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Learn about the different ways surgery is used in the prevention, diagnosis, and treatment of cancer in Your Guide to Cancer Care.
For many years, radical mastectomy — also called Halsted radical mastectomy — was the standard treatment for women with breast cancer. During this procedure, the surgeon would remove the entire breast, together with all of the underarm lymph nodes, the chest muscles, and some additional fat and skin.
Today, radical mastectomy is rarely used, and only then in cases of advanced cancer that has spread to the chest muscles. Instead, surgeons aim to preserve as much healthy breast tissue as possible through approaches like sectional mastectomy, described below, and lumpectomy. Below are some of the breast-conserving approaches to mastectomy used today, beginning with the least invasive.
Learn about the possible side effects of breast cancer surgery, including lymphedema.
Segmental mastectomy is the surgical removal of the cancer, as well as a wide margin of normal breast tissue around it. Occasionally, the surgeon will also remove some of the lining over the chest muscles below the tumor and some of the lymph nodes under the arm.
Total mastectomy, also known as simple mastectomy, is the removal of the whole breast. The surgeon may also remove lymph nodes under the arm.
Modified radical mastectomy entails the removal of the whole breast, most of the lymph nodes under the arm, and often the lining over the chest muscles. The surgeon also takes out the smaller of the two chest muscles to help in removing the lymph nodes.
Some women who have very aggressive breast cancer in one breast may decide to have both breasts removed, or a double mastectomy, to reduce the risk of the cancer spreading or recurring in the other breast.
While a double mastectomy can significantly reduce the likelihood of developing breast cancer in the second breast, it can’t eliminate it altogether, since not all of the breast tissue can be removed.
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Depending on the stage and other characteristics of the cancer, you may have a choice between a lumpectomy and a mastectomy. Deciding between the two is a very individual and sometimes difficult decision. The risks and benefits of each approach will also depend on your individual situation and diagnosis.
The type of surgery your doctor recommends may also depend on his or her treatment philosophy and training. Radiation therapy is frequently used after a lumpectomy, since studies suggest that without radiation treatment, the cancer is very likely to recur in the same site. However, when radiation is used after surgery, people with earlier stage breast cancer typically fare equally well with either treatment.
It’s important to discuss all of your concerns about your treatment choices with your doctors and other healthcare professionals, so that you have the knowledge you need to make a decision that you are comfortable with. You may want to consult with a second, or even third, oncologist to get another opinion on which of your options may be most appropriate for you. Your decision may ultimately affect which surgeon you decide to seek treatment with.
Breast prosthetics are artificial breasts and bra inserts — called breast forms — that are worn underneath your clothing. They are often made of silicone and other materials that can simulate the appearance of a natural breast.
Breast cancer surgery can affect the way you feel about your body and your sexuality. However, newer, less invasive approaches to breast cancer surgery, as well as advances in breast reconstruction and breast prosthetics, can help minimize the impact that treatment may have on your appearance and give you options for restoring your physical shape and self-confidence.
Breast reconstruction can be used to rebuild the contour of your breast, along with the nipple and the dark area around it, called the areola. It’s a good idea to consult with a reconstructive surgeon before your breast cancer surgery, even if the restoration will be done later.
Lymphedema, or swelling, especially in the arm, after breast cancer surgery can also have an impact on the way you look and feel. Learn how this common side effect can be managed.
The surgeon may be able to use implants or your own tissue to rebuild the breast. The most common approaches are:
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