Breast Cancer Surgery
The goal of breast cancer surgery is to remove the entire tumor from the breast.
Some of the axillary lymph nodes (lymph nodes in the underarm area) may also be removed to see if they contain cancer.
Lumpectomy and mastectomy
There are 2 basic types of surgery to remove breast cancer:
Lumpectomy (also called breast-conserving surgery, partial mastectomy or wide excision). The surgeon removes the tumor and a margin (small rim of normal tissue around the tumor). The rest of the breast remains intact. How your breast will look after a lumpectomy depends on the amount of tissue removed.
Mastectomy. The surgeon removes the entire breast. In many cases, but not all, this includes the nipple and areola. Sometimes, breast reconstruction is done at the same time as a mastectomy.
Radiation therapy after surgery
Radiation therapy after a lumpectomy
After surgery, most people who have a lumpectomy will have radiation therapy to the breast and sometimes the underarm area.
If your treatment plan also includes chemotherapy, radiation therapy is given after chemotherapy.
Radiation therapy after a mastectomy
Some people who have a mastectomy may have radiation therapy to the chest and/or the underarm area. If your treatment plan also includes chemotherapy, radiation therapy is given after chemotherapy.
Learn more about radiation therapy.
Breast reconstruction
Breast reconstruction can help restore the look of the breast after a mastectomy. It can be done at the same time as the mastectomy or later.
In some cases, breast reconstruction or breast reduction may be done after a lumpectomy to help restore a more natural appearance of the breast, or to match the size and shape of the other breast.
Learn more about breast reconstruction.
Deciding between lumpectomy and mastectomy
You may have a choice between a lumpectomy (plus radiation therapy) or a mastectomy.
If you have a choice of surgery, study your options. Weigh the risks and benefits of each surgery and choose the one that’s right for you. If both surgeries are options, overall survival is the same for a lumpectomy plus radiation therapy and a mastectomy [1-2]. This means both treatments lower the risk of dying (from breast cancer or other cause) by the same amount.
Surgery and drug therapies
The choice of surgery doesn’t affect whether you’ll need chemotherapy, hormone therapy, HER2-targeted therapy and/or other drug therapies. Drug therapies are given based on the characteristics of the tumor, not the type of surgery you have.
For example, whether or not you will need hormone therapy depends on the hormone receptor status of the tumor.
Learn more about deciding between a lumpectomy and a mastectomy.
Questions you may want to ask your health care provider
Before surgery
- Will you do a sentinel lymph node biopsy?
- If my sentinel lymph node(s) contains cancer cells, will I need an axillary lymph node dissection? When and how will that decision be made?
- Can I have a lumpectomy plus radiation therapy? If not, why not?
- Would treatment before surgery improve my chances of having a lumpectomy?
- Would chemotherapy or another type of drug therapy before surgery improve my chances of having a lumpectomy?
- If I have a lumpectomy, when will I meet with the radiation oncologist to discuss radiation therapy?
- How long will I be in the hospital after the surgery?
- Will I need someone to help me when I return home from the hospital?
- What restrictions will I have on my activities after the surgery? For how long?
- Will I have a surgical drain when I go home? If so, how will I care for it? When will it be removed?
- How should I expect to feel after the surgery?
- What side effects might I expect after surgery? What problems should I report to you right away?
- Will I have any numbness after the surgery?
- Where will the surgical scar(s) be?
- How does the removal of lymph nodes affect my chances of getting lymphedema? Does radiation therapy to the lymph nodes in the underarm area after surgery increase my chances of getting lymphedema?
- What are the long-term side effects or health risks from surgery?
- When should I return for follow-up? Do I need to bring someone with me?
- Who will discuss the findings of my pathology report with me? Can I get a copy of the report for my records?
- Will I need other treatments? If so, which one(s)? How long after surgery will I begin the other treatment(s)?
- Who will coordinate my care?
- How does my surgery (a lumpectomy or a mastectomy) affect my risk of having a local breast cancer recurrence, metastasis or a new breast cancer? Please explain the differences to me.
- Tell me about breast reconstruction. If I decide I want reconstruction, when can I have it (at the same time as the mastectomy or at a later date)? What are the risks? What about prosthesis options? Who else should I see to discuss and plan for reconstruction or prosthesis?
- Will part of my tumor be stored? Where will it be stored? For how long? How can it be accessed in the future?
- Who will talk with me about the cost of my treatment (including the expenses covered by my insurance and the costs I should expect to pay out-of-pocket)?
After surgery
- If surgery was a lumpectomy: Were there cancer cells at my tumor margins? Do I need more surgery?
- When will I be able to get back to my normal routine? When can I go back to work? Ask about specific jobs or activities you do.
- Are there any precautions I should take? Are there activities I should avoid?
- When can I start exercising again? Are there special exercises I should do? Are there any exercises I should avoid? Should I see a physical therapist or a lymphedema specialist?
- What problems should I report to you right away?
- Do I need to meet with a medical oncologist and a radiation oncologist? If not, why not? If yes, when?
- If I’d like to have a child after being treated for breast cancer, who should I talk to about my options?
- Should I continue to see my regular physician or gynecologist during my treatment? Will you update them on my care and prognosis?
- How often will I have check-ups and follow-up tests after treatment ends?
- Will a follow-up care plan be prepared for me? Who will prepare the plan?
- Which health care provider is in charge of my follow-up care?
- Where can I find information about support groups and other types of support for me and my loved ones?
- Who will talk with me about the cost of my treatment (including the expenses covered by my insurance and the costs I should expect to pay out-of-pocket)?
Learn more about talking with your health care team.
If you’ve been recently diagnosed with breast cancer or feel too overwhelmed to know where to begin to gather information, Susan G. Komen® has a Questions to Ask Your Doctor About Breast Surgery resource and a Questions to Ask Your Doctor About Breast Reconstruction resource that might help.
You can download and print them to take with you to your next doctor’s appointment or you can save it on your computer, tablet or phone using an app such as Adobe. Plenty of space and a notes section are provided to write or type the answers to the questions.
There are other Questions to Ask Your Doctor resources on many different breast cancer topics you may wish to download.
Treatment guidelines
Although the exact treatment for breast cancer varies from person to person, evidence-based guidelines help make sure high-quality care is given. These guidelines are based on the latest research and agreement among experts.
The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) are respected organizations that regularly review and update their guidelines.
In addition, the National Cancer Institute (NCI) has treatment overviews.
Talk with your health care team about which treatment guidelines they follow.
After you get a recommended treatment plan from your health care team, study your treatment options. Together with your health care team, make thoughtful, informed decisions that are best for you. Each treatment has risks and benefits to consider along with your own values and lifestyle.
You’re not alone
If you’re facing breast cancer surgery, it’s normal to feel worried or afraid. Many people have been where you are today. They had the same fears and faced the same tough choices. They’ve gone through breast cancer treatment and are living their lives.
It may help to talk with others who’ve finished treatment to help ease your fears. You can do this in a support group or by connecting one-on-one with another breast cancer survivor.
You can also talk with your health care providers about how you’re coping. They care about your overall well-being and can help you find ways to improve it. In addition to suggesting a support group, they may connect you to another member of your health care team, such as a social worker or patient navigator, for support. They may also refer you to a counselor.
Our Support section has a list of resources to help you find local and online support groups and other resources.
Learn more about social support and support groups.
Learn about ways to cope with stress.
Susan G. Komen® Support Resources |
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Surgery does not cause cancer to spread
Exposing breast cancer to air, removing some breast tumor tissue during a needle biopsy or cutting into the breast cancer during surgery does not cause breast cancer to spread.
For a short time after surgery, you will feel worse than you did before surgery. This isn’t because the breast cancer has spread. Your body just needs time to recover from the surgery.
Sometimes, the surgeon finds more cancer during surgery than was seen on an imaging test, or more than was felt during a clinical breast exam. This doesn’t mean the breast cancer spread between the diagnosis and the surgery, or during surgery. The breast cancer was already there. It just didn’t show up on the imaging tests or couldn’t be felt. So, it wasn’t found until the surgery.
Updated 04/09/24
