Surgery

Currently, almost all women who receive a diagnosis of breast cancer undergo surgery as well as radiation therapy. Surgery is the first step in accurately determining the stage of your breast cancer and deciding on the best treatment option. If you have breast cancer, your doctor will likely perform one of the following procedures to remove your tumor:

Mastectomy

Partial mastectomy

    – Lumpectomy

    – Excision

    – Quadrantectomy

The type of surgical procedure will depend on the stage of the breast cancer and size of the tumor. Your surgeon might use terms such as breast-saving, breast-preserving, or breast-conserving surgery to describe the procedure. This means the tumor and cancerous tissue will be removed, while as much of your breast as possible will be preserved.

It's important to discuss your procedure with your surgeon so that you'll know how much breast tissue will be removed and what to expect after surgery. Although many surgeons do not discuss plastic surgery options, breast reconstruction can be part of your total breast cancer care. Before you have surgery, talk with your doctor about whether you're a candidate for breast reconstruction. He or she may want to include a plastic surgeon as part of your surgical team.

Lumpectomy involves removing the tumor (or lump) and tissue surrounding the tumor. The tissue is then carefully examined to be sure no cancer cells remain in the normal tissue, or margins, that surround the tumor.

If cancer cells are found in the surrounding tissue, your surgeon will perform another surgery, or excision, to remove the remaining cancerous tissue and check again for cancer. Once the tissue is considered clear of cancer cells, radiation therapy is likely to be used as follow-up treatment to prevent the cancer from coming back.

The combination of lumpectomy and radiation therapy is known as breast conservation therapy. Studies have shown that overall survival is similar for patients treated with lumpectomy plus radiation compared with those treated with surgery to remove the entire breast (modified radical mastectomy). Still, many surgeons and patients choose mastectomy over combination lumpectomy with radiation therapy.

Because each patient is different, breast surgery and treatment should be tailored to the individual. To decide the best course of treatment, your surgeon will evaluate your medical and family history, risk factors, current medications, and imaging results (including mammograms, ultrasounds, magnetic resonance images [MRI]), as well as the stage of the cancer and size of the tumor. Depending on your case, your doctor also may discuss breast reconstruction options. Good communication between you and your doctor will help you know what to expect after your surgery and throughout your treatment.