Most women who have been diagnosed with breast cancer will undergo some type of surgery as part of their treatment plan. In the video below, Breast Surgeon, Dr. Patricia Dawson explains in detail breast cancer surgery and recovery.
Depending on the location, tumor size, aggressiveness of the cancer and the woman's degree of attachment to her breast, there are several surgical options to consider:
Lumpectomy / Partial Mastectomy
This surgery involves the removal of only the cancerous lump and a rim of normal tissue (margin) around it. The amount of tissue it is necessary to remove will vary according to the individual circumstances. If the cancer is invasive, usually some of the axillary (underarm) lymph nodes will also be removed to determine if the cancer has spread (Sentinel node biopsy or axillary lymph node dissection). A lumpectomy is usually followed by radiation therapy to the breast.
Simple or Total Mastectomy
This is the removal of the entire breast, including the nipple-areolar complex.
Modified Radical Mastectomy
The entire breast is removed ( Total Mastectomy) as well as the axillary (underarm) lymph nodes.
This is the removal of the entire breast, axillary lymph nodes and the chest-wall muscles under the breast. This type of surgery is rarely performed these days because, in the great majority of cases, it is no more effective than other surgical options with fewer side effects. Radical mastectomy may cause disfigurement, arm swelling, and other side effects.
Working together, cancer surgeons and plastic/reconstructive surgeons can sometimes perform a mastectomy without removing the skin that holds the breast tissue. The procedure may involve removing the nipple and surrounding areola, then extracting the breast tissue through this opening. In selected circumstances the nipple-areolar complex may be preserved. This procedure results in less visible scars after breast-reconstruction surgery.
In some situations, to help diagnose the extent of the breast cancer, removal of the arm pit lymph nodes is recommended. Depending on the individual’s anatomy, the dissection may remove between 6 and 30 lymph nodes.
For some women, the sentinel-node biopsy is another option for collecting a lymph-node sample. During this surgical procedure, which is less extensive than lymph-node dissection, only a few (one to six) lymph nodes (known as the sentinel nodes) are removed and studied. The nodes are identified by a harmless radioactive dye injected before surgery. The sentinel lymph node is the most likely to be affected by cancer and is a good indicator of whether the cancer has spread. A sentinel-node biopsy, however, is not an option if a patient's tumor is large or if the lymph nodes are enlarged.
According to the National Cancer Institute, reconstructive surgery is "surgery that is done to reshape or rebuild (reconstruct) a part of the body changed by previous surgery." For example, a woman may consider reconstructive breast surgery after a mastectomy. In the video below, Plastic Surgeon, Dr. Wandra Miles explains what to expect with breast reconstruction.
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