Surgery is usually the first stage of breast cancer treatment. The aim of surgery is to remove the cancer cells from the breast. The cancer (tumour) is then sent to a pathologist who will develop a pathology report. This will help your medical team to decide the best treatment options for you. For more information about this, visit the pathology page of this website.
The two main types of breast cancer surgery are:
- Breast conserving surgery (also called lumpectomy, partial mastectomy or wide local excision). This involves the removal of the part of the breast affected by the cancer; and
- Mastectomy. This involves the total removal of one or both breasts.
In most cases, breast cancer surgery also involves the removal of one or more lymph nodes from the armpit (axilla). For more information on this, please read the section on types of surgery.
In some instances, especially if you have a large tumour, chemotherapy or hormone therapy may be recommended before you have surgery. This will help to shrink the tumour before breast cancer surgery. This is called neoadjuvant chemotherapy.
Making your decision
The type of surgery you have will depend on your particular breast cancer (the pathology) and your personal preference. It’s important to make sure you have all the information you need before you make a decision. Don’t be afraid to ask your surgeon questions, or to get a second opinion from another surgeon if you are unhappy with, or unsure about, the advice you receive.
If you are offered a choice between breast conserving surgery and mastectomy, ask your doctor if there is any reason she or he would recommend one over the other.
Breast conserving surgery is often followed by a course of three to six weeks of radiotherapy. You may want to ask about radiotherapy before making your decision.
Before surgery, some women also ask for a referral to a plastic surgeon if they think they may want to have a breast reconstruction. Some types of reconstruction are done at the same time as breast cancer surgery, so it is important to think about reconstruction before your breast cancer surgery. Our Breast reconstruction page has more information about what’s involved in breast reconstruction.
Does your surgeon participate in the BreastSurgANZ Quality Audit?
If you are in the process of choosing a surgeon, you may wish to see if there is a surgeon in your area who participates in the BreastSurgANZ Quality Audit.
The Audit collects data and information from breast surgeons across Australia and New Zealand about the treatment and care of women with breast cancer. The Audit was established in 1998 with the purpose of improving the quality of care for women with breast cancer. It now has more than 300 surgeons from Australia and New Zealand participating in the reporting process.
The ‘find a surgeon’ section of the BreastSurgANZ website has a list of participating surgeons.
Information about some of the research that has resulted from the data collected through the Audit can be found on our BreastSurgANZ Quality Audit page.
Staying in hospital
The amount of time you spend in hospital will depend on the type of surgery you have and how you respond to it. Your surgeon can give you an idea of what to expect.
Here are some tips from other women to help make your hospital stay more comfortable:
- Buy some pyjamas that button at the front. They are easier for you to manage, and make it easier for your medical team to check your dressings.
- If you are sharing a room or are easily disturbed, pack earplugs and/or a music player.
- If you have a breast care nurse, ask her to order you a free My Care Kit. The kit contains a Berlei bra which has been specially designed for women to wear after breast cancer surgery.
- Before you go to hospital, you might like to order a free breast care cushion from Zonta. The cushion can be tucked under your arm to provide support when you sleep. Zonta breast care cushions are also available from most major hospitals.
Side effects of surgery
Lymphoedema is swelling in the arm or the breast following the removal of lymph nodes in the armpit. You can find more information in the lymphoedema section of our website
Seromas are collections of fluid which occur in the area where the surgery took place. They are quite common following surgery. In most cases the fluid will be absorbed by your body over time. If it is uncomfortable, it can be drained by a member of your medical team.
Cording is a common side effect of breast cancer surgery. Cording refers to the development of tender vertical ‘cords’ in the armpit after the lymph nodes have been removed. Cording creates a pulling sensation down to the elbow or wrist. It is not harmful, but if tender, a warm pack on the area may help to reduce discomfort. Cording usually disappears by itself within a few months. If you are having trouble with cording, a physiotherapist can help you with gentle massage and exercises.
If you would like more information on breast cancer surgery, please consider the following resources:
- Sign up to BCNA's My Journey for more information about mastectomies and breast surgery.
- The personal stories section of our website contains stories written by women who have undergone breast reconstruction surgery.
- Join our online network if you think talking to others online and sharing experiences will help.
- Visit our breast reconstruction page. It provides more information about the procedures involved in breast reconstruction.
- The Westmead Breast Cancer Institute has a brochure called Your Breast Cancer Operation which helps to explain what to expect before and after your breast cancer surgery. A brochure is also available on post-operative Wound Care. You can order these and other brochures free of charge through their website.