Breast Cancer Surgery Options

Medically Reviewed by Dr. K on 30 March 2021

Breast Cancer Surgery Options

Breast cancer treatment aims to remove the tumour and a part of the underlying tissue while preserving as much of the breast as possible.

The volume of breast tissue removed with the tumour varies with different breast cancer surgery methods. This is dependent on the site of the tumour, the extent to which it has grown, and your personal opinions. A few lymph nodes under the arm are often removed so that cancer cells may be examined. This will assist the doctor in preparing your post-surgery treatment.

Take some time to learn about the many types of breast cancer surgeries before you have yours. You and your doctor will determine which choice is better for you.

 

Simple or Total Mastectomy

In this operation, the doctor removes your entire breast, including the nipple. Your lymph nodes, which are tiny glands that are part of your immune system, are not removed.

You’re most likely to have this procedure when the cancer isn’t in your lymph nodes, or if you’re having a mastectomy to lower your risk of getting breast cancer.

 

Modified Radical Mastectomy

Both of your breast tissue, plus the nipple and lymph nodes in the armpit, are removed by the surgeon. The chest muscles are not affected.

If you have invasive breast cancer, this may be a good option.

Radical Mastectomy

Your surgeon will remove all of the breast tissue, as well as the nipple, lymph nodes in your armpit, and the muscles in your chest wall behind the breast.

Today, this technique is rarely used. In certain instances, a modified radical mastectomy is almost as successful as radical mastectomy, but it’s less disfiguring. Only if the cancer has advanced to your chest muscles, then a radical mastectomy is advised.

 

Skin-Sparing Mastectomy

The skin of the nipple and areola and the region where the tumour was removed is removed by your doctor, but the remainder of the skin is preserved to be used for breast reconstruction.

If you have cancer cells next to your skin or plan to wait for breast reconstruction, that might not be a choice for you.

 

Lumpectomy (Partial Mastectomy)

Your doctor will remove the tumour as well as any of the underlying breast tissue. After that, you’ll almost always require radiation therapy.

If you can’t or won’t get radiation, this might not be the best choice for you. Often, if you’re breastfeeding, have a big tumour, or the cancer has advanced into the breast tissue, a lumpectomy is typically not a choice.

Lymph Node Surgery

Evaluating the lymph nodes to see how the disease has advanced is vital in breast cancer surgery. This is normally done around the moment of the initial surgery, although it may also be done afterward. For breast cancer, there are two forms of lymph node surgery:

  • Axillary lymph node dissection (ALND): Around 10 to 20 lymph nodes are removed from under the arm by the surgeon. Those are examined for cancer cells.
  • Sentinel lymph node biopsy: The surgeon identifies and removes the lymph node from where the breast cancer is most likely to have spread. Compared to an ALND, this surgery is less likely to cause lymphedema or arm swelling.

 

Breast Reconstruction

Many people who have a mastectomy tend to have their breasts reconstructed either immediately or later. Breast implants or your own tissue, normally from your lower abdomen, may be used.

Preparing for Breast Cancer Surgery

Whatever type of breast cancer surgery you have, you’ll need to plan ahead of time.

Sharing your medical history is one of the first things you’ll need to do. Any medications you’re taking, including vitamins and supplements, would need to be raised with your doctor. They’ll also want to know if you’ve ever experienced any adverse reactions to medications or surgery. You can tell the doctor whether you have any problems that could change how your body reacts to surgery, such as heart failure, diabetes, or high blood pressure.

Your doctor may recommend you to donate a pint or two of blood in the event that you need it during surgery. You’ll need to add more time to your pre-op schedule to donate and recover if you do this.

Your doctor may order tests for you when your surgery date approaches. A chest X-ray, an ECG, and blood and urine samples are examples of these tests. These checks will tell the doctor if your body is ready for surgery. A CT scan can be requested to determine the size and location of your tumour.

 

How Long Will I Be in the Hospital?

The duration of your hospital stay will be determined by the kind of treatment you have, how well you handle the procedure, and your overall health.

Lumpectomies are normally performed on an outpatient basis. You’ll be treated in a short-stay monitoring facility and will most likely be discharged the next day.

If you get a mastectomy or an ALND, you would most definitely spend one or two nights in the hospital.

Sources

Referenced on 30.3.2021

  1. American Cancer Society: “Surgery for Breast Cancer."
  2. Breastcancer.org: “What is Mastectomy?” “Planning for Surgery: Medical History and Testing,” “The Day of Surgery.”
  3. UpToDate: “Patient education: Breast cancer guide to diagnosis and treatment (Beyond the Basics)."
  4. https://www.webmd.com/breast-cancer/breast-cancer-surgery-options

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