Surgery is a common treatment for breast cancer, and its main purpose is to remove as much of the cancer as possible. There are different types of surgery. You may have a choice about which type to have. Or your doctor may recommend a certain operation based on your breast cancer type and your medical history. It’s important to know about your options so you can talk about them with your doctor and make the choice that is right for you.
Most women with breast cancer have some type of surgery as part of their treatment. Depending on the situation, surgery may be done for different reasons. For example, surgery may be done to:
- Remove as much of the cancer as possible (breast-conserving surgery or mastectomy)
- Find out whether the cancer has spread to the lymph nodes under the arm (sentinel lymph node biopsy or axillary lymph node dissection)
- Restore the breast’s shape after the cancer is removed (breast reconstruction)
- Relieve symptoms of advanced cancer.
Types of surgery
There are many different types of surgery for breast cancer. The type you have depends on:
- the size of the cancer
- where the cancer is in your breast
- the size of your breasts
- your personal wishes and feelings
Surgery to remove breast cancer
There are two main types of surgery to remove breast cancer:
- Breast-conserving surgery (also called a lumpectomy, quadrantectomy, partial mastectomy, or segmental mastectomy) – in which only the part of the breast containing the cancer is removed. The goal is to remove the cancer as well as some surrounding normal tissue. How much of the breast is removed depends on the size and location of the tumor and other factors.
- Mastectomy – in which the entire breast is removed, including all of the breast tissue and sometimes other nearby tissues. There are several different types of mastectomies. Some women may also get a double mastectomy, in which both breasts are removed.
Surgery to remove nearby lymph nodes
To find out if the breast cancer has spread to axillary (underarm) lymph nodes, one or more of these lymph nodes will be removed and looked at under the microscope. This is an important part of figuring out the stage (extent) of the cancer. Lymph nodes can be removed either as part of the surgery to remove the breast cancer or as a separate operation.
The two main types of surgery to remove lymph nodes are:
- Sentinel lymph node biopsy (SLNB) – in which the surgeon removes only the lymph node(s) under the arm to which the cancer would likely spread first. Removing only one or a few lymph nodes lowers the risk of side effects from the surgery.
- Axillary lymph node dissection (ALND) – in which the surgeon removes anywhere from about 10 to 40 (though usually less than 20) lymph nodes from under the arm. ALND is not done as often as it was in the past, but it might still be the best way to look at the lymph nodes in some situations.
Surgery for advanced breast cancer.
Although surgery is very unlikely to cure breast cancer that has spread to other parts of the body, it can still be helpful in some situations, either as a way to slow the spread of the cancer, or to help prevent or relieve symptoms from it. For example, surgery might be used:
- When the breast tumor is causing an open wound in the breast (or chest)
- To treat a small number of areas of cancer spread (metastases) in a certain part of the body, such as the brain
- When an area of cancer spread is pressing on the spinal cord
- To treat a blockage in the liver
- To provide relief of pain or other symptoms
If your doctor recommends surgery for advanced breast cancer, it’s important that you understand its goal—whether it’s to try to cure the cancer or to prevent or treat symptoms.
Which treatments are used for breast cancer?
There are several ways to treat breast cancer, depending on its type and stage.
Local treatments: Some treatments are called local therapies, meaning they treat the tumor without affecting the rest of the body. Types of local therapy used for breast cancer include:
- Radiation therapy
These treatments are more likely to be useful for earlier stage (less advanced) cancers, although they might also be used in some other situations.
Systemic treatments: Breast cancer can also be treated using drugs, which can be given by mouth or directly into the bloodstream. These are called systemic therapies because they can reach cancer cells anywhere in the body. Depending on the type of breast cancer, several different types of drugs might be used, including:
- Hormone therapy
- Targeted therapy
Many women will get more than one type of treatment for their cancer.
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