Breast cancer surgery is a key component of breast cancer treatment that involves removing the cancer with an operation. Breast cancer surgery may be used alone or in combination with other treatments, such as chemotherapy, hormone therapy, targeted therapy and radiation therapy.
For people with a very high risk of breast cancer, breast cancer surgery may be an option to reduce the risk of future breast cancer.
Breast cancer surgery includes different procedures, such as:
Which breast cancer operation is best for you depends on the size and stage of your cancer, your other treatment options, and your goals and preferences.
The goal of breast cancer surgery is to remove cancer cells from your breast. For those who choose breast reconstruction, a procedure to place breast implants or reconstruct a breast from your own tissue (flap surgery) may be done at the same time or in a later operation.
Breast cancer surgery is used to treat most stages of breast cancer, including:
Surgery is seldom used to treat breast cancer that spreads to other parts of the body (metastatic breast cancer).
During a total (simple) mastectomy, the surgeon removes the breast tissue, nipple, areola and skin. Other mastectomy procedures may leave some parts of the breast, such as the skin or the nipple. Surgery to create a new breast is optional and can be done at the same time as your mastectomy surgery or it can be done later.
A nipple-sparing mastectomy involves removal of the breast tissue, but spares the skin, nipple and areola. This illustration shows two examples of common incisions used for the procedure, though your surgeon will determine the approach that's best for your particular situation. Dissolvable stitches are placed under the skin so they won't need to be removed later.
A lumpectomy involves removing the cancer and some of the healthy tissue that surrounds it. This illustration shows one possible incision that can be used for this procedure, though your surgeon will determine the approach that's best for your particular situation. Dissolvable stitches are placed under the skin so that they won't need to be removed later.
Breast cancer surgery is a safe procedure, but it carries a small risk of complications, including:
Your initial meeting with a breast cancer surgeon can help you understand your treatment options and what you can expect from surgery. Prepare for this meeting by creating a list of questions to ask, such as:
Breast cancer surgeons work closely with plastic surgeons who do breast reconstruction. If you're planning to undergo breast reconstruction, make an appointment to discuss these options, too.
Breast cancer surgery is done in a hospital. Before the procedure, you're given medicine (general anesthesia) that keeps you in a sleep-like state.What happens during your surgery will depend on the operation, but you can expect:
An assessment of the lymph nodes in your armpit. During a sentinel node biopsy, the surgeon removes a few lymph nodes into which a tumor is most likely to drain first (sentinel nodes). These are then tested for cancer. If no cancer is present, no additional lymph nodes need to be removed.
If cancer is found, the surgeon may remove more lymph nodes or recommend radiation therapy to your lymph nodes after surgery. Sometimes both lymph node treatments are combined.
After your surgery, you can expect to:
Expect to spend one night in the hospital after mastectomy if you also undergo breast reconstruction. Those undergoing mastectomy without reconstruction or lumpectomy may leave the hospital the day of surgery.
Sentinel node biopsy identifies the first few lymph nodes into which a tumor drains. The surgeon uses a harmless dye and a weak radioactive solution to locate the sentinel nodes. The nodes are removed and tested for signs of cancer.
In pre-pectoral breast implant placement, the implant is placed on top of the chest (pectoralis) muscle. After mastectomy, a balloonlike tissue expander can be placed between your chest muscle and your skin. The tissue expander is gradually filled with saline to stretch the breast skin and make room for a breast implant. To support your breast skin, the surgeon may insert a layer of collagen cells (tissue matrix) around the expander. Over time, your own cells fill in the matrix to create supportive tissue to hold the implant in place. You will need a second surgery to exchange the tissue expander for a permanent implant.
During a deep inferior epigastric perforator (DIEP) flap procedure, the surgeon removes a section of abdominal skin and fat, along with the associated blood vessels. Using complex microsurgical techniques, the blood vessels are attached to the ones in your chest and the skin and fat are used to create a breast.