by EBSCO Medical Review Board

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Surgery is mainly used to treat breast cancer. The goal is to remove the cancer and save as much of the breast and its function. Surgery is often one part of a treatment plan. Chemotherapy or radiation therapy may also be included. Chemotherapy can also be used before surgery to shrink the tumor.

Breast-saving Surgeries

Breast-saving surgeries are often used for women in the early stages of cancer. They may be used along with radiation. This surgery involves removing the tumor and a small area of healthy tissue around it. Breast-sparing surgery types include:

  • Lumpectomy
  • Wide excision
  • Segmentectomy
  • Quadrantectomy
  • Partial mastectomy
Lumpectomy
Diagram of lumpectomy
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Not all women with early stage breast cancer can have these types of surgery. It depends on the tumor and other health conditions.

Mastectomy

A mastectomy is the removal of the breast. Sometimes this involves removing lymph nodes. The type will depend on how much the cancer has spread and if breast reconstruction will be done.

Mastectomy
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Simple Mastectomy

A simple mastectomy is a common type of surgery. All of the breast is removed. A simple mastectomy may be done for women who:

  • Have ductal carcinoma in situ (DCIS)
  • Have no risk cancer spreading to the lymph nodes
  • Cannot have any type of breast-sparing surgery

Lymph nodes can be taken out and checked for cancer as well. It can be done with the surgery or at a later date.

A simple mastectomy can be used to prevent breast cancer. One or both breasts can be removed in women who have:

  • A high risk for breast cancer
  • Cancer in one breast and a high risk of cancer in the other

    • Skin-sparing Mastectomy

    The skin over the breast is spared with a simple mastectomy. This is done for women who will have reconstruction.

    A form of this type can spare the nipple and areola. The nipple area will be checked for cancer to see if it can be left behind. Radiation may be given to the nipple during or after surgery. This lowers the risk of cancer coming back. This may not be the best type for all women.

    Modified Radical Mastectomy

    This surgery is used to treat cancer that has spread beyond the breast. The breast and lining of the chest muscle are removed. Lymph nodes from under the arm are also removed. Radiation may or may not be needed. It depends on the size of the tumor and if lymph nodes have cancer.

    Radical Mastectomy

    A radical mastectomy involves removing:

  • The breast
  • Chest wall muscles
  • Lymph nodes under the arm
  • Some fat and skin
    • This type of surgery is rare.

    Other Procedures

    The lymph nodes are often removed and tested for cancer. This can help find if cancer has spread. The types are:

    • Sentinel node biopsy —A sentinel node is the first lymph node that a tumor drains into. Other nodes are checked until the they are clear from cancer.
    • Axillary node dissection—Many lymph nodes under the arm are removed and checked for cancer. It may be done with breast surgery or at a later date.

    When lymph nodes are removed, it can lead to lymphedema. This can cause a backup of fluid into tissue.

    Breast Reconstruction

    The breast can be reconstructed. This can be done with a mastectomy. Or, it may be done at a later date, or not at all.

    References

    Breast cancer. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/breast-cancer. Accessed March 25, 2022.

    Breast cancer in women. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/breast-cancer-in-women. Accessed March 25, 2022.

    Surgery for breast cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer.html. Accessed March 25, 2022.

    Locoregional therapy and locally advanced breast cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/locoregional-therapy-for-early-and-locally-advanced-breast-cancer. Accessed March 25, 2022.

    Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#section/%5F185. Accessed March 25, 2022.

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