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Guide to Breast Cancer Surgery: Understanding the Types

Which you choose depends on many factors, including personal preference.

Surgery is a common treatment for breast cancer, regardless of which type of breast cancer you have. Surgery helps remove the tissue affected by cancer, especially if the cancer is caught early and has not spread beyond the main tumor site. 

"Most women that are diagnosed with breast cancer will have surgery at some point during their treatment," says Jaime Alberty-Oller, MD, breast cancer oncologist and surgeon at the Dubin Breast Center at Mount Sinai Hospital. The surgery not only treats the cancer, but prevents it from coming back in the future.

That said, not every woman will receive the same kind of breast cancer surgery. The type of surgery a patient will choose depends on her risk of cancer recurrence, stage of breast cancer, lymph node involvement, and (of course) her personal preferences, according to the American Cancer Society.

The two main surgeries used to treat breast cancer are lumpectomy and mastectomy.

Lumpectomy

Also called “breast-conserving surgery,” lumpectomies remove the tumor and a small amount of tissue surrounding it, leaving the breast itself. The goal is to conserve the shape and appearance of the breast, which helps maintain the patient’s body image and confidence after breast cancer.

"We will normally take the lump, or the area that has cancer in it, with a rim of normal tissue around it ... which we call the margin," says Dr. Alberty-Oller.

Lumpectomies are used if the tumor is small and hasn’t spread throughout the breast tissue. Sometimes, doctors may use a neoadjuvant therapy (such as chemotherapy or radiation therapy) to shrink the tumor *before* surgery, which may help a woman get a lumpectomy instead of a total mastectomy.

Because lumpectomies only remove a small amount of tissue, recovery time is usually less than a week. Learn more about what to expect after a lumpectomy here.

Mastectomy

Mastectomies remove the entire breast (and sometimes other nearby tissues, such as the chest wall tissue). When both breasts are removed, this is called a double mastectomy. Mastectomies may be more appropriate than lumpectomies in certain cases, such as if the tumor is large. If the cancer has spread beyond the breasts, mastectomies may still be useful to slow the spread of breast cancer.

"In the majority of mastectomy surgeries, we will take out the nipple and the areola, which is sort of the darker skin around the nipple," says Dr. Alberty-Oller. Surgeries that leave the nipple are known as nipple-sparing mastectomies.

While this completely removes the breasts, there are options to reconstruct the breasts afterwards—although some women choose to skip breast reconstruction and go “flat.”

Because it removes the entire breast (or breasts), mastectomies generally require longer recovery times than mastectomies. Learn more about what to expect after a mastectomy here.

"The most important thing is to get the cancer out, and do a surgery that is safe, oncologically speaking," says Dr. Alberty-Oller. That means "that we're taking out the cancer and trying to avoid a cancer from coming back in the future."

No matter which surgery for breast cancer you choose, prioritizing your overall health is beneficial. Here are tips for self-care during breast cancer treatment.

Jaime Alberty, MD

This video features information from Jaime Alberty, MD. Dr. Alberty is a surgical breast oncologist at the Dubin Breast Center of the Tisch Cancer Institute at Mount Sinai Hospital.

Duration: 2:32. Last Updated On: July 29, 2019, 3:26 p.m.
Reviewed by: Mera Goodman, MD . Review date: July 26, 2019
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