Breast Cancer Treatment Options: Surgery
View an animation of the process of a lumpectomyTreatment options:
- State-of-the-art surgical techniques to address metastatic tumors
- Advanced minimally invasive surgery, including use of robotics to enhance complex procedures, minimize patient stays and speed recovery times
- Intra-operative radiation therapy (IORT), which delivers high-dose radiation directly to a patient's tumor site during surgery
- New and investigational treatments, including PARP inhibitors, immunotherapies such as dendritic cell therapy, and ovarian cancer vaccines
- Fertility-conserving surgery and advanced assisted reproductive technology to help maximize your childbearing options
Surgery is generally the primary treatment for breast cancer, depending on your individual case. Techniques have been refined over the years, so there are more breast-sparing options than before. The type of surgery performed depends upon:
- Size and location of the breast lump or tumor
- Type and stage of the breast cancer (If the cancer has spread within the breast or has spread outside of the breast to the lymph nodes, or to other parts of the body.)
- Size of the breast
- Preference
Questions to ask your physician before surgery
- Which type of surgery do you recommend for me – lumpectomy or mastectomy? Why?
- Where will the incision be located and how much of the breast tissue will be removed?
- Will any lymph nodes be removed?
- Will I be able to have breast reconstruction if I have a mastectomy?
- Do you recommend breast reconstruction at the same time of the mastectomy surgery or at a later date?
- Will additional treatment such as radiation or chemotherapy be required following surgery?
- What type of follow-up care is needed?
- How long will it be before I resume my normal activities?
Types
There are two types of breast conservation (tissue-sparing) surgery, including:
- lumpectomy - removal of the breast cancer and a portion of normal tissue around the breast cancer lump to provide a buffer of normal tissue, which helps ensure the lesion has been removed completely. Radiation therapy is usually administered following a lumpectomy to destroy microscopic deposits of cancer cells that may have been in the breast tissue around the site of the main tumor.
Your physician may recommend a mastectomy (removal of the breast) as the best surgical option, depending on your circumstances:
- total (or simple) mastectomy – your surgeon removes the entire breast (including the nipple, the areola, and most of the overlying skin) and may also remove some of the lymph nodes under the arm.
- Skin-sparing mastectomy: a form of simple mastectomy which leaves intact much or all of the normal skin of the breast. This is good for smaller lesions that don't come close to the skin.
- Nipple-areolar sparing mastectomy: a form of simple mastectomy that leaves intact much or all of the normal skin of the breast, including the nipple-areolar complex. This is a new approach, whose long-term safety has not been established. View related clinical trial
- modified radical mastectomy - your surgeon removes the entire breast (including the nipple, the areola, and the overlying skin), some of the lymph nodes under the arm (also called the axillary lymph glands), and the lining over the chest muscles. In some cases, a small part of the chest wall muscles is also removed.
- radical mastectomy (rarely performed today)- your surgeon removes the entire breast (including the nipple, the areola, and the overlying skin), the lymph nodes under the arm, also called the axillary lymph glands, and the chest muscles. A radical mastectomy is generally only recommended when the breast cancer has spread to the chest muscles.
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