Breast-sparing techniques
Once breast cancer is detected or diagnosed, treatment plans need to be made
to reduce the chance of the cancer returning in or outside of the breast. The
goal of surgery is to remove localized cancer (cancer that hasn’t spread to
other parts of the body) by removing the tumor itself and a portion of
surrounding tissue, while conserving as much of the breast as possible.
Surgical options
The various surgical techniques differ in the amount of breast tissue that
is removed with the tumor. The technique used depends on the tumor’s
characteristics, whether it has spread (metastasized) and your personal
feelings. The surgeon often removes some axillary (under the arm) lymph nodes as
part of the operation so they can be tested for signs of malignancy. This is
done to help plan your treatment after surgery.
The breast surgeon will discuss your surgery options with you before the
procedure. A specific surgical procedure may be recommended for you based on the
size, location, or type of breast cancer you have. Some of the procedures the
physician may discuss with you include lumpectomy, simple or total mastectomy,
and modified radical mastectomy.
Lumpectomy — This is also referred to as breast conservation. 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. Upon completion,
this treatment aims to maintain a normal breast appearance.
After the lumpectomy, a six week course of radiation therapy is
used to treat the remaining breast tissue. Most women who have small, early stage breast cancers are excellent candidates for this treatment approach. Women
who usually are not 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
Women who have cancer that is not completely removed with the lumpectomy may
need further surgery to take out those remaining cancer cells.
Partial or segmental mastectomy or quadrantectomy — The surgeon
removes up to one quarter more breast tissue than is removed in a lumpectomy.
The cancerous area and a surrounding margin of normal tissue are removed, and
radiation therapy is given after surgery for six weeks.
Simple or total mastectomy —The entire breast is removed, but no
lymph nodes are removed in this procedure. Simple mastectomy is most frequently
used for further cancer prevention or when the cancer does not go to the lymph
nodes.