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Breast Care Center

Breast Cancer Surgery

Overview

Breast cancer is one of the most common types of cancer in women. It occurs in men also, but much less frequently. Your workup may involve additional mammograms, an ultrasound, and a biopsy to make the diagnosis.

Surgery is one of the most common treatment options for breast cancer. Depending upon the severity, spread, and aggressiveness of the cancer, you may have several surgical options available to you. They can range from the removal of a small portion of breast tissue (breast-sparing surgery) to the removal of the entire breast (mastectomy), depending upon your specific situation.

The treatment and care for breast cancer is part of an ongoing process. Your individual case is reviewed by a team of our experts. The team will likely include a group of multidisciplinary cancer care specialists who are part of what is known as a tumor board. For example, if surgery is recommended, it will be done as part of an integrated treatment plan for breast cancer that may also involve chemotherapy and radiation therapy. If surgery is performed after other treatments, such as chemotherapy, it is known as adjuvant or neo-adjuvant surgery.

Surgery is usually performed to remove the cancer. Your surgeon will meet with you to discuss your choices that can range from removing only part of the breast to removing the entire breast as well as the possible need for removing and evaluating lymph node(s).
Lymph node biopsy is a specialized procedure that helps gauge the spread, if any, of the cancer.

Diagnosis

Breast biopsy is most commonly performed after an abnormal finding on a mammogram or ultrasound or if your doctor finds a suspicious breast lump. There are different types of breast cancer known as ductal carcinoma in situ (also called DCIS), infiltrating ductal carcinoma, and infiltrating lobular carcinoma. Once a breast cancer diagnosis is made, we will discuss your options. In the majority of cases, surgery is recommended to remove, treat, and stage the cancer.

Staging

Once we determine the stage of the tumor, this information will help us develop the best treatment approach for that specific type of tumor. The following are some of the most common stages of breast cancer:

Stage 0.
Also known as carcinoma in situ, this type of breast cancer is confined (or “localized”) to inside the milk duct and has not moved out of its original location. Ductal carcinoma in situ (DCIS) is not an invasive cancer and has not spread outside the duct.

Stage 1.
The tumor has not spread beyond the breast to lymph nodes or other locations. The tumor may be up to 2 centimeters (cm), or three-quarters of an inch, in size.

Stage 2.
The tumor is either 2 to 5 cm in size or has spread to a nearby lymph node. Usually, only one of these conditions is true for it to be classified as stage 2 disease.

Stage 3.
It is also known as locally advanced cancer since the tumor is 5 cm or larger or has spread into many neighboring lymph nodes or into the chest wall.

Stage 4.
The cancer has spread beyond the breast area and beyond nearby lymph nodes into other organs or bones by way of the bloodstream. It is considered a late-stage cancer.

The staging process is important to help determine the best treatment plan for you.

Methods of Surgery

Depending on the size, location, and type of cancer, you may have different choices for surgery:

  • Lymph node biopsy (also called sentinel node biopsy). The operation involves an injection or series of injections that are performed on the same day as your surgery. The procedure is used to identify the lymph nodes or glands in the armpit. The lymph nodes or other glands are then removed for testing. If the lymph nodes contain cancerous cells, you may need to undergo a separate procedure afterwards known as an axillary node dissection during which we remove additional lymph nodes.
  • Breast-conserving surgery (also known as lumpectomy, quadrantectomy, or partial mastectomy). This procedure is offered to patients with a single or small tumor. The cancer as well as some surrounding tissue (margins) is removed during the procedure. You may also need to have a lymph node biopsy done at the same time.
  • Mastectomy. In this operation, the entire breast is removed along with the cancerous cells. This might be the safest choice for someone with several tumors, a large tumor, or a tumor that has spread into the nipple area or into the skin. We may need to perform a lymph node biopsy at the same time as the mastectomy.
  • Double mastectomy. In this operation, both breasts are removed along with the cancerous cells. This procedure is done for someone who has cancerous tumors in both breasts, or if she or he has an especially high risk for developing another cancer in the future. You may also need to have a lymph node biopsy at the same time. A double mastectomy is a relatively rare operation.

Following a mastectomy, you may choose to wear a breast prosthesis or have breast reconstruction surgery. If you choose breast reconstructive surgery, it may be performed at the same time as the mastectomy or may even be performed much later. You can view our Emmi tools to learn more about lumpectomy and mastectomy.