Breast Cancer

Surgery

Contact:

Vascular Surgery Division
Wright State Physicians Surgery
Miami Valley Hospital
30 East Apple Street, Suite 5253
Dayton, OH 45409

(937) 208-2552
Fax: (937) 208-6154

Breast Cancer

The goal of breast cancer surgery is to remove the entire tumor from the breast. Some of the lymph nodes from the underarm area (axillary nodes) may also be removed to see if cancer cells are present.

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

Lumpectomy

During a lumpectomy, a surgeon removes the cancer, including some normal breast tissue around the tumor. If cancer cells are found at any of the edges of the cancer that has been removed, it is said to have positive margins and additional surgery may be needed to remove additional tissue.

Mastectomy

A mastectomy is the surgical removal of the breast. A mastectomy is most often recommended when:

  • there are multiple areas of cancer in your breast
  • your breast is small or shaped in such a way that removal of the cancer will leave little breast tissue
  • you do not want or cannot have radiation therapy

Breast cancer staging

Staging is a way of describing a cancer. There are five breast cancer stages. Knowing your cancer stage helps your doctors decide what kind of treatment is best for you. Your doctor will use information based upon the stage and type of your cancer to determine the best treatment options for you.

Your cancer stage and treatment will depend on:

  • the size of your tumor
  • if cancer is found in the lymph nodes in your armpit
  • if cancer is found in other parts of your body

Breast Cancer Stages

  • Stage 0: The cancer cells are contained within the ducts or lobules of the breast.
  • Stage 1: The tumor measures two centimeters or less. It has invaded other breast tissue, but has not spread to the underarm lymph nodes.
  • Stage 2: The tumor measures more than two centimeters or has spread to three or fewer lymph nodes under the armpit.
  • Stage 3: The tumor measures larger than five centimeters and/or the tumor has spread to the skin, chest wall, or nearby lymph nodes.
  • Stage 4: The tumor has spread to the bones, lungs, liver, other distant organs, or lymph nodes far away from the breast.

What are lymph nodes?

Lymph nodes are small structures found throughout the body. They act as filters for germs, and help fight off infection and disease.

Sometimes cancer cells enter these lymph nodes. When breast cancer spreads outside the breast, it frequently spreads to the lymph nodes in the armpit first. These lymph nodes are called axillary lymph nodes. Finding out whether or not the cancer has spread to these nodes is important and helps your doctor develop your treatment plan.

Removal of Lymph Nodes

Sentinel lymph nodes are the first lymph nodes to which cancer is likely to spread. To perform a sentinel biopsy your surgeon will inject a radioactive substance, a blue dye, or both near the tumor to locate the position of the sentinel lymph node. The surgeon then uses a device that detects radioactivity to find the sentinel node or looks for lymph nodes that are stained with the blue dye. Once the sentinel lymph node is located, the surgeon makes a small incision in the overlying skin and removes the node.

If the sentinel nodes show no cancer cells, then it is very likely that the other axillary nodes will also be cancer free and the nodes will require no further treatment.

If the sentinel nodes do show cancer cells, depending on your circumstances, the surgeon may remove more lymph nodes in the armpit. The remaining nodes may be treated with chemotherapy, radiation, or hormonal therapy to control any remaining disease.

Lumpectomy removes:

  • cancer tumor
  • some normal breast tissue around the tumor

Total or simple mastectomy removes:

  • as much breast tissue as possible
  • some of the overlying skin of the breast the nipple
  • in some cases it may be possible to save the nipple and surrounding tissue
  • the lymph nodes in the armpit are NOT removed
  • Modified radical mastectomy removes:
  • as much breast tissue as possible
  • the nipple
  • the tissue lining the muscles of the chest, but qnot the muscles themselves
  • some lymph nodes in the armpit