Medically Reviewed by Joseph M. Pearson, MD

Nearly every woman diagnosed with breast cancer has surgery – even if they also have radiation, hormone therapy, targeted drug therapy or chemotherapy.  Lets review a woman’s surgical options.

“If a woman’s breast cancer is small or Stage I or II, she may choose a surgical option that will preserve her breast,” says McLeod General Surgeon Dr. Joseph Pearson. “If the cancer is more advanced, her specialist or surgeon may recommend more aggressive treatment, such as a total mastectomy – the complete removal of a breast.”

BREAST CONSERVATION SURGERY

Lumpectomy. When the cancer is caught early enough, the cancerous lump and some surrounding tissue can be removed. Radiation or chemotherapy may be recommended following surgery.

For women with Stage I or II breast cancer, the breast conservation surgery (plus radiation therapy) is as effective as a total mastectomy.

TOTAL MASTECTOMY

Removal of the entire breast may or may not include removing lymph nodes (where breast cancer often spreads) and surrounding muscle tissue.

If only the breast is involved it‘s called a “simple” mastectomy.

A modified radical mastectomy removes the breast and lymph nodes.

Radical mastectomy surgery involves removing the breast, lymph nodes and muscle tissue in the chest.

A growing trend among women with early stage breast cancer is undergoing a total mastectomy of both breasts.  The goal is to prevent death from cancer developing in the second breast.  A recent study, however, says this approach does not lower death rates from breast cancer any more than breast-conserving surgery with radiation.

Reasons a woman may choose a total mastectomy include, women who have:

• Two or more areas of cancer in the same breast.
• Already undergone radiation therapy to the breast.
• Certain disease, which may make them sensitive to radiation therapy (lupus, scleroderma).
• Large tumors that did not shrink satisfactorily during pre-surgery chemotherapy.
• Pregnant women, where radiation therapy might hurt the fetus.

RECONSTRUCTION SURGERY

Advances in cosmetic surgery are providing women the opportunity to regain a realistic breast, in some cases, even recreating the nipple area. Some 80 to 90% of women undergoing breast reconstruction will see little or no change in breast size, shape, texture and appearance from before surgery.

Many times this breast reconstruction is completed at the same time as the cancer surgery.  Talk to your cancer specialist or surgeon about this possibility.

FINAL THOUGHT

Your surgeon and oncologist should walk you through all your options – their advantages and disadvantages. If you have any doubts, seek a second opinion. This choice may be one of the most important decisions you’ll make about your physical and emotional well being.

Another important decision is scheduling an annual mammogram, beginning at age 40.

To schedule your mammogram at McLeod Health in Florence, Darlington, Dillon, Loris or North Myrtle Beach, call 843-777-2095.

Find a Cancer Specialist near you.

Sources include:  McLeod Health, American Cancer Society, Cancer Journal for Clinicians, National Cancer Institute, Journal of the American Medical Association, US Centers for Disease Control & Prevention, Radiological Society of North America