The Who, What, Where, When and Sometimes, Why.

Surgery

Find information about coronavirus and breast cancer surgery.

The goal of breast cancer surgery is to remove the entire tumor from the breast.

Some of the lymph nodes in the underarm area (axillary nodes) may also be removed to see if they contain cancer.

Lumpectomy and mastectomy

There are 2 basic types of surgery to remove breast cancer:

Figure 5.1 shows each type of surgery.

Figure 5.1

Lumpectomy. The surgeon removes the breast tumor and a small rim of normal tissue around it. The rest of the breast remains intact.

How your breast looks after lumpectomy depends on the amount of tissue removed. The image below is just an example. Your scar may be a different size and/or in a different place.

 Lumpectomy image from BC101

Image courtesy of Lange Productions (http://langeproductions.com/).

Mastectomy. The surgeon removes the entire breast. In many, but not all, cases this includes the nipple and areola.

Sometimes, breast reconstruction is done at the same time as a mastectomy.

Mastectomy image from BC101

Image courtesy of Lange Productions (http://langeproductions.com/).

 

Radiation therapy

Radiation therapy after lumpectomy

After surgery, most women who have a lumpectomy will have radiation therapy to the breast, and sometimes the underarm area. If the treatment plan includes chemotherapy, radiation therapy is given after chemotherapy.

Radiation therapy after mastectomy

Some women who have a mastectomy may have radiation therapy to the chest and/or the underarm area. If the treatment plan includes chemotherapy, radiation therapy is given after chemotherapy.

Learn more about radiation therapy.

 

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 rare cases, breast reconstruction or breast reduction may be done after a lumpectomy to maintain a more natural appearance of the breast, or to match the size and shape of the other breast.

Learn more about breast reconstruction.

 

Treatment guidelines

Although the exact treatment for breast cancer varies from person to person, guidelines help ensure high-quality care. 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 providers about which treatment guidelines they use.

Deciding between lumpectomy and mastectomy

You may have a choice between a lumpectomy (plus radiation therapy) or a mastectomy.

If you have a choice, take time to study your options. Weigh the risks and benefits of each and choose the surgery that’s right for you. Survival is the same no matter which option you choose [2].

Also, the choice of surgery does not affect whether you will need chemotherapy, hormone therapy and/or HER2-targeted therapy. Drug therapies are given based on the characteristics of the tumor, not the type of surgery you have.

Learn more about deciding between lumpectomy and mastectomy.

You are not alone

If you’re facing breast cancer surgery, remember, 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, recovered and are living their lives.

It may be helpful to talk with others who’ve finished treatment to help ease your fears.

Our Support section has a list of resources to help find local and online support groups. Your health care provider may also be able to help you find a support group.

Learn more about social support and support groups.

 SUSAN G. KOMEN® SUPPORT RESOURCES 

  • If you or a loved one needs more information about breast health or breast cancer, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636). All calls are answered by a trained specialist or oncology social worker in English and Spanish, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET. You can also email the helpline at helpline@komen.org
  • We offer an online support community through our closed Facebook Group – Komen Breast Cancer group. The Facebook group provides a place where those with a connection to breast cancer can discuss each other’s experiences and build strong relationships to provide support to each other. Visit Facebook and search for “Komen Breast Cancer group” to request to join the closed group.
  • Komen Affiliates offer breast health education and some fund breast cancer programs through local community organizations. Your local Affiliate may also help you find breast cancer resources in your area. Find your local Affiliate.
  • Our fact sheets, booklets and other education materials offer additional information.

 

Surgery does not cause cancer to spread

Exposing breast cancer to air, removing some tumor tissue with a needle biopsy or cutting through the cancer during surgery does not cause it to spread.

Surgery and diagnostic procedures (such as surgical and needle biopsies) don’t cause breast cancer to spread.

For a short time after surgery, you will feel worse than you did before surgery. This is not because the breast cancer spread. Your body just needs time to recover from the surgery.

Sometimes, the surgeon finds more cancer during surgery than could be seen on a mammogram or other imaging tests. This doesn’t mean the breast cancer spread during surgery. The breast cancer was already there. It just didn’t show up on the imaging tests.

 

Before surgery

  • Will you do a sentinel node biopsy?
  • If my sentinel lymph node(s) contains cancer cells, will I need an axillary dissection? When and how will that decision be made?
  • Can I have a lumpectomy plus radiation therapy? If not, why not?
  • Would chemotherapy, HER2-targeted therapy and/or hormone therapy before surgery improve my chances of having a lumpectomy?
  • If I have a lumpectomy, when will I meet with a 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?
  • How should I expect to feel after the surgery?
  • What limits will I have on my activities? For how long?
  • Where will the surgical scar(s) be?
  • Will I have any numbness after the surgery?
  • Will I have a surgical drain when I go home? If so, how will I care for it? When will it be removed?
  • What side effects might I expect after surgery? What problems should I report to you right away?
  • How does the removal of lymph nodes affect my chances of getting lymphedema? Does radiation therapy after surgery affect 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 (lumpectomy or 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 saved? 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

  • Were there cancer cells in my tumor margins (if had lumpectomy)? 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 any activities I should avoid?
  • When can I start exercising again? Are there any exercises I should avoid? Are there special exercises I should do? 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 would like to have a child after being treated for breast cancer and I will need chemotherapy or other treatments that can affect fertility, 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?
  • 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 provider.

If you have breast cancer, Susan G. Komen® has a series of Questions to Ask Your Doctor resources that may be helpful. For example, we have a Questions to Ask Your Doctor About Breast Surgery resource and a Questions to Ask Your Doctor About Breast Reconstruction resource.

It may be helpful to download and print these resources and take them with you to your next doctor appointment. There’s plenty of space to write down the answers to these questions, which you can refer to later.

There are other Questions to Ask Your Doctor resources on many different breast cancer topics you may wish to download. They are a nice tool for people recently diagnosed with breast cancer, who may be too overwhelmed to know where to begin to gather information.

 

TOOLS & RESOURCES

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