Types of surgery
There are a number of different types of surgery used to treat breast cancer. The surgery that is right for you will depend on the extent of your breast cancer and your personal preferences.
Breast conserving surgery
Breast conserving surgery is also referred to as a lumpectomy, partial mastectomy or wide local incision. It involves removing the breast cancer as well as a small amount of surrounding healthy tissue. Most women who have breast conserving surgery will be recommended to have radiotherapy treatment afterwards.
A mastectomy involves the removal of the whole breast. It is usually recommended if the breast cancer is large or if there is more than one cancer in the breast. A double mastectomy refers to the removal of both breasts. If you need, or choose to have a mastectomy, you may also consider having breast reconstruction surgery.
Have you wondered what a mastectomy looks like?
- BCNA member Judy Pippen has shared her own mastectomy story through this video ‘Owning my Scars’.
Breast reconstruction surgery can be done at the same time as your breast cancer surgery or at a later time. Some women leave it for a number of years. Breast reconstruction is a very personal decision. If you think you may be interested in having a reconstruction, talk to your breast surgeon early on. It’s a good idea to talk about it before you have your breast cancer surgery. You may also like to ask your surgeon for referral to a plastic surgeon so that you can discuss your reconstruction options in advance.
Types of breast reconstruction
There are a number of types of breast reconstruction. These include:
- Implant reconstruction, in which silicone or saline implants are inserted under the chest muscle to create a breast mound.
- Flap reconstruction, in which muscles and skin from other parts of the body are used to form new breasts.
You can find more information on breast reconstruction on our Breast reconstruction page.
Making the decision
Not all women who have a mastectomy choose to have a breast reconstruction. In fact, many women decide to have no further surgery. Some women who don’t want a reconstruction choose to wear an external breast prosthesis. Ultimately, the choice is yours and you should not feel pressured into making any decision that you are not comfortable with.
Removal of lymph nodes from the armpit
When cancer cells begin to spread from the breast, the first place they are usually found is in the lymph nodes in the armpit. If you are having surgery for breast cancer, your surgeon will probably remove one or some of your lymph nodes to determine if they also contain cancer cells. Knowing whether or not the cancer has spread to the lymph nodes will help your doctor to determine the best treatment options for you.
There are two ways of removing lymph nodes:
- Axillary dissection (also known as axillary clearance). This involves removing several, or all, lymph nodes from the armpit. This is usually done at the same time as the breast cancer surgery.
- Sentinel node biopsy. This involves injecting a dye into your breast to determine which lymph node/s it spreads to first. This is known as the sentinel node. The surgeon removes the sentinel node/s during the breast cancer surgery and they are tested by a pathologist to determine if cancer cells are present. If they are cancer free, 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 undertaken.
It can be a good idea to talk to your surgeon about the possible removal of lymph nodes during your surgery and which procedure will be right for you.
Having your lymph nodes removed can increase your risk of developing a condition called lymphoedema. Lymphoedema is a swelling in the breast or arm.
If you would like more information on the types of surgery used in breast cancer treatment, please consider the following resources:
- Join our Choosing breast reconstruction group on our online network to connect with other women who have had, or have considered, breast reconstruction.
- If you are unsure if breast reconstruction is right for you, you can use our free breast reconstruction decision aid BRECONDA.
- The breast reconstruction page of this website provides more detailed information about the procedures involved in breast reconstruction.
- The lymphoedema page of this website has more information on managing and preventing lymphoedema.
- The Westmead Breast Cancer Institute has a Sentinel node biopsy brochure which you can order free of charge through their website.