What is breast cancer surgery?

• Surgery that does not remove the whole breast is called breast-conserving surgery (lumpectomy). It removes the tumor in the breast and a small amount of normal tissue around it. It is also called a partial mastectomy.
• Surgeries to remove the whole breast are called:
  • Total mastectomy. This removes the whole breast, including the nipple.
  • Nipple-sparing mastectomy. This removes the whole breast but leaves the nipple.
  • Modified radical mastectomy. This removes the whole breast and the lymph nodes under the arm (axillary lymph nodes).
  • Radical mastectomy. This removes the whole breast, the chest muscles under the breast, and all the lymph nodes under the arm.

During the surgery, the doctor may remove lymph nodes from the armpit. The lymph nodes will be looked at under a microscope. This is used to check if cancer has spread from the breast into the lymph nodes. There are two types of lymph node surgery:

• Axillary lymph node dissection. This removes some or all of the lymph nodes in the armpit.
• Sentinel lymph node biopsy. This removes the lymph nodes that are the first to receive lymph fluid from the tumor. If the sentinel nodes don’t contain cancer, it is unlikely that the cancer has spread. Then the doctor won’t remove any more lymph nodes. If there is cancer in the sentinel nodes, the doctor may remove other nearby lymph nodes.

Possible problems from mastectomy or breast-conserving surgery include breast pain or numbness, buildup of blood or clear fluid in the wound, and the general risks of surgery. These include infection, bleeding, and reactions to the anesthesia. If lymph nodes under the arm were removed, swelling of the arm (lymphedema) may occur.

Surgery is a key part of treatment for breast cancer. The type of surgery you have depends on the size, location, and type of the cancer. It also depends on your health and what is important to you.

Your doctor may combine treatments. This is a common way to treat breast cancer. You may have surgery to remove the cancer. After surgery you may need other treatments, such as radiation or endocrine therapy.

During the surgery, the doctor may remove lymph nodes from the armpit. The lymph nodes will be looked at under a microscope. This is used to check if cancer has spread from the breast into the lymph nodes.

How long you will need to recover depends on the type of surgery you have. It also depends on whether you will need any more treatment.

If you have a lumpectomy, you will probably look the same in a bra. But your breasts may not match in size or shape after surgery. This depends on the size of your breasts and how much tissue is removed.

If you are having a mastectomy or will have a lot of your breast tissue removed in a lumpectomy, you may want to think about breast reconstruction. This is surgery to create a new breast. It may be done at the same time as your breast surgery. Or you may plan to have it done later. Some people choose not to do reconstruction at all. You choose what feels right for you.

No matter what kind of surgery you have, you will get information about your treatment. You will learn how to prepare, what to expect, and what to do afterward.