August 31, 2015
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Surgeryinfo-icon is a local therapyinfo-icon used to treat breast cancer. The goal of local therapy is to control the disease in the breast and nearby lymphinfo-icon nodes. It reduces the risk for local recurrenceinfo-icon, a return of the cancer to the treated areas of the breast or lymph nodes.  Surgery removes the cancer and usually some lymph nodes. 

Almost everyone diagnosed with breast cancer has some surgery. Your doctor will use your initial pathology report, the results of imaging tests and physical exams to recommend the type of surgery. Ask your treatment team to explain why they recommend a certain surgery and how it will impact you.

In some cases, you may have a choice about the type of surgery. Usually, this decision involves whether you want to preserve your breast in a lumpectomyinfo-icon, or have the entire breast removed in a mastectomyinfo-icon.

Here are the most common types of breast cancer surgery.


Lumpectomy (Breast-Conserving Surgery)

In breast conservation, the surgeoninfo-icon performs a lumpectomyinfo-icon, also called a partial mastectomyinfo-icon or segmental excisioninfo-icon. This is often followed by radiation therapy to the remaining breast tissueinfo-icon.

Lumpectomy removes the tumorinfo-icon from your breast, along with a rim of normal tissue called the margininfo-icon. When a lumpectomy is done, the goal of surgeryinfo-icon is to remove the cancer with a negative margin, meaning the pathologistinfo-icon does not find cancer close to the edge of a sample of the tissue taken from your breast. Because cancer often can’t be seen with the naked eye, it can sometimes take several surgeries to remove all the cancer.

Not everyone can have a lumpectomy. In general

  • the tumor needs to be less than 5 centimeters across and in only one area of your breast
  • your breast must be large enough compared to the size of the tumor for the surgery to leave a good-looking result
  • you must be able and willing to have radiation therapyinfo-icon

If you can’t have a lumpectomy because of the size or extent of the tumor but you wish to do so, you may be able to get chemotherapyinfo-icon or hormonal therapyinfo-icon before surgery to shrink the tumor. This is called neoadjuvant therapyinfo-icon.



Mastectomyinfo-icon removes the entire breast. In general, this means also removing your nippleinfo-icon and areolainfo-icon, the dark area around the nipple. You may have mastectomy for a number of reasons, including:

  • personal choice
  • several tumors in different parts of the breast
  • tumors in the nipple area
  • previous breast cancer in the same breast
  • large tumors
  • a gene mutation, such as BRCA1info-icon or BRCA2info-icon, that increases the risk for breast cancer


Most of the time radiationinfo-icon is not given after mastectomy, but sometimes it is recommended. Talk with your care team about whether radiation might be needed.

If you have a mastectomy, you may choose to have breast reconstruction, either at the time of surgeryinfo-icon or at a later date.

Some people are eligible for skin-sparing mastectomy, removing all the breast tissueinfo-icon but leaving the skin, nipple and areola intact. A skin-sparing mastectomy allows a plastic surgeoninfo-icon to use your tissue to form the reconstructed breast with either an implantinfo-icon or tissue from another area of your body.


Lumpectomy or Mastectomy?

Most women are given the option of lumpectomyinfo-icon or mastectomyinfo-icon.  Studies show that lumpectomy with radiationinfo-icon or mastectomy alone work equally well in women with tumors less than 5 centimeters across who had no cancer remaining in the healthy margins of tissueinfo-icon removed during lumpectomy. 

When making a decision, you’ll want to weigh both the medical issues and your quality-of-life concerns. Talk to your medical team about which type of surgeryinfo-icon is right for you.

Lymph Node Surgery

If you have an invasive cancerinfo-icon, your surgeoninfo-icon will need to look at some of the lymphinfo-icon nodes in your armpit to see whether they contain cancer. This surgery is usually done at the same time as your breast surgeryinfo-icon. It will help you and your treatment team learn more about the stageinfo-icon of the cancer and what treatments you may need in addition to surgery and radiation therapyinfo-icon.

Breast Reconstruction Surgery

If you have a mastectomyinfo-icon, you may choose to have breast reconstruction, surgeryinfo-icon to rebuild your breast or breasts. There are many types of reconstructive surgeryinfo-icon and you can choose to have your breast reconstructed at the time of your mastectomy or even months or years later. In the United States, about 20 to 40 percent of women who have mastectomy have breast reconstructioninfo-icon.

If you do not rebuild your breast, you may get a breast form, or prosthesisinfo-icon, to place in your bra after surgery to maintain symmetry.  You may also choose not to have reconstructive surgery or use a prosthesis.

You have options, and you can take your time to decide which one makes most sense for you and your lifestyle.




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