Types of Surgery for Breast Cancer
Written by : Dr.M.D.Mazumdar, MD
Surgery is the first line of treatment in breast cancer. It is generally combined with other treatment options like chemotherapy, radiotherapy or immunotherapy. Different types of surgeries are carried out depending on:
- The size and location of the tumor.
- The type of breast cancer
- The size of the breasts
- Whether it is still within the breast or has spread out to the surrounding tissues(metastasis).
- The woman's personal choice is also important to a certain degree.
Different Types of Breast Cancer Surgery
Breast Cancer Surgery may be Conservative or Radical -
Conservative Breast Cancer Surgery In this type of surgery, only the tumor or a part of the breast is removed. The rest of the breast is conserved. There are two types of conservative breast surgery.
- Lumpectomy A lumpectomy is the removal of the breast cancer and a portion of normal tissue around the breast cancer lump. The whole breast is not removed. Some of the nearby lymph nodes may also be removed if the surgeon deems it necessary. Lumpectomy is usually followed by radiotherapy or chemotherapy to ensure that all the cancer cells are destroyed.
- Partial Mastectomy Also known as Segmental mastectomy or quadrantectomy, the surgeon, in this operation, removes a larger amount of breast tissue around the tumor, maybe even 1/4th of it. He/she may also remove the lining over the chest muscles below the tumor and some of the lymph nodes under the arm.
Non-Conservative Breast Cancer Surgery Removal of the whole breast is a non-conservative surgery and is known as mastectomy. They may or may not be followed by radiotherapy. Mastectomy may be of diffeent types, depending on the amount of tissue removed.
- Total (Simple) Mastectomy - During a total (or simple) mastectomy, the entire breast (including the nipple, the areola, and most of the overlying skin) and also some of the lymph nodes under the arm,(called the axillary lymph glands) are removed.
- Modified Radical Mastectomy - This is a type of radical mastectomy in which 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 glands), and the lining over the chest muscles are removed. Depending on the size and location of the tumor, part of the chest wall muscles may also be removed.
- Radical Mastectomy This was the standard operation in earlier years. But now, with better diagnostic procedures and better chemotherapy drugs available, it is rarely done unless the cancer has spread to the underlying chest muscles. In radical mastectomy, the entire breast (including the nipple, the areola, and the overlying skin), the lymph nodes under the arm, also called the axillary lymph glands, and the chest muscles are removed.
- Skin-Sparing Mastectomy - The nipple and areola is removed but the rest of the skin of the breast is left intact. This type of surgery is only done if the tumor is not close to the skin or if breast reconstruction surgey is done in the same sitting.
- Prophylactic Mastectomy This is a type of mastectomy in which one or both the breasts are removed to prevent the development of cancer in future. It may be done in women who are at high risk for cancer.