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Breast Cancer Surgery

Breast-sparing techniques

Once breast cancer is detected or diagnosed, treatment plans need to be made to reduce the chance of the cancer returning in or outside of the breast. The goal of surgery is to remove localized cancer (cancer that hasn’t spread to other parts of the body) by removing the tumor itself and a portion of surrounding tissue, while conserving as much of the breast as possible.

Surgical options

The various surgical techniques differ in the amount of breast tissue that is removed with the tumor. The technique used depends on the tumor’s characteristics, whether it has spread (metastasized) and your personal feelings. The surgeon often removes some axillary (under the arm) lymph nodes as part of the operation so they can be tested for signs of malignancy. This is done to help plan your treatment after surgery.

The breast surgeon will discuss your surgery options with you before the procedure. A specific surgical procedure may be recommended for you based on the size, location, or type of breast cancer you have. Some of the procedures the physician may discuss with you include lumpectomy, simple or total mastectomy, and modified radical mastectomy.

Lumpectomy — This is also referred to as breast conservation or a partial mastectomy. The surgeon removes the cancerous area and a surrounding margin of normal tissue. A second incision may be made in order to remove the lymph nodes. Upon completion, this treatment aims to maintain a normal breast appearance.

After the lumpectomy, a six week course of radiation therapy is used to treat the remaining breast tissue. Most women who have small, early stage breast cancers are excellent candidates for this treatment approach. Women who usually are not eligible for a lumpectomy include those who:

  • Have already had radiation therapy to the affected breast
  • Have two or more areas of cancer in the same breast that are too far apart to be removed through one incision

Women who have cancer that is not completely removed with the lumpectomy may need further surgery to take out the remaining cancer cells.

Simple or total mastectomy — The entire breast is removed, but no lymph nodes are removed in this procedure. Simple mastectomy is most frequently used to prevent breast cancer in a woman at increased risk for the disease or for cancer that is confined to the milk ducts (ductal carcinoma in situ).

Modified radical mastectomy — The surgeon removes all of the breast tissue along with the nipple. Lymph nodes in the axilla (arm pit) are also removed and the chest muscles are left intact. For many patients, mastectomy is accompanied by either an immediate or delayed breast reconstruction. This can be done quite effectively using either breast implants or the patient's own tissue—usually from the lower abdomen.

Radical mastectomy — The surgeon removes all of the breast tissue along with the nipple, lymph nodes in the arm pit, and chest wall muscles under the breast. This procedure is rarely performed today because modified radical mastectomy has proven to be as effective and does not have the same disfiguring side effects.

You should thoroughly discuss these surgical options with your physician to achieve the best outcome. Whichever type of surgery is your best option, you will be able to return home after a short stay in the hospital.

Hospital stay

The length of stay in the hospital varies depending on the type of surgery that is performed. Generally, lumpectomies are done on an outpatient basis, with the patient recovering in a 23-hour, short-stay observation unit after the procedure. Mastectomies with lymph node removal surgery usually require a one- to two-night stay in the hospital.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/10/2012...#8338


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