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Maj Patel
Surgery is most often the primary treatment for breast cancer. The operations that are used to treat breast cancer include removing the tumor, removing one entire breast, removing both breasts, and removing lymph nodes. Dr. Malone, what else can you tell us about the surgical options for treating breast cancer?

Dr. Malone
Well, Dr. Patel, an operation that removes the tumor and a small amount of the surrounding tissue is called a lumpectomy. You may also hear it referred to as breast-sparing surgery or wide local excision. This procedure is typically used only for smaller tumors. After a lumpectomy, most women receive radiation therapy to the breast. This treatment is designed to destroy any cancer cells that may remain in the breast.

When one entire breast is removed, it’s called a unilateral mastectomy. Most mastectomy procedures remove all of the breast tissue, including the lobules, ducts, fatty tissue, nipple, and areola. However, depending on the location and size of the tumor, a skin-sparing mastectomy may be an option. Skin-sparing mastectomy leaves the skin over the breast intact, including the nipple, to improve reconstruction and appearance.

Removing both breasts is called bilateral mastectomy. Some women choose to have both breasts removed, even if one is healthy, if they have a genetic predisposition or strong family history of breast cancer. However, most women with cancer in one breast will never develop cancer in the other breast.

In many cases, the surgeon will remove lymph nodes as well. When a limited number of lymph nodes are removed, it’s called sentinel node biopsy. Lymph nodes that are the first to receive lymph drainage from the tumor are removed and tested to see if the cancer has spread. If no cancer is found, no other lymph nodes need to be removed.

If cancer is found, however, additional lymph nodes under the arm may be removed. This procedure is called axillary lymph node dissection.

Your provider will explain the different types of surgery, compare the benefits and risks of each option, and help you select the procedure that will most effectively treat your cancer. Before choosing a surgical treatment, many women find it helpful to consult a plastic surgeon to discuss how different procedures affect their options for reconstruction.