When diagnosed with breast cancer, you have many decisions to make about your treatment and care.

One of the most important will be surgery – specifically what kind to help you achieve the best outcome. Your oncologist and/or surgeon will recommend a comprehensive approach to your care.

You also might get a second opinion to make certain you have all the information you need to decide what’s best for you.

Here are some answers to common questions about breast cancer surgery:

What are the surgical goals?

Surgeries performed on breast cancer patients have a common focus:

• Removing as much of the cancer as possible.
• Investigating whether or not the cancer has spread into the lymph nodes.
• Confirming the stage of cancer.

What are the surgical options?

Depending on scope and location of the cancer, there are two surgical options:

Breast-conserving surgery (also called a lumpectomy, quadrantectomy, partial mastectomy or segmental mastectomy).In this procedure, surgeons remove only part of the breast where they find the tumor(s). Some of the normal tissue is removed around the cancer as well – to make certain the tumor is completely gone. This is the best way to save most or some of the breast.

Mastectomy. This is the more radical approach to treatment and usually is recommended when the cancer cells are deemed more aggressive. Surgeons remove the entire breast and related or nearby tissue. In more advanced cases, both breasts are removed.

If breast cancer is diagnosed early, women can decide between a lumpectomy or mastectomy. In most cases, breast-conserving surgery requires additional treatment of radiation. Early-stage cancer patients who have a mastectomy are less likely to need radiation, according to the American Cancer Society.

Why do doctors remove lymph nodes during breast cancer surgery?

Besides removing breast tissue, it is important for surgeons to extract some lymph nodes located near the breasts – in particular those under the arm.

Lymph nodes are small, bean-shaped organs which produce and store blood cells that help fight disease and infection. Lymph nodes are part of the lymphatic system and are located throughout the body, including the neck, armpits, abdomen and groin.

Lymph nodes play an important role in cancer staging, which determines the extent of cancer in the body. 

To find out if the breast cancer has spread to axillary (underarm) lymph nodes, one or more of these lymph nodes will be removed and looked at under the microscope. This is an important part of figuring out the stage (extent) of the cancer. Lymph nodes can be removed either as part of the surgery to remove the breast cancer or as a separate operation.

How long does it take to recover from the surgery?

Barring complications, incisions should heal within three to four weeks. If lymph nodes are removed during your mastectomy, healing will take longer than one week. Mastectomy is often done with immediate breast reconstruction, but that should not delay healing from surgery.

When should reconstructive surgery be done?

Having breast reconstruction can be done at the same time as the cancer surgery or it can be done later. ACS says immediate reconstruction can produce better results sometimes because breast skin can be preserved. However, waiting weeks or months later allows patients to take time about the type and extent of reconstructive surgery. Most importantly, patients have choices.

If you want more information about breast cancer surgery options, please contact the JMH Cancer Care Center at 317.736.4436.