Types of Breast Cancer Surgery
Lumpectomy or Breast-Sparing Surgery
Lumpectomy is breast-conserving surgery that removes only the breast tumor and some of the normal tissue that surrounds it, but not the breast. The amount of tissue removed can vary greatly depending on the size of the tumor. The surgeon may also remove lymph nodes under the arm. The surgeon sometimes removes some of the lining over the chest muscles below the tumor. Sometimes, when breast cancer is detected early, an excisional biopsy is the only surgery a woman needs because the surgeon removed the whole lump.
Breast conservation with lumpectomy is an excellent and safe option in the majority of breast cancers. Other names for breast-sparing surgeries can include segmental mastectomy, partial mastectomy, or quadrantectomy.
Mastectomy
Mastectomy is the surgical removal of the entire breast (or as much of the breast tissue as possible). There are several types of mastectomy. Your surgeon will work closely with you to determine the most appropriate surgery for your needs.
In a total (simple) mastectomy, the surgeon removes the whole breast. Some lymph nodes under the arm may also be removed.
In a modified radical mastectomy, the surgeon removes the whole breast, and most or all of the lymph nodes under the arm. Often, the lining over the chest muscles is removed. A small chest muscle also may be taken out to make it easier to remove the lymph nodes.
Advanced surgical options are also now available that allow us to preserve all or part of the original “breast envelope,” the skin overlying the breast mound. These are called nipple-sparing and skin-sparing mastectomies and allow for the reconstructive process to begin at the time of the mastectomy with excellent cosmetic results.
Lymph Node Surgery
A very important part of breast cancer surgery is assessing the lymph nodes for disease spread. The surgeon usually removes one or more lymph nodes from under the arm to check for cancer cells. If cancer cells are found in the lymph nodes, other cancer treatments will be needed.
We know that breast cancer spreads to the glands under the arm first, and, from there, can spread to other parts of the body. Using the least invasive methods possible, our surgeons perform a Sentinel Lymph Node Biopsy (SLNB) at the time of lumpectomy or mastectomy to check for the presence of disease. Traditional methods of removal of the majority of the lymph nodes are no longer necessary in most cases and performed infrequently.
Breast Reconstruction
You may or may not choose to have breast reconstruction after having surgery to remove breast cancer. Breast reconstruction is plastic surgery to rebuild the shape of the breast. It may be done at the same time as the cancer surgery or later. If you’re considering breast reconstruction, you may wish to talk with a plastic surgeon before having any initial breast cancer surgeries.
Visit our page on breast reconstruction after cancer for more information on this procedure.
