Breast Cancer Surgery Options

Nipple-Sparing Mastectomy

Your surgeon removes breast tissue and typically some lymph nodes, but leaves the nipple, areola, and skin of the breast that can be used for your breast reconstruction.  

It may not be an option if you have cancer cells close to the nipple or areola.

Lumpectomy (Partial Mastectomy)

Your surgeon removes the tumor along with some of the breast tissue surrounding it. You may need radiation treatments afterward.

This may not be a good option for you if radiation therapy is recommended after surgery and you can’t or won’t have radiation.

Also, a lumpectomy is usually not an option if you have a large tumor or if cancer has grown outside the breast tissue. 

Lymph Node Surgery

An important part of breast cancer surgery involves checking the lymph nodes to see if the cancer has spread. The doctor usually does this at the time of the original surgery, but they can also do it later. There are two main types of lymph node surgery for breast cancer:

• Axillary lymph node dissection (ALND). The surgeon takes out about 10 to 20 lymph nodes from under the arm. Those get checked for cancer.
• Sentinel lymph node biopsy. The surgeon finds and removes the lymph node where the breast cancer would most likely have spread first. This surgery is less likely to cause lymphedema, or swelling in the arm, than an ALND.

Breast Reconstruction

Many women who get a mastectomy choose to get breast reconstruction either right afterward or later on. You can use breast implants or your own tissue, usually from your lower belly.

Preparing for Breast Cancer Surgery

No matter what type of breast cancer surgery you have, you’ll need to take steps to get ready.

One of the first things you’ll need to do is to give your medical history. Your doctor will ask you about any medications you’re taking, including vitamins and supplements. They’ll also want to know if you’ve had any reactions to medications or surgical procedures in the past. If you have any conditions that could affect how your body responds to surgery, such as heart disease, diabetes, or high blood pressure, you should let your doctor know at this time.

Your doctor may suggest that you donate a pint or two of blood in case you need it during surgery. If you do this, you’ll need to allow extra time in your pre-op schedule to donate and recover.

As your surgery date gets closer, your doctor may order tests for you. These can include a chest X-ray, EKG, and blood and urine tests. These tests let your doctor know if your body is ready for the operation. They may also request a CT scan or breast MRI to check the size and location of your tumor.

How Long Will I Be in the Hospital?

The length of your stay in the hospital will vary depending on the type of surgery you have, how well you tolerate the operation, and your general health.

Lumpectomies are usually outpatient procedures. You’ll recover in a short-stay observation unit and will likely go home later the same day.

If you have a mastectomy or an ALND, you’ll probably stay in the hospital for 1 or 2 nights.

Breast Cancer Surgery and Recurrence 

Even if you've had a mastectomy in one breast, it's possible for your cancer to come back. This can happen in your remaining breast, your lymph nodes, or another part of your body, such as your lungs, bones, or brain. It's important to continue with self breast exams and yearly mammograms to spot any recurrence as soon as possible. Your treatment for a recurrence will depend on several things, including where the tumor is located and what treatments you had along with your first surgery.

If you've had a double (bilateral) mastectomy, the chances of your cancer coming back are much lower, but it can still form along the chest wall if any breast tissue cells are still in your body. Your doctor won't recommend mammograms, but you should continue to see your doctor regularly and report any symptoms or changes in your breast area to your doctor right away.