The types of breast cancer surgery differ in the amount of tissue that is removed with the tumor, depending on the tumor's characteristics, whether it has spread (metastasized), and your personal feelings. The surgeon often removes some lymph nodes under the arm as part of the operation, so they can be tested for the presence of cancer cells. This will help your doctor plan your treatment after surgery.

The surgeon will discuss your options with you before surgery. A specific surgical procedure may be recommended for you based on the size, location, or type of breast cancer you have. Some of the procedures you may discuss with your doctor include:

• Lumpectomy
• Partial or Segmental Mastectomy or Quadrantectomy
• Total Mastectomy
• Modified Radical Mastectomy
• Radical Mastectomy

Lumpectomy for Breast Cancer
This is also referred to as breast-conserving therapy. The surgeon removes the cancerous area and a surrounding margin of normal tissue. A second incision may be made in order to remove the lymph nodes. This treatment aims to maintain a normal breast appearance when the surgery is over.

After the lumpectomy, a five- to eight-week course of radiation therapy is often used to treat the remaining breast tissue. The majority of women who have small, early-stage breast cancers are excellent candidates for this treatment approach.

Women who are not usually eligible for a lumpectomy include those who have already had radiation therapy to the affected breast, have two or more areas of cancer in the same breast that are too far apart to be removed through one incision, or have cancer that was not completely removed during the lumpectomy surgery.

Partial or Segmental Mastectomy or Quadrantectomy
During a partial or segmental mastectomy or quadrantectomy, the surgeon removes more breast tissue than with a lumpectomy. The cancerous area and a surrounding margin of normal tissue are removed, and radiation therapy is usually given after surgery for six to eight weeks.

Simple or Total Mastectomy
With a simple or total mastectomy, the entire breast is removed, but no lymph nodes are removed in this procedure. Simple mastectomy is most frequently used for further cancer prevention or when the cancer does not go to the lymph nodes.

Modified Radical Mastectomy
The surgeon removes all of the breast tissue along with the nipple in a modified radical mastectomy. Lymph nodes in the armpit are also removed. The chest muscles are left intact. For many patients, mastectomy is accompanied by either an immediate or delayed breast reconstruction. This can be done quite effectively using either breast implants or the patient's own tissue -- usually from the lower abdomen.

When a radical mastectomy is used to treat breast cancer, the surgeon removes all of the breast tissue along with the nipple, lymph nodes in the armpit, and chest wall muscles under the breast. This procedure is rarely performed today because modified radical mastectomy has proved to be as effective, and is less disfiguring.

You may be asked to give blood before breast cancer surgery, in case a transfusion becomes necessary.

You should thoroughly discuss these surgical options with your physician to achieve the best outcome. Whichever type of surgery is your best option, you will be able to return home after a short stay in the hospital.
 

Types of Mastectomy to Treat Breast Cancer
A mastectomy is surgery to remove a breast in cases of breast cancer. In the past, a radical mastectomy with complete removal of the breast was the standard treatment for breast cancer. But medical breakthroughs over the past two decades have given women more options than ever before. One of those options is breast-conserving therapy. That means some women are able to choose treatment procedures that are far less invasive and just as effective.

The appropriate type of mastectomy and treatment for breast cancer depend on several key factors, including:

• age
• general health
• menopause status
• tumor size
• tumor stage (how far it has spread)
• tumor grade (aggressiveness)
• tumor's hormone receptor status
• whether or not lymph nodes are involved

What Is a Preventive Mastectomy?
Women who have a high genetic or familial risk of breast cancer may elect to have a preventive mastectomy. Preventive mastectomy is also called prophylactic mastectomy. It may be a total mastectomy with the removal of the entire breast and nipple. Or it may be a subcutaneous mastectomy, where the breast is removed but the nipple is left intact.

Studies show that the occurrence of breast cancer may be reduced by 90% or more after preventive mastectomy in women with high risk for this disease. Sometimes, women who have had breast cancer in one breast will decide to have a preventive mastectomy to remove the other breast. This can reduce the chance of cancer recurrence. In some cases, both breasts are removed. This is called a double mastectomy.

Breast reconstruction can be done at the time of the preventive mastectomy. When it is, it's called an immediate reconstruction. It can also be scheduled for a later time. When it is, it's known as delayed reconstruction. During breast reconstruction, the surgeon may use synthetic implants or tissue flaps from another part of the body.
 

What Is a Partial Mastectomy?
Doctors may perform a partial mastectomy for women with stage I or stage II breast cancer.The partial mastectomy is breast-conserving therapy in which the part of the breast containing the tumor is removed. This procedure is then followed by radiation therapy for the remaining breast tissue. With radiation therapy, powerful X-rays target some of the breast tissue. The radiation kills cancer cells and prevents them from spreading.

A lumpectomy removes just the tumor and a small cancer-free area of tissue surrounding the tumor. If cancer cells are found later, the surgeon may remove more of the tissue. This procedure is called re-excision.

Another type of partial mastectomy is called a quadrantectomy. For this procedure, the surgeon removes the tumor and more of the breast tissue than is removed with a lumpectomy.

In some cases, more surgery is required after a partial mastectomy. Sometimes, if cancer cells are still in breast tissue, it may be necessary to remove the entire breast.

What Is a Radical Mastectomy?
A radical mastectomy is the complete removal of the breast, including the nipple. The surgeon also removes the overlying skin, the muscles beneath the breast, and the lymph nodes. Because radical mastectomy isn't more effective than other less extreme forms of mastectomy, it's rarely performed today.

There is a procedure called a modified radical mastectomy or MRM. An MRM is less traumatic than a radical mastectomy, and it is the most common breast cancer surgery in the U.S.

With the modified radical mastectomy, the entire breast is removed as well as the underarm lymph node. But pectoral muscles are left intact. The skin covering the chest wall may or may not be left intact. The procedure may be followed with breast reconstruction, which is performed by a plastic surgeon.

Along with the mastectomy to remove the tumor, the surgeon will determine if the breast cancer has spread. This is called staging. After the cancer has been staged, the surgeon will prescribe appropriate follow-up treatment, which could include radiation therapy, chemotherapy, and/or medications.

Some women choose to begin breast reconstruction surgery immediately following the mastectomy. However, there are trade-off risks to be considered. You should discuss these risks with your surgeon.