Breast Cancer Surgery
Breast Cancer
- Breast Cancer Overview
- Newly Diagnosed
- Signs & Symptoms
- Detecting & Diagnosing
- Types of Breast Cancer
- Hormone Receptor Status
- Staging
- Treatment Options
- Surgical Treatment Options
- Breast Cancer Recurrence
- Breast Reconstruction
- Risk Factors
- Genetics & Breast Cancer
- Breast Cancer FAQs
- Living as a Survivor
Breast Cancer Surgical Treatment Options
One of the first things most breast cancer patients consider as part of their treatment process is breast surgery. The type of breast surgery that is right for you depends on several factors, including the size and location of the tumor, as well as your overall health.
Learn about different types of breast cancer surgeries and how to choose what's best for you.
Meet Our Breast Cancer Surgeons
Get to know our breast cancer surgeons who are dedicated to the treatment of breast cancer and perform hundreds of breast cancer surgeries every year.
Understanding Breast Cancer Surgery
Types of Breast Cancer Surgeries
Breast-Conserving Surgery
Breast-conserving surgery, commonly known as lumpectomy, aims to remove as much cancer as possible while also preserving much of the surrounding healthy breast tissue. This procedure may also involve the removal of nearby lymph nodes to check for cancerous cells. Several factors influence how much breast tissue needs to be removed, including the size and specific location of the tumor.
The two most common types of lumpectomies include oncoplastic lumpectomy and localized lumpectomy.
Oncoplastic Lumpectomy
Oncoplastic lumpectomy combines lumpectomy surgery with plastic surgery techniques to improve the cosmetic outcome after the cancer removal. It is essentially a reconstructive surgery aimed at making the breast look better if the lumpectomy alters its appearance. The nipple can usually stay intact.
Various oncoplastic techniques can be used to reshape the breast after removing the cancer. The choice of approach the surgeon chooses will depend on the size and location of the cancer, as well as your breast size, body type, and personal preferences.
Oncoplastic surgery techniques are generally used to:
- Prevent “dents” in the breast.
- Place the scar where it’s less visible, often called "hidden scar surgery."
- Combine the removal of cancerous breast tissue with a breast reduction, breast lift, or both.
If necessary, your OSW breast cancer surgeon can make adjustments to the other breast to ensure a balanced appearance. It's important to understand that oncoplastic lumpectomy is not suitable for those diagnosed with inflammatory breast cancer (IBC) due to its widespread nature. Individuals with IBC may need to undergo a mastectomy instead.
Localized Lumpectomy
Localized lumpectomy is performed when imaging tests like mammography and ultrasound identify an abnormality that the surgeon cannot feel. To locate the tumor accurately before the surgery begins, a breast cancer surgeon will do a procedure called localization to mark where the tumor is in the breast. This may be done a few days before the lumpectomy or on the same day as the lumpectomy.
There are several methods for performing a localized lumpectomy:
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Wire-free localization.
Advances in technology allow surgeons to locate lesions accurately before surgery. One such system is the SAVI SCOUT system. Instead of using a wire, the surgeon places a small, 1 cm device called a reflector in the breast tissue up to seven days before surgery. On the day of the operation, the surgeon uses a handheld device that emits a tiny radar signal to find the reflector and identify the exact area of tissue that needs to be removed. -
Wire-guided localization.
This procedure involves using a needle to place a wire into the breast on the same day as surgery. The wire serves as a guide, allowing the surgeon to locate the precise area of abnormal breast tissue or cancer. The wire is then removed from the site of the abnormal tissue. -
Magseed® localization.
This technique involves placing a small magnetic seed into the center of the tumor days or even weeks before surgery. During the procedure, the surgeon uses a magnetic probe to detect the seed and precisely locate and remove the tumor with minimal disruption to surrounding tissue. -
VeraForm® localization.
VeraForm is a flexible tissue marker placed inside the area where the tumor was removed during surgery. It helps clearly mark the exact area for follow-up radiation therapy treatment. Because VeraForm fits the shape of where the tumor was, it gives doctors a more accurate picture of where to aim the radiation. This can help protect healthy tissue and improve cosmetic results after treatment.
Mastectomy (Breast Removal Surgery)
Mastectomy is a surgery that removes the entire breast, often including the removal of lymph nodes to check for cancer. The presence or absence of cancer cells in the lymph nodes will guide future treatment options. There are a few types of mastectomy, and the breast surgeon will recommend the most effective technique based on your unique circumstances.
Simple (Total) Mastectomy
This procedure involves the removal of breast tissue, nipple, areola, fascia (covering) of the pectoralis major muscle (main chest muscle), and skin. A sentinel lymph node biopsy may also be performed during this surgery to determine if cancer has spread beyond the breast and into nearby lymph nodes. This involves removing only a few nearby lymph nodes where cancer is likely to spread and helps oncologists assess breast cancer staging and plan further treatment.
Modified Radical Mastectomy
This procedure combines a total mastectomy with an axillary lymph node dissection, rather than a sentinel lymph node biopsy. An axillary lymph node dissection is a surgical procedure that involves removing more lymph nodes from the armpit (axilla) to check for the spread of cancer. This procedure also helps determine the extent of cancer spread and guides further treatment decisions.
Nipple-Sparing and Skin-Sparing Mastectomy
A nipple-sparing and skin-sparing approach is used whenever possible, allowing women to retain more of their own breast tissue and sensation. This technique offers both cosmetic and emotional benefits.
In a skin-sparing mastectomy, the nipple and areola are removed along with the breast, but only a small amount of skin is taken. A nipple-sparing mastectomy preserves the nipple and areola, along with the surrounding breast skin. It’s reattached, giving you more sensation in that area of the body after you’ve healed.
When possible, your OSW breast surgeon will strategically place the incision to minimize visible scarring after healing. This approach helps maintain much of the female form and sensation, which is important to many patients.
Risk-Reduction Mastectomy
Risk-reducing mastectomy (RRM), also known as prophylactic mastectomy (PM), is performed to lower the risk of developing breast cancer or breast cancer recurrence. A prophylactic mastectomy involves removing one or both of the breasts. Women at high risk, including those with a strong family history of breast cancer and the BRCA 1 or BRCA 2 gene mutation, may be candidates for this type of breast cancer surgery.
Consider Reconstruction Options Before Cancer Removal Surgery
While breast cancer surgeons do not typically place implants at the time of the breast cancer removal surgery, they work with plastic surgeons and can help prepare your body for future reconstruction. Advanced oncoplastic techniques can be incorporated during cancer removal to prepare you for future surgery to re-form your breasts. Some women choose to “go flat,” which is also an option you should discuss beforehand because it affects the incisions that will be used. Discuss your thoughts on reconstruction to develop a plan before the surgery.
The Latest Treatments for Breast Cancer Available at Willamette Valley Cancer Institute
If you are newly diagnosed with breast cancer, the first step is to schedule a consultation with a breast cancer doctor. At Willamette Valley Cancer Institute (WVCI), we offer personalized treatment plans, including the latest cancer treatments available, as well as second opinions.
Breast Cancer Surgery FAQs
Why do you need radiation after a lumpectomy?
Radiation therapy after breast sparing surgery is proven to reduce the risk of breast cancer recurrence. Only about 3-15% of patients have a breast cancer recurrence within 10 years of diagnosis when using this combination of treatments.
Do you need to have radiation after a mastectomy?
Radiation therapy after a mastectomy is not usually required, but it may be recommended if the cancer was large, if it spread to nearby lymph nodes, or if cancer cells were found at the edges of the removed tissue (margins).
Read more in our blog: How is radiation used to treat breast cancer?
Will my breast cancer come back?
The possibility of breast cancer returning, or recurring, after initial treatment depends on several factors, including the breast cancer type and its stage when you were diagnosed. The type of surgery used does not impact the likelihood of it returning. While no one can predict with certainty whether cancer will come back, the earlier it's found and treated, the less likely it is to come back.
What is recovery like for breast cancer surgery?
Most women can generally resume their normal activities within two weeks after lumpectomy surgery. Mastectomies may require a longer recovery due to the extent of the surgery with most people recovering in three to six weeks. You may need assistance at home during your recovery time. Most likely, you won’t be able to lift anything heavy or raise your arm(s) over your head for at least a week. You may also be extra tired as you heal. Your surgeon will give you specific instructions about your personal dos and don’ts before you leave the surgery center.
Will there be a scar on my breast after surgery?
Surgeons do all they can to minimize scarring, although some is usually unavoidable. It tends to be easier to hide the scar for those who have a lumpectomy.
Talk with your surgeon before a mastectomy surgery to discuss whether you would prefer reconstruction, wearing a prosthetic, or “going flat” afterwards. This will impact the surgical closure. You may also be able to hide some of the scarring if you have breast reconstruction surgery. If the surgeon knows you want to go flat, they will use a different closure than if reconstruction is planned.