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Surgery

The prospect of surgery is never pleasant. But fortunately, breast cancer surgery today is more targeted than in years past. That leads to less scarring and quicker recovery, at the same time providing an effective treatment to lower the odds of recurrence.

Diagnostic tools are more precise and the disease is better understood. Traditional options still largely apply, but employing them is no longer automatic. Each case is unique and individually analyzed. The breast cancer patient has choices and is an active participant in the decision making process.

One of the most common choices made is known as a lumpectomy. Just what it sounds like, a lumpectomy is the surgical removal of the lump that constitutes the cancer tumor. Even here there are a wide range of choices. The amount of tissue removed around the lump varies. Surgeons make a judgment call about how much is needed to reduce the chances of the cancer returning.

Depending on the size and location, and how long the tumor has been developing, one or more lymph nodes might be removed during a lumpectomy. The lymph nodes are oval, bean-sized glands that are part of a connected system that runs throughout the body. They play a major role in the immune system, fighting bacteria and the invasion of foreign bodies.

Once a cancer reaches a lymph node it can easily and rapidly spread through the body by means of the vessels connecting all the lymph nodes. When or if that happens, the cancer becomes much more difficult to treat. Often chemotherapy or radiation treatment is called for at this stage.

To minimize the likelihood of that happening, surgeons will sometimes remove one or more lymph nodes near a cancerous tumor. Then, lab tests are performed to check for any spread of the cancer. Here again, each case is unique and the options and likely actions should be discussed with all the physicians involved.

Breast cancer, like others, develops in stages determined by the size, location and type of tumors that make up the cancer. When breast cancer has reached a stage where it's called for, surgery may go beyond a lumpectomy. The patient and doctor (usually an oncologist) may opt for a partial or segmental mastectomy, sometimes called a quadrantectomy.

In that procedure more breast tissue is removed than in a simple lumpectomy. In many cases radiation therapy may be part of the follow up treatment regimen, often extending for six or eight weeks. The goal is to ensure that all the cancer was removed, or that any remaining malignant tissue the surgeon was unable to get is destroyed by the radiation.

In more extreme cases, which are fortunately recommended much less often today, a mastectomy may be performed. Most or all of the breast is removed. When no lymph nodes are taken, the procedure is called a simple or total mastectomy. When all the breast tissue is removed, along with the nipple and lymph nodes in the armpit, the surgery is termed a modified radical mastectomy.

When the surgeon has to go further and remove the accompanying chest wall muscles the procedure is called a radical mastectomy. Fortunately, this extreme action is rarely called for today. Even when required, reconstructive surgery or prosthetics can often restore appearance almost entirely.

Hospital stay varies with the type of treatment, ranging from outpatient, same-day release for a simple lumpectomy to a week for more intensive procedures. Explore all your options and research the effects carefully. Ask questions and don't be put off by too-busy physicians. Finding one willing to answer questions at length in layman's terms is the first step toward proper treatment.