Breast Cancer Surgical Options

Most women who are diagnosed with breast cancer will require surgery as part of their treatment plan. There are several options available to women depending on the stage of their cancer and their preference for an aggressive or more conservative approach.

Breast-Conserving Surgery

If you and your physician decide on a partial or segmental mastectomy, the surgeon will only remove part of the affected area and may insert metal clips which will serve as markers for radiation treatments that you may receive following your surgery. There are different types of breast-conserving surgeries, which one you will receive will depend on the type, stage, and position of your tumor. Most women with stage I or II breast cancer will receive a breast-conserving surgery with radiation; this treatment will be as effective as a mastectomy.

In a lumpectomy only the breast lump and some surrounding tissue will be removed. Radiation and/or chemotherapy normally accompany this procedure.

In a quadrantectomy approximately one-quarter of the breast is removed. Radiation and/or chemotherapy usually following this procedure as well.

In these breast-conserving surgeries it is very important for the surgeon to have good margins around the excised tumor. A positive margin means that in the tissue surrounding the excised area additional cancerous cells have been detected. A positive margin can require a re-excision where the surgeon must go back and remove more tissue. A good margin will be an ideal distance from the tumor and contain no cancerous cells.

Mastectomy

In a mastectomy all of the breast tissue is removed, occasionally with additional surrounding tissue. The mastectomy is the main surgical option for women with more advanced stages of breast cancer and those with a family history of the disease. There are different types of mastectomies, which one you receive will depend on your cancer’s type and stage.

In a simple mastectomy the entire breast is removed, including the nipple, but surrounding muscle and lymph nodes are not excised. Sometime women will have a double mastectomy where both breasts are removed.

For women considering immediate breast reconstruction a physician may recommend the skin-sparing mastectomy where as much skin is left behind as possible excluding the nipple and areola. There is also a nipple-sparing mastectomy where if the cancer has not spread to the skin and nipple a surgeon may be able to save them.

In a radical mastectomy a surgeon will remove the entire breast, axillary lymph nodes and the pectoral muscles under the breast. This surgery used to be quite common but now it is only performed when a tumor is large and is spreading to the pectoral muscles. Instead many surgeons will use the modified radical mastectomy where the entire breast and axillary lymph nodes are removed.

Deciding Between Breast-Conserving Surgery and a Mastectomy

Your physician, surgeon, and specialists will all give you all the information you need to make this decision. They will prevent with your risks and treatment options as well. When making this decision a lot of women lean towards a mastectomy believing it to be an aggressive approach to take it all out but with early stage breast cancer, and breast-conserving surgery and radiation can present equal chances of long-term survival.

You don’t have to experience breast cancer alone. You do not have to make this decision by yourself. At the Baptist Memorial Hospital for Women , no one fights alone. Our team of experts and specialists will help you understand your diagnosis and treatment options and will guide you throughout the whole process.