Surgery

The role of surgery in breast cancer treatment

For well over a century, surgery has been the first line of attack against breast cancer. But things have changed a lot in recent years. Today, the goal is precise, targeted surgery that aims to preserve as much of the healthy breast and surrounding areas as possible. Even mastectomy (breast removal) is a more refined, less drastic option than it was a generation ago.

This section of breastcancer.org will help you to explore your options and to understand how decisions about surgery depend on many factors. The most important of these deciding factors are: the stage of the cancer, the overall "personality" of the cancer, and what is acceptable to you in terms of your long-term peace of mind.

You may hear many different terms used to describe the kinds of surgery that can be done, but there are really two main options:

• breast-conserving surgery, (commonly known as lumpectomy) in which only the tumor is removed from the breast. This is usually followed by radiation therapy to the remaining breast tissue.
• mastectomy, an operation in which the whole breast is removed. Sometimes radiation is given after mastectomy.

For invasive breast cancer, both of these procedures may also be accompanied by an axillary lymph node dissection. Recommendations for whole body or "systemic" treatments such as hormonal therapy, chemotherapy, or both, may follow either approach.

The need for systemic treatment is independent of which surgical procedure you choose. Do not elect to have a mastectomy thinking that this will eliminate the need for chemotherapy.

If you have early-stage breast cancer, ask your doctor about the sentinel lymph node dissection as an alternative to traditional lymph node dissection. Find out if you are a good candidate. If you are, ask if your surgeon has a high level of experience with this new technique, before proceeding.

The medical experts for Surgery are:

• Thomas G. Frazier, M.D., general and breast surgeon, Thomas Jefferson University Health System, Philadelphia, PA
• Anne L. Rosenberg, M.D., breast surgeon, Thomas Jefferson University Health System, Philadelphia, PA
• Marisa C. Weiss, M.D., breast radiation oncologist, Thomas Jefferson University Health System, Philadelphia, PA

These experts are members of the breastcancer.org Professional Advisory Board, including more than 60 medical experts in breast cancer-related fields.