Surgery for Breast Cancer - Understanding Your Options

Surgery is a common part of breast cancer treatment and there are several options depending on the situation. Your doctor may recommend a certain procedure based on your breast cancer features and your medical history. In some cases, you may be able to choose which type to have. Regardless, it’s important to know your options so you can talk to your doctor about them and make the choice that is right for you.

There are two main types of surgery to remove breast cancer:

Breast-Conserving Surgery

This type of surgery involves the removal of only part of the breast containing the cancer. The goal is to remove the cancer as well as some surrounding normal tissue. How much breast is removed depends on where and how big the tumor is, as well as other factors.

Mastectomy

This type of surgery involves the complete removal of the breast, including all of the breast tissue and sometimes other nearby tissues. There are several different types of mastectomies and even a double mastectomy that requires the removal of both breasts.

So which type of surgery is right for you?

Patients with early-stage cancers can often choose between having breast-conserving surgery and a mastectomy. One of the main advantages of the breast-conserving surgery is that most of the breast is kept but it’s common to also need radiation with this option. Patients who have mastectomy for early-stage cancers are less likely to need radiation. Mastectomy may be a better option for some patients due to the type of breast cancer, large size of the tumor, previous treatment with radiation or certain other factors.

Surgery to remove nearby lymph nodes

Underarm lymph nodes can be removed and examined to determine if the breast cancer has spread. This procedure is a vital part of figuring out the stage of the cancer. Lymph nodes may be removed either as part of the surgery to remove the breast cancer or as a separate operation.

The two main types of surgery to remove lymph nodes are:

Sentinel lymph node biopsy (SLNB)

Only the lymph node(s) under the arm where the cancer would likely spread first are removed. Removing only one or a few lymph nodes lowers the risk of side effects from the surgery, such as arm swelling that is also known as lymphedema.

Axillary lymph node dissection (ALND)

Many (usually less than 20) underarm lymph nodes are removed. ALND is not done as often as it was in the past, but it might still be the best way to look at the lymph nodes in some situations.

To learn more about these procedures, see Lymph Node Surgery for Breast Cancer.