Medically reviewed by
Dr. Danielle Saldana
McLeod Surgery Clarendon – Sumter Office

Physicians often turn to surgery as the primary treatment for breast cancer – occasionally assisted by chemotherapy or radiation therapy. Women and their physicians have numerous surgical options these days.

“When discussing breast mastectomy with a cancer patient, we consider a wide range of considerations,” says McLeod General Surgeon Dr. Danielle Saldana. “There’s the size and location of the tumor, how much skin is involved, is there more than one tumor, has the tumor spread (metastasized), how much of the breast is affected, the size of the breast, the patient’s general health and her family and medical history.”
 
MASTECTOMY TYPES
Lumpectomy: Occasionally given its own category as “breast conservation surgery,” the lumpectomy involves removing only the tumor and tissue around the cancer.  Following this surgery, patients usually receive radiation.  A lumpectomy may not be suitable if:
·       The tumor is large or attached to the chest wall or nipple.
·       There’s more than one tumor and they are too far apart of be removed with one incision.
·       The patient already underwent radiation therapy on the breast.

Skin-Sparing Mastectomy: The surgeon removes the breast, nipple and areola. The surgeon preserves the remainder of the skin over the breast and this surgery is often followed immediately by breast reconstruction surgery. The surgeon can also spare the nipple or areola, which is also followed by breast reconstruction.
 
Simple (or Total) Mastectomy: The surgeon extracts the entire breast but leaves the lymph glands.  A biopsy of the lymph glands may be performed to ensure that the cancer has not spread. This surgery may be undertaken as a preventive measure for a woman, who does not have cancer but is at high risk.

Modified Radical Mastectomy: The surgeon takes out the breast along with the nipple and underarm lymph nodes. Chest wall muscles remain intact.

Radical Mastectomy: This relatively rare surgery occurs, when the breast cancer becomes very large and involves the chest wall muscles. The breast along with nipple, lymph nodes and chest wall muscles are all removed.

Contralateral Prophylactic Mastectomy: Women with high risk due to a family history or genetic mutation may choose to have the other healthy breast removed to lower their overall risk of a second breast cancer.

ACTION YOU CAN TAKE
If your mammogram reveals or your primary care physician thinks you have breast cancer, you will probably be referred to a cancer specialist (oncologist) and a surgeon to discuss the best course of treatment for you. Take an active role in making decisions about your treatment.

Find a Surgeon near you.

Sources include: McLeod Health, Up-To-Date,  National Institutes of Health, Cancer Research UK, American College of Surgeons