Breast Cancer Surgery -
Overview
The aim of surgery is to remove the cancer from the affected breast and treat any affected lymph glands.
The cancer can be removed as a lump with a margin of normal tissue around it (called wide local excision) and so leaving the majority of the breast (breast conserving surgery) or by removing the whole breast (mastectomy). The type of cancer, size and evidence of other cancer cells elsewhere in the breast help decide whether mastectomy or wide local excision will be advised. With both of these options about four lymph glands from the armpit (and sometimes from behind the ribs) are usually removed at the time of cancer excision (axillary node sampling) to be checked for cancer spread. If there is known cancer in the lymph glands then all the lymph glands are removed (axillary node clearance).
When only part of the breast is removed (breast conserving surgery) radiotherapy is advised to the remaining breast tissue. When breast conserving surgery with radiotherapy is suitable it is an equally effective method of cancer treatment compared to mastectomy.
If the amount of breast tissue removed is more than 10% a deformity of the breast can be noticeable. Newer methods (Oncoplastic Surgery techniques) aim to reduce the chance of these deformities. Stephen McCulley is a leading UK surgeon in Oncoplastic techniques. These techniques include re-shaping the breast or adding tissue to fill the part removed. If mastectomy is performed the only reconstructive options are total breast reconstruction.
