Your healthcare provider may recommend an additional procedure be done alongside your cancer surgery, such as sentinel lymph node biopsy, axillary lymph node dissection, or full axillary lymph node dissection. They’re sometimes done separately from cancer-removal surgery, as well.
This article will review the types of breast cancer surgery.
Lumpectomy
A lumpectomy can also be referred to as breast conservation surgery and is commonly used for early-stage breast cancer. It’s sometimes also done to remove precancerous or noncancerous breast changes.
During a lumpectomy, the surgeon removes the cancerous tumor along with a margin of healthy tissue around it. Additionally, the surgeon may remove lymph nodes close to the cancer and check for cancer cells.
Depending on how much tissue is removed, your breast may not change much in size or shape. Following the surgery, scar tissue can form in this area, which may change the texture of your breast. This scarred area will show up on future mammograms as looking different from the unaffected breast tissue.
A scar will be present on the skin where your incision was made. The surgeon can instruct you on how to take care of the incision and promote healing.
Mastectomy
A mastectomy may be needed when the tumor in the breast is large or if there are multiple tumors present. Additionally, mastectomy may be recommended in cases of small or early-stage cancer if other factors are involved, such as when it’s a recurrence of cancer or if there’s a strong family history of the disease.
There are several types of mastectomy. What type you need is based on your specific prognosis.
Simple Mastectomy
During a simple mastectomy, all of the breast tissue is removed, including the skin, nipple, areola, as well as the covering of the muscle underneath the breast tissue.
Modified Radical Mastectomy
In a modified radical mastectomy, a simple mastectomy is combined with the removal of all of the lymph nodes under the arm of the side of the affected breast.
Radical Mastectomy
During a radical mastectomy, the entire breast is removed, along with all of the lymph nodes under the arm. The muscles in the chest that sit under the breast are removed as well.
Skin-Sparing Mastectomy
With a skin-sparing mastectomy, all of the breast tissue, except the skin, is removed. The nipple and areola are removed as well. To fill the space under the skin, an implant is placed in the cavity. Sometimes tissue from other areas of the body is used to replace the missing breast tissue.
Nipple-Sparing Mastectomy
A nipple-sparing mastectomy is similar to a skin-sparing mastectomy, but the nipple and areola are left in place. The breast is reconstructed with either an implant or other tissue.
There is a risk that due to changes after surgery, the nipple and areola may not get enough blood supply to keep feeding the tissue with oxygenated blood. If this happens, the nipple may need to be removed later.
Making Your Choice
If you need breast cancer surgery, you may have multiple options to choose from in terms of surgery. Your surgeon will review all of the possible surgeries that may be appropriate for you.
Determining which surgical procedure is best for you depends on several factors, including:
The type, size, and stage of the cancerThe size of your breastWhere the cancer is located in your breastWhether the cancer has spread Risk of recurrenceFamily history of breast cancerAdditional treatments you may need in the futureCosmetic preferencesRecovery time
Moving Ahead
Surgery can cause some fear and anxiety, but it’s important to know that breast cancer surgeries are very successful. A study published in 2018 found a low risk of local recurrence (2.3%) and distant metastasis (5.7%). Meanwhile, the five-year survival rate was high (98.6%).
Reading up on each type of surgery can help you understand the benefits and risks, and can help you discuss the options with your surgeon so you can make a more informed choice.
Finding a Good Surgeon
If you need help finding a surgeon, ask your healthcare provider for a recommendation. If you have an oncologist, they should also be able to refer you to surgeons who are experienced in breast surgery.
In addition to excellent surgical skills, other qualities to a surgeon are important. These can include good listening skills, the ability to answer your questions, and having patience for your questions.
Health Insurance
Check with your health insurance company to see whether the surgeon you’re considering and the hospital or surgical center where they work is in-network.
While you’re checking on your insurance coverage, you may also want to find out which anesthesia firms work with the hospital. Your surgeon, the hospital, and the anesthesiologist will bill you and/or your health insurance separately. Doing your homework first can help prevent any financial surprises after surgery.
Summary
There are multiple options for breast surgery when needed for breast cancer treatment. Depending on factors such as tumor size and grade, the surgeon will make recommendations on the type of surgery that should be done.
Options for surgery include partial mastectomy, in which only part of the breast is removed. The other option is mastectomy, in which all of the breast is removed.
A Word From Verywell
In considering these procedures, it is important that you select the one that you are most comfortable with. Consider getting a second opinion no matter which way you’re leaning. You may have more choices for breast cancer management. Learn how to advocate for yourself to get the best care possible.
