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used."}},{"purpose":"result_review","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Review of final pathology and discussion of adjuvant therapy, usually with a multidisciplinary plan."}},{"purpose":"assessment","requirement":"conditional","after":{"min":28,"max":56,"unit":"days","qualifier":"Check of healing, arm mobility and lymphedema before or during adjuvant treatment."}}],"indications":["Biopsy-proven invasive breast cancer","Ductal carcinoma in situ","Localized, operable breast cancer suitable for breast-conserving surgery or mastectomy","Residual disease or operable tumor after neoadjuvant therapy"],"main_risks":["Bleeding or hematoma","Seroma","Wound infection or delayed healing","Pain, numbness or chronic postsurgical pain","Lymphedema and reduced shoulder mobility, particularly after axillary dissection","Positive margins requiring re-excision","Breast asymmetry or contour deformity","Anesthesia-related risks and venous thromboembolism","Psychological and body-image effects"],"pain":"Mild to moderate pain, usually controlled with oral analgesics, most noticeable in the first several days; chest wall and armpit tightness, numbness or tingling may persist for weeks to months.","preparation":["Completed imaging, biopsy and staging per oncology team","Multidisciplinary tumor board review and surgical planning","Preoperative assessment and anesthesia evaluation","Review of current medications and supplements with the surgical team","Fasting before general anesthesia per hospital instructions","Preoperative localization of the tumor if non-palpable","Stop smoking where possible","Arrange help at home; discuss reconstruction options"],"recovery_timeline":[{"phase":"Day 0-3","description":"Recovery from anesthesia, wound and drain care, early gentle arm movement.","restrictions":["No driving while on opioid analgesics","Avoid lifting heavy objects"]},{"phase":"Weeks 1-2","description":"Wound healing, drain removal if present, pathology review, return to light daily activity.","restrictions":["No heavy lifting","Keep wound dry and clean as instructed"]},{"phase":"Weeks 3-6","description":"Progressive restoration of shoulder range of motion and return to work; adjuvant therapy may begin.","restrictions":["Avoid strenuous upper-body exercise until cleared"]},{"phase":"Months 2-12","description":"Scar maturation, resolution of swelling and numbness, ongoing oncologic follow-up.","restrictions":[]}],"rehabilitation_days":{"min":14,"max":42,"unit":"days","qualifier":"Ordinary functional recovery of daily activity and arm mobility after breast-conserving surgery or mastectomy without reconstruction; longer with axillary dissection."},"result_longevity":"Surgical removal of the tumor is permanent, and scars and breast contour are long-lasting once healed. Long-term cancer control depends on stage, pathology, adjuvant therapy and ongoing surveillance.","revision_rate_pct":{"min":10,"max":25,"unit":"percent","qualifier":"Repeat surgery, mainly re-excision for positive margins after lumpectomy; mastectomy rates much lower"},"scars":"Linear breast scar (lumpectomy) or horizontal chest wall scar (mastectomy), plus a small axillary scar if lymph nodes are treated. Fades over 6-12 months; hypertrophic scarring possible.","sessions_or_stages":{"sessions":{"min":1,"max":2,"unit":"visits","qualifier":"One operation typically; a second operation may be needed for re-excision of margins or completion axillary surgery."},"stages":[{"code":"primary_surgery","label":"Lumpectomy with sentinel node biopsy","after":{"min":0,"max":0,"unit":"days","qualifier":"Initial operation."}}],"qualifier":"Scope is surgery without reconstruction; adjuvant radiotherapy, chemotherapy and endocrine therapy are separate treatments."},"success":{"metric":"Local recurrence-free rate after surgery","value":95,"unit":"percent","horizon":"5 years","population":"Adults with operable early-stage breast cancer, with appropriate adjuvant therapy","evidence_status":"limited"},"techniques":[{"name":"Lumpectomy (breast-conserving surgery)","suits_whom":"Smaller, localized tumors with favorable tumor-to-breast ratio and ability to receive radiotherapy","recovery":"Faster; often same-day discharge, about 1-3 weeks to return to usual activity"},{"name":"Mastectomy (simple or skin-sparing)","suits_whom":"Large or multicentric tumors, patient preference, or when radiotherapy is not possible or breast conservation is not feasible","recovery":"Longer; about 2-6 weeks, often with drains for 1-2 weeks"},{"name":"Sentinel lymph node biopsy","suits_whom":"Nodal staging in invasive cancer with clinically negative axilla","recovery":"Minimal arm impact; axillary dissection slows arm recovery and raises lymphedema risk"}],"treatment_conditions":["day_case","inpatient"],"treatment_duration_hours":{"min":1,"max":2,"unit":"hours","qualifier":"Operating time for unilateral lumpectomy with sentinel node biopsy, without reconstruction."},"initial_assessment_documents":["Breast biopsy pathology report","Receptor status report","Mammogram and ultrasound reports","Breast MRI report (if available)","Staging CT or PET-CT report (if available)"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"One trip usually; 7-14 days' stay for drain removal and pathology review. Second trip only for re-excision or axillary surgery."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check that you can put questions about your treatment to the treating team","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that you are satisfied with the facilities and standards where you will be treated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check whether follow-up care is at the same facility as the surgery","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Medical tourists should also know whether follow-up care is scheduled to occur at the same facility as the procedure.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C5","text":"Check that the surgical team has your full medical record and has reviewed it","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Make sure the surgical team has received your full medical record and reviewed it","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Offer pushes a quick decision or a cheap, time-limited deal before booking","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Chest pain or trouble breathing","urgency":"emergency","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments_and_procedures/hic_Breast_Cancer_Surgery","host":"my.clevelandclinic.org","quote":"Call 911 or go to the emergency room if you have chest pain or trouble breathing.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W2","text":"Redness, heat, swelling, and tenderness","urgency":"contact_clinic","general":false,"source":{"url":"https://leaflets.ekhuft.nhs.uk/your-breast-cancer-follow-up-and-support/html/","host":"leaflets.ekhuft.nhs.uk","quote":"Signs of infection can include redness, heat, swelling, and tenderness / pain.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W3","text":"New pain worsening over two to three weeks","urgency":"contact_clinic","general":false,"source":{"url":"https://leaflets.ekhuft.nhs.uk/your-breast-cancer-follow-up-and-support/html/","host":"leaflets.ekhuft.nhs.uk","quote":"However, if you develop a new pain that gets worse over 2 to 3 weeks, contact the Breast Care team to arrange a review.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Gives your home doctor the instructions for care after the hospital stay","document":"discharge summary","source":{"url":"https://www.med.unc.edu/surgery/surgonc/forpatients/breast-cancer/breast-surgery-post-op/","host":"med.unc.edu","quote":"Immediately before discharge, you will receive a discharge summary with instructions on what to do when you go home.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"T2","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-12","next_check_at":"2027-02-10"},"technique_details":{"status":"ok","items":[{"id":"lumpectomy","name":"Lumpectomy (breast-conserving surgery)","how_it_works":{"text":"The tumor and some surrounding tissue are removed, not the 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