Breast cancer surgery can be broadly categorised into Lumpectomy (preserving the breast) or Mastectomy (removing the whole breast). The surgery that is recommended to you will be determined by multiple factors, including the size of the tumour and the size of your breast. Your opinions will also play an important role in the decision-making process. If a mastectomy is recommended, then breast reconstruction will also be discussed with you.
Your surgeon may recommend a “therapeutic mammoplasty”. This procedure involves utilising a breast reduction technique, traditionally used for cosmetic procedures, to treat a breast cancer. You may also require a breast reduction on the other breast to achieve symmetry; this may be offered at the same time, or at a later date, depending on the individual circumstances
A “simple mastectomy” involves removing the breast an overlying skin with the nipple. The result is a flat chest on the side of the breast cancer with a scar extending from the breast bone to the underarm.
A “skin-sparring mastectomy” involves removing the breast through a cosmetically desirable incision, whilst preserving the skin envelope of the breast. This is often combined with an immediate breast reconstruction.
You may require surgery to the lymph nodes of your underarm on the same side as the breast cancer. A “sentinel lymph node biopsy” involves removing the first draining lymph nodes in the underarm. It is routine practice to offer this procedure to any patient where the breast cancer has not obviously spread to the lymph nodes on their scans. If there is evidence of spread to the underarm lymph nodes, you may be offered an “axillary node clearance”, which involves removing most of the lymph nodes of the underarm.