Breast conserving surgery
Breast conserving surgery (also called lumpectomy, partial mastectomy or wide local incision) involves the removal of the breast cancer and a small amount of healthy tissue surrounding it. Most women who have breast conserving surgery will have a course of radiotherapy afterwards.
Mastectomy
Mastectomy involves the removal of the whole breast and is recommended if the breast cancer is large or if there is more than one cancer in the breast. Double mastectomy is the removal of both breasts. If you need, or opt for, a mastectomy, you may also consider having a breast reconstruction.
Breast reconstruction
Breast reconstruction can be done at the same time as your breast cancer surgery, or as a separate procedure at a later time, even many years later if you wish.
Breast reconstruction is a very personal decision. If you think you may be interested in having a reconstruction, you should talk to your surgeon about this before you have your breast cancer surgery. You may also like to ask for referral to a plastic surgeon to discuss your reconstruction options.
Types of breast reconstruction include:
- Implant reconstruction, which uses silicone or saline implants under the chest muscle to create a breast mound
- Flap reconstruction, which uses muscles and skin from other parts of the body to form new breasts.
"If considering breast reconstruction, research surgery/surgeon, recovery times and possible problems thoroughly beforehand and talk to women who have had the different procedures performed. Ask to see pictures of final results." --Robin.
You can find out more about reconstruction on the Breast reconstruction page.
Not all women who have had a mastectomy choose to have a breast reconstruction. If you do not think you want a reconstruction, you may like to read the section on breast prostheses.
Removal of lymph nodes from the armpit
If cancer cells have begun to spread from the breast the first place they are usually found is in the lymph nodes under the armpit. If you are having surgery for breast cancer, it is likely that the surgeon will remove one or some of your lymph nodes to determine if they contain cancer cells. Knowing whether or not the cancer has spread to the lymph nodes will help your doctor to determine the best treatment for you.
There are two ways of removing lymph nodes:
- Axillary dissection (also known as axillary clearance) involves the removal of all or several of the lymph nodes from the armpit. This is usually done during breast cancer surgery.
- Sentinel node biopsy is a relatively new procedure which allows the surgeon to identify the first lymph node, or nodes, to which cancer cells are likely to spread. These nodes are removed during surgery and tested by a pathologist to determine if cancer cells are present. If they are found to be free of cancer, other nodes are unlikely to be affected and therefore do not need to be removed. If cancer is found in the sentinel nodes, you may have further surgery to remove some or all of the remaining nodes. In a small number of cases, the sentinel node is unable to be identified and an axillary dissection will be recommended. Sentinel node biopsy is not appropriate for all women; you may like to speak to your surgeon about whether it is suitable for you.
- Axillary dissection is identification and removal of some or all lymph nodes from the armpit and is usually done during breast surgery.
You may like to talk to your surgeon about the possible removal of lymph nodes during your surgery and which procedure he/she recommends for you.
The removal of lymph nodes can place you at increased risk of developing a condition called lymphoedema, which is swelling in the breast and/or arm. See our section on lymphoedema for more information.
More information
- The breast reconstruction page provides more detailed information about the procedures involved in breast reconstruction.
- The lymphoedema page has more information on managing and preventing lymphoedema.
- The Westmead Breast Cancer Institute has a Sentinal Node Biopsy brochure which you can order free of charge through their website.
