Breast Cancer Surgery

Although surgery can lead to pain and other adverse effects, if you have breast cancer, your chance of undergoing surgery to remove the cancer is very high. The type of surgery performed depends greatly on the size of the tumor. Your surgeon may, at the same time, perform an axillary lymph node dissection on the same side as the tumor to determine if the cancer has spread to the lymph nodes. In general, the surgeon will perform one of the following surgical procedures:   

• Lumpectomy : often performed in surgical treatment of breast cancer, lumpectomy is a surgical procedure consists of removing breast tumor (benign or cancerous) and tissue that surrounds it. It is usually followed by radiotherapy to kill cancerous cells remaining in the breast tissue. Your surgeon may also remove some axillary lymph nodes during the lumpectomy. However, there are tumors that cannot be eradicated by lumpectomy:  

1)    large tumor  

2)    cancer deep within the breast 

3)    cancer metastasis (in the same breast) 

4)    Inflammatory breast cancer  

5)    In addition, if you have already had radiation therapy or suffer from a connective tissue disease, lumpectomy may not be appropriate for you. 

Partial mastectomy – also called segmental mastectomy, partial mastectomy involves surgical removal of the tumor along with a large amount of breast tissue and some skin. Depending on the extension of the tumor, your surgeon may also remove a small part of your chest and some lymph nodes. As for lumpectomy, partial mastectomy is often followed by radiation therapy.  

Simple mastectomy – this surgery is more radical than both lumpectomy and partial mastectomy; it involves complete removal of the breast: nipple, areola, lobules, ducts, fatty tissue and skin. A mastectomy may be followed by radiation therapy, chemotherapy or hormone therapy. After surgery, the surgeon may recommend you breast prosthesis until a date when it is possible to consider a reconstruction.  

Modified radical mastectomy: This method is the most performed surgical intervention in the treatment of breast cancer. It involves the removal of the entire breast including the nipple and the skin tissue but without removing the pectoral muscles, which includes pectoralis major muscle and pectoralis minor muscle.  Your surgeon may remove some axillary lymph nodes to determine if the cancer has metastasized.  

Radical mastectomy: this is a total removal of the breast including underlying pectoral muscles and axillary lymph nodes. Your surgeon will perform this operation if the cancer is deep within your breast or if the cancer cells have invaded your chest wall.  

Reconstructive surgery - If you have a mastectomy, it can negatively change your appearance, and causes emotional and social impacts on you. You do need a breast reconstruction to help you overcome those problems. This could be done at the time of the mastectomy or later after the surgery. A breast reconstruction may include reconstruction of your nipple and areola, reconstruction with implants, reconstruction with a tissue flap, or deep inferior epigastric perforator (DIEP) reconstruction. However, not all women can have these operations; talk to your doctor for more details.