When a woman is diagnosed with breast cancer, a million thoughts run through her head. What type of breast cancer do I have? How quickly is it growing? Has the cancer spread? Will I lose one or both of my breasts?
All of this can have a profound impact on the treatment decisions a woman makes – especially in cases where breast surgery may play a pivotal role in their overall treatment plan. In fact, surgery is one of the primary treatments for breast cancer and is used:
• As a diagnostic and treatment tool to determine the cancer’s growth and progression
• To relieve symptoms found in advanced stages
• To cosmetically reconstruct the breast(s) after cancer surgery
• To reduce breast cancer risk for those with higher risk, such as women with an immediate family member who has had breast cancer, or those whose genetic tests indicate a mutation that conveys a high risk of breast cancer
Excluding skin cancers, the World Health Organization reports that breast cancer is the most common form of cancer worldwide. In Texas, over 21,000 women are expected to face a new diagnosis of breast cancer in 2022, according to the American Cancer Society.
How to decide which breast surgery is right for you
Surgery for breast cancer depends on several factors including the size and location of the tumor(s), stage of cancer, treatment options, and individual goals and preferences. While surgery will not fully treat metastatic breast cancer, it can be helpful to treat one site with significant symptoms.
Common surgical procedures used to treat breast cancer include breast-conserving surgery and mastectomy.
• Breast-conserving surgery, also referred to as a lumpectomy, quadrantectomy, or partial mastectomy, removes the area of cancerous tissues from the breast without removing the entire breast.
• Mastectomy is the surgical removal of an entire breast. It is usually performed when a patient cannot be treated with lumpectomy. In some cases, mastectomy will be the most appropriate or only option due to the type of breast cancer, tumor size, location of the tumor in the breast, or previous radiation treatment in the area. Some women may have both breasts removed in what is called a double mastectomy. If the cancer does not involve the nipple, a nipple sparing mastectomy may be performed. An oncoplastic partial mastectomy is another option, which removes the cancer and reconstructs the tissue and breast.
Additional procedures include sentinel lymph node biopsy, lymph node dissection also known as a lymphadenectomy, and breast reconstruction surgery, which can be part of treatment after breast-conserving surgery or mastectomy.
Is breast reconstruction required after a mastectomy?
The impact of breast cancer and its treatment is an important part of every patient’s cancer experience. The loss of one or both breasts may change a woman’s self-perception or body image. This can be a factor for patients deciding if breast reconstruction surgery is right for them. Some women decide to not proceed with reconstruction.
Many women who have a mastectomy choose to have breast reconstruction to restore the breast’s appearance. This procedure rebuilds the shape and appearance of the breast using saline or silicone implants, or tissue moved from elsewhere in the body. In some cases, after a lumpectomy, reconstructive surgery can help restore breast symmetry and appearance.
Breast reconstruction can be performed at the same time as a mastectomy (immediate reconstruction), or after the completion of further treatment such as radiation and chemotherapy (delayed reconstruction). The timing of reconstruction depends on the type of breast surgery performed and individual patient factors.
As each person has a unique set of preferences and concerns related to the physical changes associated with surgery for breast cancer, patients should evaluate which surgical procedures are right for them based on their own priorities and goals and address any questions or concerns with their physician.