Learning About Breast Cancer Surgery

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What is breast cancer surgery?

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 overall health and personal preferences. You may have surgery that removes the tumour but does not remove the whole breast. Or you may have surgery to remove the whole breast.

Breast cancer usually needs a combination of treatments. You may have surgery to remove all the cancer that can be seen. But after surgery you may also need radiation, chemotherapy, or hormone therapy. These treatments get rid of any cancer cells that may be left.

What surgeries are used?

  • Surgery that does not remove the whole breast is called breast-conserving surgery (lumpectomy). It removes the tumour 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.
    • Radical mastectomy. This removes the whole breast and the lymph nodes under the arm (axillary lymph nodes).

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 tumour. 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.

What can you expect after surgery?

Your doctor will send the breast tissue to a lab for testing. This will help the doctor know more about the type of cancer you have. It may take up to a week or more to get the results back. Your doctor will discuss the results with you. You may meet with a doctor who specializes in cancer treatment (an oncologist) to decide about any other treatment you may need. Your personal preferences are important when choosing a treatment that is right for you.

The amount of time you will need to recover depends on the type of surgery you had and whether you need any more treatment.

After a mastectomy, some women choose to have surgery to restore the way the breast looked. This surgery is called reconstruction. It is done by a plastic surgeon. It can sometimes be done at the same time as the mastectomy. Or you may choose to have it done later. Some women choose to wear a breast-form (prosthesis) in their bra instead of having reconstructive surgery. Others decide to go without a prosthesis or reconstructive surgery. You choose what feels right for you.

If you had 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 was removed.

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

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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