Surgical Treatment of Breast Cancer
There are two types of surgery for breast cancer. These are surgery to remove just the cancerous lump (tumour), known as breast-conserving surgery, and surgery to remove the whole breast, which is called a mastectomy. In many cases, a mastectomy can be followed by reconstructive surgery to recreate the breast that was removed. Studies have shown that breast-conserving surgery followed by radiotherapy is as successful as total mastectomy at treating early-stage breast cancer.
Diagram showing the amount of breast tissue that needs to be removed during a mastectomy.
Breast-conserving surgery
Breast-conserving surgery ranges from a
lumpectomy or wide local excision, in which just the tumour and a little
surrounding breast tissue is removed, to a partial mastectomy or
quadrantectomy, in which up to a quarter of the breast is removed. If you have breast-conserving surgery,
the amount of breast tissue you have removed will depend on:
- the type of cancer you have
- the size of the tumour and where it is in your breast
- the amount of surrounding tissue that needs to be removed
- the size of your breasts.
Your surgeon will always remove an area
of healthy breast tissue around the cancer, which will be tested for traces of
cancer. If there is no cancer present in the healthy tissue, there is less
chance that the cancer will recur. If cancer cells are found in the surrounding
tissue, you may need to have more tissue removed from your breast. After breast-conserving surgery, you
will usually be offered radiotherapy to destroy any remaining cancer cells.
A mastectomy is the removal of all the
breast tissue, including the nipple. If there are no obvious signs that the
cancer has spread to your lymph nodes, you may have a mastectomy, in which your
breast is removed, along with a sentinel lymph node biopsy (SLNB). If the cancer has spread to your lymph
nodes, you will probably need more extensive removal (clearance) of lymph nodes
from the axilla (under your arm).
Drawing showing a female patient who has had a left mastectomy.
Breast reconstruction is surgery to
make a new breast shape that looks as much as possible like your other breast.
Reconstruction can be carried out at the same time as a mastectomy (immediate
reconstruction) or it can be carried out later (delayed reconstruction). It can
be done either by inserting a breast implant or by using tissue from another
part of your body to create a new breast.
To find out if the cancer has spread, a
procedure called a sentinel lymph node biopsy (SLNB) may be carried out. The
sentinel lymph nodes are the first lymph nodes that the cancer cells reach if
they spread. They are part of the lymph nodes under the arm (axillary lymph
nodes). The position of the sentinel lymph nodes varies, so they are identified
using a combination of a radioisotope and a blue dye.
The sentinel lymph nodes are examined
in the laboratory to see if there are any cancer cells present. This provides a
good indicator of whether the cancer has spread. If there are cancer cells in the
sentinel nodes, you may need further surgery to remove more lymph nodes from
under the arm.
Source: NHS Choices.
Source: NHS Choices.