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Breast Cancer

Common Surgeries for Breast Cancer

Breast cancer surgery is one of the most important components of breast cancer treatment.

Common Surgeries for Breast Cancer

Breast cancer surgery is one of the most important components of breast cancer treatment. The primary aim of surgery is to completely remove the cancer while achieving the best possible cosmetic and functional outcome. The type of surgery depends on the size and stage of the tumor, breast size, lymph node involvement, and patient preference.

Breast Conserving Surgery (Lumpectomy)

Breast conserving surgery, also known as lumpectomy or wide local excision, involves removal of the cancerous lump along with a margin of surrounding healthy breast tissue while preserving most of the breast.

Procedure:
  • The tumor and a rim of normal tissue are removed.
  • The removed tissue is examined to ensure clear margins.
  • Usually combined with radiation therapy after surgery.
Commonly Recommended For:
  • Early-stage breast cancer
  • Small tumors relative to breast size
  • Patients wishing to preserve the breast
Advantages:
  • Preserves the natural breast appearance
  • Shorter surgery and recovery period
  • Equivalent survival outcomes to mastectomy in selected early cancers
Recovery:
  • Most patients recover quickly
  • Mild pain and temporary swelling may occur
  • Radiation therapy is generally advised after surgery

Mastectomy

Mastectomy involves removal of the entire breast tissue and is commonly performed for larger tumors, multicentric cancers, or when breast conservation is not suitable.

a) Simple / Total Mastectomy

In this procedure, the entire breast tissue is removed while preserving the chest wall muscles.

Indications:
  • Multiple tumors in different areas of the breast
  • Recurrent breast cancer
  • Preventive surgery in high-risk patients
Advantages:
  • Effective local cancer control
  • May reduce need for radiation in selected cases
Recovery:
  • Hospital stay is usually short
  • Temporary drainage tubes may be required
b) Modified Radical Mastectomy (MRM)

Modified radical mastectomy is one of the most commonly performed surgeries for breast cancer.

Procedure:
  • Entire breast tissue is removed
  • Axillary lymph nodes are removed
  • Chest muscles are preserved
Commonly Recommended For:
  • Breast cancer with lymph node involvement
  • Locally advanced breast cancer
Benefits:
  • Excellent local disease control
  • Helps determine extent of cancer spread
Possible Side Effects:
  • Arm swelling (lymphedema)
  • Shoulder stiffness
  • Numbness around the surgical area

Sentinel Lymph Node Biopsy (SLNB)

Sentinel lymph node biopsy is a minimally invasive procedure used to evaluate whether breast cancer has spread to lymph nodes.

Procedure:
  • The first draining lymph nodes (sentinel nodes) are identified using dye or tracer.
  • Only these nodes are removed and examined.
Advantages:
  • Smaller incision
  • Less pain and faster recovery
  • Lower risk of lymphedema compared to full node removal
Commonly Used In:
  • Early breast cancer with clinically negative lymph nodes

Axillary Lymph Node Dissection (ALND)

Axillary lymph node dissection involves removal of multiple lymph nodes from the armpit (axilla).

Recommended When:
  • Cancer has spread to lymph nodes
  • Sentinel node biopsy is positive in selected patients
Purpose:
  • Control regional spread of disease
  • Accurate staging of cancer
Possible Complications:
  • Arm swelling (lymphedema)
  • Restricted shoulder movement
  • Numbness or discomfort

Physiotherapy and early exercises help improve recovery.

Skin-Sparing Mastectomy

In this technique, the breast tissue is removed while preserving most of the breast skin.

Advantages:
  • Better cosmetic appearance
  • Ideal for immediate breast reconstruction
Commonly Performed In:
  • Early breast cancer
  • Preventive mastectomy

Nipple-Sparing Mastectomy

This procedure preserves the nipple and areola while removing underlying breast tissue.

Suitable For:
  • Selected early-stage cancers
  • Preventive surgery in high-risk patients
Benefits:
  • Improved cosmetic and psychological outcomes
  • Natural breast appearance after reconstruction

Breast Reconstruction Surgery

Breast reconstruction is performed to restore breast shape following mastectomy.

Timing:
  • Immediate reconstruction – performed during the same surgery
  • Delayed reconstruction – performed later after completion of treatments
Common Reconstruction Methods:
Implant-Based Reconstruction:
  • Silicone or saline implants are used
Autologous Tissue Reconstruction
  • Uses tissue from the abdomen, back, or thigh
Goals:
  • Restore body image and confidence
  • Improve cosmetic appearance
  • Enhance quality of life

Modern Approach to Breast Cancer Surgery

A multidisciplinary treatment approach involving surgical oncology, medical oncology, radiation oncology, radiology, and pathology ensures personalized and comprehensive breast cancer care.

Early detection and timely surgical treatment significantly improve outcomes and survival in breast cancer patients.

Current breast cancer surgery focuses on: