Breast cancer surgery can either be a breast-sparing lumpectomy or a total removal mastectomy. Sometimes, the surgeon is able to perform a breast reconstruction during the same surgery session as a mastectomy. Some women may have a choice on what type of surgery they receive, depending on the type and stage of breast cancer.
A lumpectomy is the removal of a portion of breast tissue, including the tumor and healthy tissue surrounding the tumor. The main goal of surgery is to remove all cancerous tissue from the breast. To ensure the malignant cells have all been extracted, a pathologist will check the external layers of removed tissue for cancerous cells. If the margin is “clear” of cancer cells, and if there is enough distance between the edge of the tumor and the edge of the removed tissue, the surgery is deemed successful.
Depending on the amount of tissue removed in a lumpectomy, the breast may be smaller or differently shaped. It could be possible for the surgeon to reduce the size of the unaffected breast so both breast match in size at the same time as the lumpectomy. Again, doctor-patient communication is important to best understand options and to adjust expectations.
If the margin of healthy tissue around the tumor is very shallow, or if cancerous cells are found at the edges of the tissue, further surgery or a total mastectomy may be necessary.
A mastectomy is the removal on the entire breast, including the nipple and areola. In the case of a radical mastectomy, it also involves the removal of surrounding lymph nodes and muscle tissue. If a woman is at very high risk for getting cancer in her second breast, a double mastectomy may be performed as a preventive measure.
Side-effects of surgery could include pain, swelling, scar tissue, and differently-sized breasts. In most cases, radiation and chemotherapy follow any type of breast cancer surgery.
A woman facing the choice of what type of breast cancer surgery to receive has many factors to consider. Each woman’s medical oncologist will make recommendations based on the particular circumstances. She also needs to consider factors such as:
The type of surgery a woman chooses may also affect how much radiation and chemotherapy she receives. The INTEGRIS Health team understands this can be a major decision, and is prepared to advise each woman based on her unique situation.
