Surgery for Breast Cancer

The most common treatment for breast cancer is surgery. There are several different types of surgery:
Conservative surgery (breast-sparing surgery):

This type of surgery aims to take away the cancer, while leaving behind as much healthy breast tissue as possible, ultimately leaving the breasts intact. To try to make sure that all the cancer has been removed the surgeon removes a border of healthy tissue around the tumor. This tissue is then sent to the pathologist, who inspects the healthy layer for signs of cancer cells. If the layer is clear of cancer it will be reported as a ‘healthy margin’ or ‘clear margin’. If the layer is not a ‘clear margin’, you may require further surgery. The surgeon often removes the underarm lymph nodes as well, through a separate incision. This procedure is called an axillary lymph node dissection. It shows whether cancer cells have entered the lymphatic system. The picture illustrates the tissue removed during a conservative surgery.Conservative surgery is sometimes also called Lumpectomy, or Wide local excision. In practice, these two are very similar to the conservative surgery. The surgeon removes the tumor, with a thin layer of healthy tissue around it. Lumpectomy is also used to describe an open biopsy. This is when the doctor does not know if the lump is cancer, and he/she must remove it in order to find out.

Segmentectomy (Quadrantectomy)is another form of conservative surgery, but is not performed as often as a lumpectomy. It resembles the wide local incision, but the surgeon removes more breast tissue. A segmentectomy removes approximately a quarter of the breast tissue, making the operation more noticeable than lumpectomy. Because the surgery is so noticeable breast reconstruction surgery is often an option. After any of the above mentioned surgeries, patients usually undergo radiotherapy to make sure that there are no breast cancer cells left behind in the remaining breast tissue.