There are several factors that are taken into account when determining the best surgical option, including:
- Type of cancer
- Size of tumor
- Breast size
- Imaging results
- Lymph nodes
- Location of tumor
The goal of surgery is to remove the tumor giving the patients the best chance of survival and cosmetic outcomes. Surgical treatment options for breast cancer include:
Breast conservation surgery is also sometimes also called segmental mastectomy, partial mastectomy or lympectomy. The procedure includes removing the cancer and a margin of normal tissue surrounding the tumor. If cancer cells are found in the margin by the pathologist a re-excision might be required. Neoadjuvant chemotherapy is sometimes used before surgery to shrink the tumor allowing patients to be a candidate for breast conservation surgery. Radiation treatment is often recommended following breast conservation surgery.
Mastectomy involves removing the breast. There are three types of mastectomies:
- Complete radical mastectomy—Includes removing the breast, nipple, areola, lymph nodes, chest muscle and lining over the chest wall muscles.
- Modified radical mastectomy—Includes removing the breast, nipple, areola, lymph nodes and the lining over the chest wall muscles.
- Simple mastectomy—Includes removing the breast, nipple, areola and possibly some lymph nodes.
Excisional biopsy is recommended to remove a benign breast mass or abnormality. Depending on your diagnosis your surgeon might recommend testing your axillary lymph nodes to determine if cancer cells have spread from the breast. This can be done by doing a sentinel lymph node biopsy or axillary lymph node dissection. A sentinel lymph node biopsy involves removing usually 1 to 3 lymph nodes and testing them to determine if cancer cells are present. If cancer cells are present more nodes will be removed.