The Evolution of Breast Cancer Surgery
Breast cancer surgery and treatment have evolved a lot over time, from radical mastectomies that at times removed more tissue than needed, to today’s more personalized approaches. Patients now have access to surgical options that are designed specifically to achieve their individual goals, preferences and lifestyle. Some may choose a lumpectomy to remove the cancer while still keeping as much of the breast as possible, while others might choose a mastectomy, removing the whole breast. The latter might especially be chosen if they have a family history of breast cancer, a BRCA1 or BRCA2 gene mutation or because they feel more at ease knowing the entire breast is gone to reduce the odds of recurrence.
This installment of Know More is designed to make you aware of some advanced, personalized tools that may be used during breast surgery with the goal of empowering you to clearly define your objectives so that your care team can build a plan tailored to your needs and priorities.
Whether the goal is breast conservation or total breast removal with or without reconstruction, your surgery plan is designed to match your preferences and the size and shape of your body. For example, a lumpectomy might be carefully planned to conserve as much healthy tissue as possible, whereas a mastectomy might be approached to facilitate the best outcomes based on your desired appearance. It is worth noting that a lumpectomy with radiation therapy is as effective for breast cancer survival as a mastectomy.
These decisions often depend on what matters most to you, including your peace of mind, your body image and life outside treatment. According to recent data from the American Cancer Society, around half of women diagnosed with early-stage breast cancer underwent a lumpectomy followed by radiation therapy, while nearly one third had a mastectomy. For those facing stage 3 breast cancer, a mastectomy is more common, typically combined with radiation and chemotherapy.
These numbers help underscore how breast cancer surgery decisions can be personal and highlight the value of talking with your doctor to tailor your surgical plan around clinical factors just as much as your lifestyle, comfort and priorities.
Tools That Enable Personalization in Breast Surgery
Advanced pre-surgery planning: Technologies like magnetic resonance imaging (MRI), mammography, computed tomography (CT) scans and advanced 3D surgical modeling can help surgeons visualize your unique anatomy clearly and accurately. This is an improvement contrary to the past when surgeons generalized body types and estimated targets, at times resulting in excess healthy tissue or not enough cancerous tissue being removed.
MRI uses powerful magnets and radio waves to produce detailed images of breast tissue to see tumor location. It’s an emerging technology to be used in this way in breast cancer but can help determine whether a mastectomy or lumpectomy is recommended.
Mammography is an X-ray imaging technique critical for detecting abnormalities in the breast, and CT scans combine X-ray images taken from multiple different perspectives to create a detailed, cross-sectional view of your body.
Photo Credit: Maggie Lashutka
Digital and physical 3D models can be created from your imaging scans to help plan your surgery. They can give your surgeon a detailed and tangible representation of your anatomy before they even make the first incision, thereby allowing visualization of the tumor’s location, size and relationship to surrounding tissues. Some surgeons might use them as a guide in the operating room, while others may use them to explain the procedure to you. If available at your care center, seeing a model of your own body can help you understand what’s happening while feeling more confident in your care decisions.
These tools allow for detailed and precise surgical planning, thus increasing the accuracy of cancer removal to result in better cosmetic outcomes and better functional recovery.
Real-time guidance during surgery: Different tools can provide surgeons with real-time information and insights while operating. For example, ultrasound can help pinpoint tumor location and size during the procedure whereas radioactive seed localization is sometimes used to precisely mark cancerous tissue to be removed by placing tiny radioactive seeds within or near the tumor. Additionally, margin assessment technologies help confirm that cancerous tissue has been entirely removed by evaluating the edges, known as tumor margins, of the excised tissue. Clear margins means the incision area is free from cancer cells and indicates that the surgery successfully removed all of the cancerous tissue, which can reduce the likelihood of recurrence. Together, these tools improve outcomes and can increase confidence that the surgery was successful.
Precision Versus Conservative Surgery
Using these tools to aid in surgery is not about being less aggressive; instead, it’s about operating smarter, more effectively and with greater precision. These methods enhance accuracy, surgical information and can improve outcomes. This all enables you to gain greater control over your treatment trajectory.
To benefit fully from these potential advanced tools, questions you can ask your surgeon include:
- How is my anatomy influencing your surgical approach?
- What advanced imaging or modeling tools could you use for my surgery?
- How do you confirm complete cancer removal during or after surgery?
Content covered in the Know More Educational Series may be an emerging area in research or technology. Talk with your doctor about what is right for you.
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Downloadable Resource:
Questions to Ask Your Doctor or Surgeon PDF
Read More:
“Choosing the Right Breast Surgery” Serena’s personal story
Contents of a Pathology Report
Emerging Areas in Breast Cancer Surgery
Breast Cancer Surgery Fact Sheet PDF
Questions to Ask Your Doctor PDF
Watch & Hear More:
Real Pink Podcast: “Reframing the Discussion for Surgical Options After Breast Cancer”
Real Pink Podcast: “Promising Advancements in Nipple-Sparing Mastectomies”
“What to Expect After Breast Cancer Treatment”
“Maintaining a Healthy Lifestyle After Breast Cancer Treatment”
