Breast cancer surgery is the primary treatment for most types of breast cancer. Mastectomy and lumpectomy are two different surgical methods for removing tumors. You may have additional surgeries to look for cancer in your lymph nodes or to reconstruct your breast after removal.
If you have localized breast cancer, your healthcare team will almost always recommend surgery to remove it. Surgery is considered the primary treatment for breast cancer when it's technically possible to remove the affected tissue. (It's not an effective treatment for metastatic breast cancer — when the cancer has already spread to other parts of your body.)
Sometimes breast cancer surgery removes an individual tumor from your breast (lumpectomy), and other times it may be necessary to remove your entire breast (mastectomy) to remove the cancer. Breast surgery for cancer is primarily a treatment, but it can also be diagnostic and even cosmetic. Sometimes surgery is exploratory to look for signs of cancer spreading. Sometimes it involves reconstructing your breast after a mastectomy.
The type of surgery that your healthcare team recommends for you will depend on many individual factors, including the type of cancer you have, how advanced it is, your general health and your personal preferences. Depending on your condition, surgery may be only a piece of your overall treatment plan, or it may be the only treatment you need.
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The two types of surgery used to treat breast cancer are mastectomy and lumpectomy. Additional surgeries for breast cancer may include lymph node dissection (lymphadenectomy) and breast reconstruction surgery.
Mastectomy, or breast removal surgery, is the most common surgery for breast cancer. That’s because mastectomy treats both late-stage and early-stage breast cancers. In addition, some people with a high risk of developing breast cancer in the future choose prophylactic mastectomy as a preventative measure.
Types of mastectomy procedures include:
Lumpectomy, also called breast-conserving surgery, removes only part of your breast tissue. This is an alternative option for treating earlier-stage breast cancer. When the tumor is relatively small and hasn’t spread yet, you can have surgery just to remove the “lump” — the tumor itself. Lumpectomy also removes a margin of the surrounding tissue, just to make sure there aren’t any stray cancer cells left in your breast.
The benefit of lumpectomy is that it allows you to keep most of your breast. But to prevent breast cancer from returning, your healthcare provider will most likely recommend radiation therapy after the surgery. Having a total mastectomy instead is often a way of avoiding radiation therapy. But for people who have the option, lumpectomy with radiation therapy has been shown to be equally effective to total mastectomy in treating early-stage breast cancer.
Types of lumpectomy procedures include:
Your lymph system is often the first place cancer spreads, and cancer in your lymph nodes is a warning sign that it may be spreading beyond your breast. To find out, your surgeon may remove and analyze one or several of the lymph nodes under your arm next to your affected breast. This is where breast cancer cells would be most likely to drain.
Lymph node procedures include:
If you're having some or all of your breast or breasts removed to treat breast cancer, you may be interested in reconstructive surgery to restore your breast shape. Surgeons can often rebuild the breast with plastic surgery techniques immediately following your lumpectomy or mastectomy. They can also perform a separate surgery at a later time, such as after you've finished radiation therapy or chemotherapy treatment and your tissues have had time to recover.
Regardless of whether you have immediate or delayed reconstruction surgery, you may need an additional follow-up surgery to perfect your results. Follow-up surgeries may adjust the size balance between your breasts, for example, or add a reconstructed nipple. Breast reconstruction can use a mix of different methods and can happen in stages. You and your surgeon will determine the right methods and timing based on your condition and preferences.
Breast reconstruction methods include:
You'll consult with your healthcare team to decide the types of surgery best for you. Your health condition will determine your treatment options, and your personal preferences will help shape them. If you're interested in breast reconstruction during or after breast cancer surgery, you'll want to discuss these options in advance. Your overall cancer treatment plan may affect the timing and methods that'll work best for you.
Your breast cancer surgery will be tailored to your individual needs based on your discussions with your healthcare team. It may involve removing a portion of your breast, all of your breast or both of them. It may include a sentinel lymph node biopsy (if you haven’t had one already) or removal of several or all of your underarm (axillary) lymph nodes if cancer has already been found there.
If you’ve opted for breast reconstruction, your surgeon may begin or complete your reconstruction during the same surgery. This may involve additional wounds to your body — for example, if your surgeon needs to take tissue from another place on your body to reconstruct your breast. Alternatively, you may choose to delay breast reconstruction until after you’ve completed your cancer treatment.
This will depend on how extensive it is. In general, a simple lumpectomy with or without sentinel node biopsy can usually be done in an hour. You can usually go home the same day. On the other hand, a mastectomy with axillary lymph node dissection or a flap reconstruction at the same time may take up to three hours in surgery. You may have to stay in the hospital for one or more nights afterward. Some people are candidates for having a mastectomy and going home the same day, depending on your general health and the extent of surgery.
The main purpose of breast cancer surgery is to remove the cancer, which is life-threatening if left untreated. The risks of breast cancer far outweigh the risks associated with the surgery.
Possible complications include:
You may be sore and have limited movement in your chest and arms for a few weeks afterward. You’ll have painkillers to take home with you. You’ll also be given arm and shoulder exercises to practice daily. These are important to prevent stiffness. You may feel tired for a while. It can take several weeks to regain your former energy levels. You may need someone to help you around the house. Most people are able to resume their normal activities within about a month.
While you’re recovering from your surgery, your healthcare team will likely be working on lymph node biopsy results. They’ll want to make sure they’ve removed all of the cancer cells in your body. When they have their results, they’ll discuss these and your next steps with you. You might need additional follow-up surgery, radiation therapy or chemotherapy as part of your treatment plan. If you’ve completed your cancer treatment, you may now be ready to begin or complete your breast reconstruction.
Your healthcare team will schedule a follow-up appointment about one to two weeks after your surgery. During your appointment, they’ll assess your condition, fill you in on any test results and plan the next steps in your treatment plan. Be sure to see your healthcare provider sooner if you experience any strange symptoms or complications following your surgery.
A note from Cleveland Clinic
For almost all types and stages of breast cancer, surgery will be an essential part of your treatment plan. There are several types of operations involved in breast cancer treatment, and most people will have more than one. Whether it’s to remove a tumor, to check for remaining cancer cells or to reconstruct your breast after removal, you and your surgeon will work closely together in the course of your treatment. You’ll discuss your personal options and preferences at length to devise the best strategy for beating breast cancer with surgery.
Last reviewed by a Cleveland Clinic medical professional on 05/18/2022.
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