Breast Cancer Surgery Options

The goal of breast cancer surgery is to remove the tumor itself and a portion of surrounding tissue while conserving as much of the breast as possible.

Breast cancer surgery methods differ in the amount of breast tissue that is taken out with the tumor. That depends on the tumor location, how far it’s spread, and your personal feelings. The surgeon also removes some lymph nodes under the arm so they can be tested for cancer cells. This will help your doctor plan your treatment after surgery.

Before you have surgery for breast cancer, take some time to learn about the different types of procedures. You and your doctor will choose the best option for you.

Simple or Total Mastectomy

Your doctor removes your entire breast, including the nipple, in this procedure. They don’t remove your lymph nodes, small glands that are part of your immune system.

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

The surgeon removes all of your breast tissue, including your nipple and lymph nodes in the armpit. They leave the chest muscles intact.

This may be a good option if you have invasive breast cancer.

Modified Radical Masectomy

Radical Mastectomy

Your surgeon removes all of your breast tissue along with the nipple, lymph nodes in your armpit, and chest wall muscles under the breast.

This procedure is rarely done today. The modified radical mastectomy is as effective in most cases, and it's less disfiguring. A radical mastectomy is usually recommended only if the cancer has spread to your chest muscles.

Skin-Sparing Mastectomy

Your surgeon removes the skin of the nipple and areola, and the area where the tumor was taken out, but leaves the rest of the skin so it can be used for your breast reconstruction.

It may not be an option for you if you have cancer cells close to your skin, or if you plan to wait to have breast reconstruction.

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Lumpectomy (Partial Mastectomy)

Your surgeon removes the tumor along with some of the breast tissue surrounding it. You'll most likely need radiation treatments afterward.

This may not be a good option for you if you can’t or won’t have radiation. Also, a lumpectomy is usually not an option if you’re pregnant, if you have a large tumor, or if cancer that has grown outside the breast tissue.

Lymph Node Surgery

An important part of breast cancer surgery involves checking the lymph nodes to see if the cancer has spread. The doctor usually does this at the time of the original surgery, they can also do it at a later time. There are two main types of lymph node surgery for breast cancer:

  • Axillary lymph node dissection (ALND). The surgeon takes out about 10 to 20 lymph nodes from under the arm. Those get checked for cancer.
  • Sentinel lymph node biopsy. The surgeon finds and removes the lymph node where the breast cancer would most likely have spread first. This surgery is less likely to cause lymphedema, or swelling in the arm, than an ALND.

Breast Reconstruction

Many women who get a mastectomy choose to get breast reconstruction either right afterward or later on. You can use breast implants or your own tissue, usually from your lower abdomen.

How Long Will I Be in the Hospital?

The length of your stay in the hospital will vary, depending on the type of surgery you have, how well you tolerate the operation, and your general health.

Lumpectomies are usually outpatient procedures. You’ll recover in a short-stay observation unit and will likely go home later the same day.

If you have a mastectomy or an ALND, you’ll probably stay in the hospital for 1 or 2 nights.

WebMD Medical Reference Reviewed by Gabriela Pichardo on January 26, 2020

Sources

SOURCES:

American Cancer Society: "Surgery for Breast Cancer."

Breastcancer.org: “What is Mastectomy?

Christine Laronga, MD, FACS Section Editors: Daniel F Hayes, MD, Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C), Deputy Editors: Wenliang Chen, MD, PhD, Sadhna R Vora, MD, ”Patient education: Breast cancer guide to diagnosis and treatment (Beyond the Basics)."

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