has spread and possibly prevent the spreading of cancer to other parts of the body through the lymphatic system.
Indications
A lumpectomy and sentinel lymph node biopsy is done as part of cancer treatment. It involves removing the tumour from the breast. In addition it is beneficial to do a sentinel lymph node biopsy. As an alternative an axillary node dissection may be done with the lumpectomy to remove all of the lymph nodes under the armpit.
What happens during a lumpectomy and sentinel lymph node biopsy?
Once under general anesthesia, an incision is made near the lump and the lump is removed as well as a small margin of the surrounding tissue. The rest of the breast is left intact.

Next a radioactive dye is injected into the bloodstream. Using a hand-held detector, this dye will help Dr Heyns identify the first lymph nodes to which cancer cells are likely to spread from the breast tumor. Through a small incision in the armpit, the nodes containing the dye will be removed. The sentinel nodes will be examined in theatre by an anatomical pathologist. If there are cancer cells present in the lymph nodes Dr Heyns will remove the remaining lymph nodes in the armpit before you have chemotherapy or radiation therapy.
What to expect after surgery
When waking from anaesthesia, you can expect some pain and tenderness in the particular breast and in your armpit. Pain relievers will be prescribed to make you comfortable. You will only need to stay in hospital for a day or two before you will be discharged. Dr Heyns will talk to you about caring for your incisions after surgery and any restrictions of activity, but recovery usually takes a week or two.
Mastectomy
Mastectomy
Overview
A mastectomy is an operation done to remove the entire breast as treatment for breast cancer. A mastectomy involves the removal of all the breast tissue, the nipple and the lymph nodes. A mastectomy may also be preventative, done for those with a high risk of developing breast cancer. This is known as a prophylactic mastectomy.
Indications
A mastectomy is generally advised for those with early-stage as well as locally advanced breast cancer after chemotherapy. A mastectomy may be done to remove one breast (unilateral mastectomy) or both breasts (bilateral mastectomy). Depending on your specific treatment plan, chemotherapy and radiation therapy may form part of treatment prior to or after surgery.
What happens during a mastectomy?
Before having a mastectomy you will have the opportunity to discuss the operation with your surgeon, Dr Heyns. He will explain the different types of mastectomies which include:
  • A radical mastectomy
    this involves the complete removal of the breast, including the nipple, the overlying skin, the muscles beneath the breast and the lymph nodes.
  • A modified radical mastectomy
    this involves removing the entire breast along with the lymph nodes, leaving the chest muscles and possibly the overlying skin intact. This means a breast reconstruction can be done afterward.
  • A skin-sparing mastectomy
    with this type your surgeon will remove all the breast tissue, the nipple, and the areola while saving most of the skin over the breast. A breast reconstruction is then also possible afterwards.
  • A nipple-sparing mastectomy
    here the breast tissue is removed, cutting under and around the nipple and areola, leaving the skin of them intact. This method also calls for reconstruction right after the mastectomy.

    The type of surgery recommended for you will depend on things such as how much the cancer has spread. Depending on your specific case, he will provide you with the information needed to make a decision.

    All types of mastectomy use general anaesthesia and involve making an incision either diagonally or horizontally across your breast so that the breast tissue can be removed. Thereafter, depending on the type of surgery, the breast tissue is removed.

    After your breast has been removed, you may choose to have a breast reconstruction. This is done by a plastic surgeon accompanying Dr Heyns and involves creating an artificial breast to replace the breast or breasts that have been removed. It is sometimes possible for a breast reconstruction to be carried out at the same time as a mastectomy, but it can be delayed until a later date if necessary.
What to expect after surgery
A mastectomy is a rather serious procedure with physical and emotional side-effects. After surgery you will be kept for observation in hospital for the next day or two. During this time you can expect pain in your chest and under your arm. Pain relievers will be prescribed to make you comfortable. Before being discharged Dr Heyns will instruct you on how best to care for yourself and restrictions of movement. If you have had a breast reconstruction done your plastic surgeon will also see you to discuss these aspects. You will need to rest for the next 2-3 weeks.
Click on the sections here above for more details
Lumpectomy with Sentinel Lymph Node
Overview
A lumpectomy is a surgical procedure for removal of a cancerous lump from the breast. A sentinel lymph node biopsy is a procedure that may be done at the same time, which involves your surgeon locating and removing the first lymph node or nodes under the armpit that receives the lymph drainage from the breast. These lymph nodes are called the sentinel lymph nodes. By removing the sentinel lymph nodes, your oncology team can tests whether or not the cancer has spread and possibly prevent the spreading of cancer to other parts of the body through the lymphatic system.
Indications
A lumpectomy and sentinel lymph node biopsy is done as part of cancer treatment. It involves removing the tumour from the breast. In addition it is beneficial to do a sentinel lymph node biopsy. As an alternative an axillary node dissection may be done with the lumpectomy to remove all of the lymph nodes under the armpit.
What happens during a lumpectomy and sentinel lymph node biopsy?
Once under general anesthesia, an incision is made near the lump and the lump is removed as well as a small margin of the surrounding tissue. The rest of the breast is left intact.

Next a radioactive dye is injected into the bloodstream. Using a hand-held detector, this dye will help Dr Heyns identify the first lymph nodes to which cancer cells are likely to spread from the breast tumor. Through a small incision in the armpit, the nodes containing the dye will be removed. The sentinel nodes will be examined in theatre by an anatomical pathologist. If there are cancer cells present in the lymph nodes Dr Heyns will remove the remaining lymph nodes in the armpit before you have chemotherapy or radiation therapy.
What to expect after surgery
When waking from anaesthesia, you can expect some pain and tenderness in the particular breast and in your armpit. Pain relievers will be prescribed to make you comfortable. You will only need to stay in hospital for a day or two before you will be discharged. Dr Heyns will talk to you about caring for your incisions after surgery and any restrictions of activity, but recovery usually takes a week or two.
Mastectomy
Overview
A mastectomy is an operation done to remove the entire breast as treatment for breast cancer. A mastectomy involves the removal of all the breast tissue, the nipple and the lymph nodes. A mastectomy may also be preventative, done for those with a high risk of developing breast cancer. This is known as a prophylactic mastectomy.
Indications
A mastectomy is generally advised for those with early-stage as well as locally advanced breast cancer after chemotherapy. A mastectomy may be done to remove one breast (unilateral mastectomy) or both breasts (bilateral mastectomy). Depending on your specific treatment plan, chemotherapy and radiation therapy may form part of treatment prior to or after surgery.
What happens during a mastectomy?
Before having a mastectomy you will have the opportunity to discuss the operation with your surgeon, Dr Heyns. He will explain the different types of mastectomies which include:
  • A radical mastectomy
    this involves the complete removal of the breast, including the nipple, the overlying skin, the muscles beneath the breast and the lymph nodes.
  • A modified radical mastectomy
    this involves removing the entire breast along with the lymph nodes, leaving the chest muscles and possibly the overlying skin intact. This means a breast reconstruction can be done afterward.
  • A skin-sparing mastectomy
    with this type your surgeon will remove all the breast tissue, the nipple, and the areola while saving most of the skin over the breast. A breast reconstruction is then also possible afterwards.
  • A nipple-sparing mastectomy
    here the breast tissue is removed, cutting under and around the nipple and areola, leaving the skin of them intact. This method also calls for reconstruction right after the mastectomy.

    The type of surgery recommended for you will depend on things such as how much the cancer has spread. Depending on your specific case, he will provide you with the information needed to make a decision.

    All types of mastectomy use general anaesthesia and involve making an incision either diagonally or horizontally across your breast so that the breast tissue can be removed. Thereafter, depending on the type of surgery, the breast tissue is removed.

    After your breast has been removed, you may choose to have a breast reconstruction. This is done by a plastic surgeon accompanying Dr Heyns and involves creating an artificial breast to replace the breast or breasts that have been removed. It is sometimes possible for a breast reconstruction to be carried out at the same time as a mastectomy, but it can be delayed until a later date if necessary.
What to expect after surgery
A mastectomy is a rather serious procedure with physical and emotional side-effects. After surgery you will be kept for observation in hospital for the next day or two. During this time you can expect pain in your chest and under your arm. Pain relievers will be prescribed to make you comfortable. Before being discharged Dr Heyns will instruct you on how best to care for yourself and restrictions of movement. If you have had a breast reconstruction done your plastic surgeon will also see you to discuss these aspects. You will need to rest for the next 2-3 weeks.
ROBOTIC SURGERY
Dr Michael Heyns
PRACTICE
ADDRESS
Suite M27, Second Floor,
Netcare Pretoria East Hospital,
Cnr Garsfontein & Netcare Roads,
Moreleta Park,
Pretoria



MON - THUR: 08:00 - 16:00
FRIDAY: 08:00 - 16:00
APPOINTMENTS & INFORMATION
+27(0)12 993 1160

+27(0)12 993 3986


Lynette van der Merwe
drheyns.lynette@gmail.com
(Nurse, theatre lists)

Amanda Jooste
drheyns.amanda@gmail.com
(Gastroscopies and Colonoscopies)

Hannelie Murray
drheyns.hannelie@gmail.com
(Appointments)
ACCOUNTS & PRACTICE MANAGER
Dalene van Zyl
+27(0)12 993 3121
+27(0)12 993 3986
drheyns.dalene@gmail.com
(Practice manager and finance)


MEDICAL NURSE
Lena Meintjies
+27(0)12 993 1160
+27(0)12 993 3986
(Endoscopic nurse)
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