Breast Cancer Surgery
Breast cancer surgery is performed to remove the cancer as a critical step in overcoming this disease. Most women with breast cancer have some form of surgery to treat the breast tumor. Surgical procedures can also be performed to see if the cancer has spread to the lymph nodes under the arm or to restore the shape of the breast after a mastectomy.
Common Types of Breast Cancer Surgery
Surgery to treat breast cancer ranges from the very complex to simpler approaches that can preserve the breast structure or provide for its reconstruction. Surgical procedures include:
Surgery of this type focuses on conserving as much of the breast as possible. These surgical procedures remove only a part of the breast depending upon the tumor size, location and other factors. The procedures include:
- Lumpectomy or Partial (segmental) mastectomy - This surgical procedure removes just the breast lump (tumor) and normal tissue surrounding it (called the "margin" of normal tissue). Follow-up radiation therapy is generally administered.
A Mastectomy is a surgical procedure performed to remove the entire breast. All of the breast tissue is removed and can include adjacent tissue. There are four types of mastectomies which include:
- Simple mastectomy - With this procedure the entire breast is removed. The lymph nodes under the arm or the muscle tissue beneath the breast are not removed. Occasionally both breasts are removed, most frequently in an effort to prevent cancer.
- Skin-sparing mastectomy - For some women who want breast reconstruction right away, most of the skin over the breast is left intact. The procedure works as well as the simple mastectomy with less scar tissue and a more natural looking reconstructed breast. In our practice, we also offer Nipple/Areola sparing mastectomy which preserves more of the natural appearance of the breast in patients who may be a candidate for this technique.
- Modified radical mastectomy - This surgical procedure is like the simple mastectomy in which the entire breast is removed but also includes the removal of some of the lymph nodes under the arm.
- Radical mastectomy - This surgical procedure involves the removal of the entire breast, the lymph nodes under the arm and the chest wall muscles under the breast. While this was once a very common procedure, it is rarely done now since the modified radical mastectomy has worked just as well. However for large tumors growing into the muscles under the breast, it may still be done.
Lymph nodes and surgery
- Sentinel lymph node biopsy - A sentinel lymph node biopsy helps to determine if cancer has spread to the lymph nodes under the arm without removing all of them. This procedure involves injecting a low dose radioactive substance near the tumor which is then carried by the lymph system to the first nodes called the sentinel lymph nodes. If these nodes contain cancer, more lymph nodes may be removed. If they are free of cancer, further lymph node surgery is not usually needed. This procedure is more accurate in evaluation of disease while resulting in less pain and scarring.
- Axillary lymph node dissection - Usually performed at the same time as a mastectomy or lumpectomy, this procedure is used to find out if breast cancer has spread to lymph nodes under the arm. In most cases, less than 20 lymph nodes are removed. If cancer cells are found, there is a higher chance that cancer cells have also spread through the bloodstream to other parts of the body.
- Expander/Implant - In this technique, a plastic/reconstructive surgeon is present at the time of your operation. After the breast tissue has been removed, the plastic/reconstructive surgeon will place an implant to begin the first stage of reconstruction. The details of this will be thoroughly discussed with you during your consultation with one of the members of our reconstructive surgical team. We work with skilled and dedicated reconstructive surgeons.
- Tissue - For this technique, some of your own tissue may be carefully moved to reconstruct the appearance of the breast. This tissue may come from the back or abdominal wall. The details of this will be thoroughly discussed with you during your consultation with one of the members of our reconstructive surgical team. We work with skilled and dedicated reconstructive surgeons.