What are the types of breast cancer surgery?

Dr. Ajay K. Sahajpal, MD
Transplant Surgeon

Lumpectomy is one type of breast surgery. This is when the surgeon tries to keep as much breast tissue as possible. A mastectomy is when the entire breast is removed. There are three types of mastectomies: modified radical (removal of the breast, lining of chest muscles and some underarm lymph nodes), total or simple mastectomy (removal of entire breast) and radical (removal of breast, lining of chest muscle and most of the lower, middle and upper lymph nodes).

There are two main categories of breast cancer surgeries: lumpectomy (also known as breast conservation surgery or breast conservation therapy) and mastectomy:

  • Lumpectomy, or breast conservation therapy, is the removal of the specific cancerous tissues or tumor, while leaving the rest of the breast intact. This procedure is almost always followed by radiation therapy to the breast.
  • Mastectomy is the removal of the breast and some surrounding tissue. There are several types of mastectomy, and vary based on how much of the breast tissue is removed.

There are two surgical options available for treating breast cancer: lumpectomy and mastectomy.

Only you and your physician can decide what type of breast surgery is best to treat your cancer. Breast-conserving surgery removes only the part of the breast affected by cancer and a surrounding margin of normal tissue. How much tissue is removed depends on the size and location of the tumor and other factors. Partial mastectomy, quadrantectomy and lumpectomy are all types of breast-conserving surgery.

A mastectomy involves removing all of the breast tissue, sometimes along with other nearby tissues. In a simple or total mastectomy, the surgeon removes the entire breast, including the nipple, but does not remove underarm lymph nodes or muscle tissue from beneath the breast.

A radical mastectomy is an extensive operation where the surgeon removes the entire breast, axillary lymph nodes, and the pectoral (chest wall) muscles under the breast. This surgery was once very common, but a modified radical mastectomy has proven to be just as effective without the disfigurement and side effects of a radical mastectomy. Radical mastectomy may still be done for large tumors that are growing into the pectoral muscles under the breast.

Breast reconstruction may be an option at the time of a lumpectomy or mastectomy, or after surgery to treat breast cancer.

There are two main types of surgery for breast cancer—but depending on your cancer, you may be able to choose among many variations on those two. In this video, Dr. Jesse Dirksen explains.

Dr. Helena R. Chang, MD
Surgical Oncologist

In general, there are two types of breast cancer surgery: lumpectomy and mastectomy. For those women who have a very small tumor, whose cancer is not multicentric (having multiple centers of origin), who have no contraindication for radiation after the surgery and have no excessive genetic predisposition to breast cancer, lumpectomy usually is chosen by the women and also by their treatment doctor.

Radiation can come in different forms. Whole breast radiation or accelerated partial breast radiation limited to the area of lumpectomy can be done, or radiation can be done during the lumpectomy surgery, which avoids subsequent radiation. The goal of radiation after lumpectomy is to keep the local recurrence as low as possible.

On the contrary, for women who have a really large tumor, multicentric disease or diffuse malignant process in the breast, a very small breast, BRCA1 or BRCA2 mutation, contraindication for radiation or a preference for having mastectomy, then mastectomy appears to be a better choice for their breast cancer surgery.

Surgery for the breast: There are 2 surgical procedures that can be used to remove breast cancers. They are called lumpectomy and mastectomy. When performing a lumpectomy, the surgical oncologist or breast surgeon removes only part of the breast and does so in such a way that the cancer is completely removed from the breast. A mastectomy involves removal of all the breast tissue and sometimes part of the skin over the breast. Both are effective treatments for breast cancer. Most women with breast cancer have the option of choosing one of these to treat her breast cancer. And, when they are done correctly and in the right situation, the chance for cure is the same.

Surgery for the lymph nodes: Lymph nodes are small, jellybean shaped pieces of tissue that are located all around the body. One of their most important jobs is to look for and trap things that don't belong in our bodies, things like cancers.

If a breast cancer were going to spread from the breast, one of the earliest places it might spread is to the lymph nodes that are under the arm on the same side as the breast cancer. So, most women with an invasive breast cancer should have some of their lymph nodes removed as part of the evaluation to determine how far along the tumor is or isn't. This is called the stage and the surgical removal of lymph nodes from under the arm is an important part of staging a breast cancer for most women.

Surgery for breast reconstruction: One unavoidable fact of breast surgery is that it changes the appearance of the breast. Sometimes the changes in the appearance of the breast can be unsettling to women. With breast reconstruction a woman can work collaboratively with her surgical oncologist/breast surgeon and a plastic and reconstructive surgeon to address these concerns to achieve an outcome that is pleasing to the woman. Breast reconstruction surgery is most commonly used in conjunction with a mastectomy, but can also be a part of lumpectomy procedures.

Surgery for other parts of the body: Although most surgery for breast cancer involves the breast, lymph nodes or reconstruction of the breast, sometimes surgery for breast cancer is necessary outside of these areas. In these situations, surgery can be used to remove tumors that are causing symptoms or to try cure a patient with cancer in another body organ. Since most surgery for breast cancer does not fall into this category, it is important to make sure that breast cancer specialists agree with the plan for any such surgery.

Today, most women who have breast cancer can, after discussion with their doctor, choose the surgical option that is best for them. You may choose breast conservation or mastectomy. Studies show that either option provides the same long-term survival rates. Neither option gives a 100 percent guarantee that your cancer will not return at the treated site or in the other breast.

The surgical options available are:

  • Breast conservation: A surgeon removes the breast cancer, a little normal breast tissue around the lump, and usually some lymph nodes under the arm. This procedure removes your cancer while leaving you with a breast that looks much the same as it did before surgery.
  • Total mastectomy: Removal of as much of the breast tissue as possible, including the nipple and some of the overlying skin.
  • Modified radical mastectomy: Removal of as much breast tissue as possible, the nipple, some of the overlying skin and some lymph nodes in the armpit.
Dr. Stuart A. Linder, MD
Plastic Surgeon

The main two surgery options for breast cancer are lumpectomy and mastectomy.

A lumpectomy may be performed with axillary lymph node dissection. A modified radical mastectomy may be performed that leaves the chest muscle (pectoralis major muscle) intact. Consultation with both the general surgeon and the oncologist will aim you in the right direction.

The following are some of the breast cancer surgery options available :

  • Sentinel node mapping and biopsy
  • Lumpectomy
  • Mastectomy
  • Breast reconstruction
  • Lymphedema management

Before or after breast cancer surgery, you may receive adjuvant (additional) treatment to stop cancer growth, spread or recurrence in the treated area. Adjuvant breast cancer treatment may include chemotherapy, radiation, hormone therapy or a combination of these treatments.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.