There are different types of breast cancer surgery. The types of surgery differ depending upon the amount of healthy tissue that is removed with the tumor, the tumor’s characteristics, whether the tumor has spread (metastasized), and your personal feelings. Some lymph nodes under the arm are usually removed as part of the operation so they can be tested for the presence of cancer cells. This will help your doctor plan your treatment after surgery.
Types of breast cancer surgery include:
- Lumpectomy (wide local excision)
- Partial or segmental mastectomy or quadrantectomy
- Total mastectomy
- Modified radical mastectomy
- Radical mastectomy
Your doctor should discuss your options with you before surgery. A specific surgical procedure may be recommended based on the size, location, or type of breast cancer you have.
Lumpectomy for Breast Cancer
This is also referred to as breast-conserving therapy. The surgeon removes the cancerous area and a surrounding margin of normal tissue. A second incision may be made in order to remove the lymph nodes. This treatment aims to maintain a normal breast appearance when the surgery is over.
After the lumpectomy, a course of radiation therapy is usually used to treat the remaining breast tissue. The majority of women who have small, early-stage breast cancers are excellent candidates for this treatment approach.
Women who are not usually eligible for a lumpectomy include those who have already had radiation therapy to the affected breast, have two or more areas of cancer in the same breast that are too far apart to be removed through one incision, have cancer that was not completely removed during the lumpectomy surgery, or have very large tumors.
Sometimes chemotherapy or hormone therapy can shrink a large tumor first to allow your doctor to perform a lumpectomy.
This type of surgery is usually followed by radiation treatments.
Partial or Segmental Mastectomy or Quadrantectomy
During a partial or segmental mastectomy or quadrantectomy, the surgeon removes more breast tissue than with a lumpectomy. The cancerous area and a surrounding margin of normal tissue are removed. Radiation therapy is usually given after surgery.
Simple or Total Mastectomy
With a simple or total mastectomy, the entire breast is removed, but no lymph nodes are removed. Simple mastectomy is most frequently used to prevent new cancer from developing or when the cancer does not go to the lymph nodes. This procedure is usually performed to treat in-situ, microinavasive, or stage IA breast cancers.
Modified Radical Mastectomy
The surgeon removes all of the breast tissue along with the nipple in a modified radical mastectomy. Lymph nodes in the armpit are also sampled. The chest muscles are left intact. For many women, mastectomy is accompanied by either an immediate or delayed breast reconstruction. This can be done quite effectively using either breast implants or the patient’s own tissue — usually from the lower abdomen.
Breast Cancer and Radical Mastectomy
When a radical mastectomy is used to treat breast cancer, the surgeon removes all of the breast tissue along with the nipple, lymph nodes in the armpit, and chest wall muscles under the breast. This procedure is rarely performed today because modified radical mastectomy has proved to be as effective, and is less disfiguring.
You should thoroughly discuss these surgical options with your doctor to determine the best treatment for you.
How Long Will I Be In the Hospital for Breast Cancer Surgery?
The length of stay in the hospital varies depending on the type of breast cancer surgery performed. Generally, lumpectomies are done on an outpatient basis, with the patient recovering in a short-stay observation unit after the procedure.
Mastectomies or lymph node removal surgery usually require a one- to two-night stay in the hospital.