Breast Surgery

Almost all women with breast cancer will have some kind of surgery to remove the cancer. There are a number of different options to discuss with your breast surgeon. They range from the now rarely performed radical mastectomy to the more common breast-conserving surgeries in which the surgeon removes only the cancer with a margin of normal, surrounding tissue. At the same time, when an invasive cancer exists, the surgeon also removes one or more of the axillary (underarm) lymph nodes to examine under the microscope for cancer cells (see Lymph Node Surgery). Women who have a mastectomy may decide to have breast reconstruction at the same time or at a later date.

Lumpectomy or mastectomy?
After learning that you have breast cancer, you will very quickly begin making decisions about your treatment. One of the first decisions is about surgery. Although your surgeon and other members of your health care team will guide you with information and advice, ultimately the decision will be yours. Particularly if you have early-stage breast cancer, you will have to choose between mastectomy and breast-conservation surgery.

In 1990, the National Institutes of Health recommended breast-conservation therapy (lumpectomy or partial mastectomy plus radiation therapy) instead of mastectomy as an effective local control for most women with Stage I or II breast cancer. Five years later, an analysis of all the randomized studies ever performed showed long-term survival rates to be equal for mastectomy and breast-conservation surgeries in early-stage cancers. In other words, both procedures offer the same chances for survival. Since these reports were published, the use of breast-saving surgery has steadily increased.

There are some advantages and disadvantages to each type of surgery. It's worth taking a little time to gather information about your choice. Making a decision about surgery while you're still in a state of shock over your diagnosis is not necessary. In most cases, breast cancer surgery can be performed several weeks after the diagnosis, giving you the chance to learn more about cancer and cancer treatments. You also may want to seek a second opinion, preferably from a breast cancer specialist at another breast center, hospital, or medical school. The more informed you are about breast cancer, the more likely it is that you will find a treatment appropriate for your cancer and your needs.

Next >> Mastectomy

In This Article:
Treating Breast Cancer
Local and Systemic Treatments
Breast Surgery
Mastectomy
Surgeries That Conserve the Breast
Lymph Node Surgery
Radiation Therapy

From the Harvard Health Publications Special Health Report, Breast Cancer: Strategies for Living. Copyright 2004 by the President and Fellows of Harvard College. Illustrations by Harriet Greenfield, M.A., and Jesse Tarantino. All rights reserved. Used with permission of StayWell. Harvard Medical School does not endorse products.
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