Breast Cancer Surgery

Surgery is one of the most common treatments for breast cancer. For many people, it’s the first step in treatment. There are different types of breast cancer surgery.

You may need it to:

• Remove a cancerous tumor from your breast
• Remove all of your breast tissue
• See if cancer has spread to nearby lymph nodes
• Reconstruct your breast

In some cases, surgery may lower your risk of breast cancer if you have a high risk of developing the disease. You may have surgery alone or as part of a treatment plan.

Learning you have breast cancer can turn your world upside down. Soon after your diagnosis, you may need to make important decisions about surgery. It’s normal to feel overwhelmed or have a lot of questions. Your healthcare team will help you understand your options. That way, you can choose the best treatment for you.

When is surgery an option?

Breast cancer surgery can help treat:

• Ductal carcinoma in situ (DCIS): Noninvasive breast cancer
• Early-stage breast cancer: Small cancers that haven’t spread outside your breast
• Inflammatory breast cancer: A type of locally advanced breast cancer that has grown larger and may involve your breast skin or nearby muscles
• Recurrent breast cancer: “Recurrent” means the cancer has returned after your first treatment

Your provider likely won’t use surgery if the cancer has spread beyond your breast.

What are the benefits and risks of breast cancer surgery?

Surgery for breast cancer can:

• Remove cancer from your breast
• Cure many early-stage breast cancers
• Lower the risk of cancer coming back
• Relieve symptoms in some people with advanced breast cancer

Like all operations, surgery for breast cancer has some risks. These may include:

• Bleeding
• Infection
• Scarring
• Fluid buildup
• Numbness or changes in nipple sensation
• Swelling in your arm from lymph node removal

What type of surgery will I need?

The best surgery for you depends on several factors, including:

• The size of the cancer
• Where the cancer is in your breast
• The size of your breast
• Whether cancer has spread
• Your overall health
• Your personal preferences

For some people, one type of surgery may be a better choice than another. Your surgeon will help you understand the benefits and risks of each approach.

What happens during breast cancer surgery?

Before surgery, you’ll meet with your care team to talk about your treatment options. Depending on your situation, your team may include a breast surgeon, plastic surgeon and surgical oncologist.

The type of surgery you have depends on your diagnosis and treatment goals.

Lumpectomy

A lumpectomy removes only the cancer and a small amount of healthy tissue around it. This allows most of your breast to remain. A lumpectomy is sometimes called a partial mastectomy.

Many people who have a lumpectomy get radiation therapy after surgery.

Mastectomy

A mastectomy removes all of your breast tissue. There are several types of mastectomy. Some procedures preserve your skin, areola or nipple.

If you have certain risk factors, you and your surgeon may decide that removing both breasts is the best option. This is called a double mastectomy.

Some people need radiation therapy or chemotherapy after a mastectomy.

Lymph node surgery

Your surgeon may remove one or more lymph nodes from under your arm to check if the cancer has spread. These procedures include:

• Sentinel lymph node biopsy: Your surgeon removes the first lymph nodes where cancer cells are likely to spread. They then send the lymph nodes to a lab to test for cancer cells.
• Axillary lymph node dissection: If the sentinel nodes test positive for cancer cells, your surgeon may remove more lymph nodes for testing.

Breast reconstruction

If you’re having a mastectomy, you may decide whether to have breast reconstruction.

Breast reconstruction rebuilds your breast’s shape and appearance. You can use implants or your own tissue (from another part of your body).

Surgeons can often do reconstruction during the same operation as your mastectomy. Or you can get it later as a separate procedure. Some people choose not to have reconstruction at all.

How successful is breast cancer surgery?

Breast cancer surgery is very successful at removing cancer. For many people with early-stage breast cancer, surgery is the main treatment and may cure the disease.

Your results depend on many factors, including:

• The type and stage of breast cancer
• Whether cancer has spread
• The type of surgery you have
• Whether you need other treatments

Your healthcare provider can explain what to expect based on your diagnosis.

How long will it take for me to feel better?

Recovery depends on the type of surgery you have.

Many people recover from a lumpectomy within a few days to two weeks. Recovery from a mastectomy usually takes longer. If you have breast reconstruction, your recovery may take several weeks or more.

Your surgeon will tell you when it’s safe to return to work, drive and lift heavy objects.

Is there anything I can do to make this easier on me?

Following your healthcare provider’s instructions can help you recover as safely as possible. They may recommend that you:

• Care for your incisions (cuts) as directed.
• Take medications as prescribed.
• Wear a surgical bra.
• Do gentle arm and shoulder exercises.
• Slowly return to your usual activities.

It’s also important to take care of your emotional health. Many people experience a wide range of feelings during recovery. Lean on family members, friends, support groups or your healthcare team when you need help.

When should I call my healthcare provider?

Contact your provider if you have:

• A fever
• Increasing redness, warmth or swelling around your incisions
• Drainage or pus from your incisions
• Heavy bleeding
• Severe or worsening pain
• Swelling in your arm or hand
• An incision that opens

Call 911 or go to the emergency room if you have chest pain or trouble breathing.

Will breast cancer surgery change how my breast looks or feels?

It can. The changes depend on the type of surgery you have.

You may notice scars, numbness or changes in breast or nipple sensation. Your breast may look different after surgery, especially if your surgeon removes a large amount of tissue.

Your healthcare provider can help you understand what changes to expect.

How do I decide which surgery is right for me?

Choosing breast cancer surgery can feel like a lot to process. Learning about your options and writing down your questions can help.

Ask your healthcare provider to explain the benefits and risks of each option. If reconstruction is an option, you may also meet with a plastic surgeon before surgery.

Your care team is there to guide you. Together, you can choose a treatment plan that fits your needs and goals.