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.
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.
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.
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Most women that are diagnosed with breast
cancer will have surgery at some point
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during their treatment.
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The majority of these women will have
surgery to treat their cancer, but again,
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a large number of them will have surgery
to prevent cancer in the future.
00:00:13,765 --> 00:00:18,446
00:00:18,446 --> 00:00:21,711
The most common surgeries that we
do in the breast would be, one,
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breast conservation surgery,
which sometimes you call lumpectomy, or
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sometimes partial mastectomy.
00:00:28,565 --> 00:00:32,757
And the point of that surgery is to take
the cancer out while leaving the breast
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00:00:33,285 --> 00:00:37,772
So we will normally take the lump or the
area that has cancer in it with a rim of
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normal tissue around it, normal healthy
breast tissue which we call the margin.
00:00:42,704 --> 00:00:46,278
So the goal of lumpectomy surgery
is to take the cancer out and
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do the safest operation that we can,
while at the same time leaving the breast
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looking the most like it
looked before surgery.
00:00:53,728 --> 00:00:57,681
The other big category of surgeries
that we do is a mastectomy,
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which is sort of a bigger surgery in that
we remove the entirety of the breast.
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In the majority of mastectomy surgeries,
we will take out the nipple and
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the areola, which is the sort of
darker skin around the nipple.
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And usually we'll take some skin.
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There are skin-sparing mastectomies,
which is a surgery in which we
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take out all of the breast tissue and
leave as much of the skin as possible.
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There's also nipple-sparing
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a nipple- and areola-sparing mastectomies,
in which, again,
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you take out all the breast tissue and you
leave behind the nipple and the areola.
00:01:30,181 --> 00:01:35,799
We also do surgery in the lymph nodes and
of the axilla, or the underarm.
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And the point of that
is to stage patients,
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because we wanna know if the cancer has
spread elsewhere beyond the breast.
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Many years ago we developed a surgery
called sentinal lymph node biopsy,
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in which we only take out the first
couple of lymph nodes in which we think
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the cancer will have spread to,
and we test them.
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If those are negative,
then we feel confident enough to say,
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there is no need for
us to do any additional surgery.
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If you do need surgery, in the majority of
cases choosing lumpectomy or a mastectomy,
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if you're a candidate for both,
your overall survival will be the same.
00:02:09,548 --> 00:02:14,822
The most important thing is to get the
cancer out, and do a surgery that is safe,
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that we're taking out the cancer and
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we're trying to avoid a cancer
from coming back in the future.
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Breast cancer treatment (PDQR). NCBI Bookshelf, 2019. (Accessed on July 8, 2019 at https://www.ncbi.nlm.nih.gov/books/NBK65969/.)
Surgery for breast cancer. Atlanta, GA: American Cancer Society, 2016. (Accessed on July 8, 2019 at https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer.html.)