Robert Wood Johnson University Hospital
 

Surgery for Breast Cancer

Tests and Procedures - Surgery for Breast Cancer Treatment

How is surgery used in breast cancer treatment?

Surgery to remove as much of the cancer as possible is the primary treatment for breast cancer. Today, women have many surgical options. The type of surgery done depends on:

There are several types of breast surgery. Your doctor can explain the benefits and risks of each type, and answer any questions or concerns you may have prior to surgery.

Questions to ask your doctor before surgery:

What are some of the different types of breast cancer surgery?

There are two types of breast conservation (tissue-sparing) surgery. These include a lumpectomy and a partial (segmental) mastectomy.

Illustration of a lumpectomy A lumpectomy is the removal of the breast cancer and a portion of normal tissue around it (the areas removed during the surgery are shaded in green). The surgeon may also remove some of the lymph nodes under the arm to determine if the cancer has spread. The bean-shaped lymph nodes under the arm (also called the axillary lymph nodes) drain the lymphatic vessels from the upper arms, the majority of the breast, the neck, and the underarm regions. Often, breast cancer spreads to these lymph nodes, enters the lymphatic system and spreads to other parts of the body. Radiation therapy is often given after a lumpectomy to destroy cancer cells that may not have been removed during the lumpectomy procedure.

Illustration of a partial mastectomy

A partial (segmental) mastectomy involves the removal of the breast cancer and a larger portion of the normal breast tissue around the breast cancer (the areas removed during the surgery are shaded in green). The surgeon may also remove the lining over the chest muscles below the tumor and some of the lymph nodes under the arm. The bean-shaped lymph nodes under the arm (also called the axillary lymph nodes) drain the lymphatic vessels from the upper arms, the majority of the breast, the neck, and the underarm regions. Often breast cancer spreads to these lymph nodes, enters the lymphatic system and spreads to other parts of the body. Radiation therapy may also be given after a partial mastectomy to destroy cancer cells that may not have been removed during the partial mastectomy procedure.

Mastectomy, a nonbreast-conserving procedure

If a woman does not choose a breast-conserving surgery, she may choose a mastectomy (removal of the breast). The doctor may recommend a mastectomy as the best surgical option under the following circumstances (among others):

There are three types of mastectomy. Your doctor can explain the benefits and risks of each type:

Illustration of a total mastectomy During a total (or simple) mastectomy, the surgeon removes the entire breast (including the nipple, the areola, and most of the overlying skin) and may also remove some of the lymph nodes under the arm, also called the axillary lymph nodes (the areas removed during the surgery are shaded in green). The bean-shaped lymph nodes under the arm drain the lymphatic vessels from the upper arms, the majority of the breast, the neck, and the underarm regions. Often, breast cancer spreads to these lymph nodes, enters the lymphatic system and spreads to other parts of the body.
Illustration of a modified radical mastectomy During a modified radical mastectomy, the surgeon removes the entire breast (including the nipple, the areola, and the overlying skin), some of the lymph nodes under the arm (also called the axillary lymph nodes), and the lining over the chest muscles. In some cases, part of the chest wall muscles is also removed (the areas removed during the surgery are shaded in green).
Illustration of a radical mastectomy During a radical mastectomy, the surgeon removes the entire breast (including the nipple, the areola, and the overlying skin), the lymph nodes under the arm, also called the axillary lymph nodes, and the chest muscles (the areas removed during the surgery are shaded in green). For many years, this was the standard operation. However, today, a radical mastectomy is rarely performed and is generally only recommended when the breast cancer has spread to the chest muscles.

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