(949) 502-3489 info@kskmedical.org

SURGERY

Decisions about surgery depend on many factors. You and your doctor will determine the kind of surgery that is most appropriate for you based upon the stage of the cancer, the type of the cancer, and what is acceptable to you in terms of your long-term peace of mind. Two of the choices most women have are deciding to have a lumpectomy or mastectomy.

LUMPECTOMY

A lumpectomy is the removal of the breast tumor (the “lump”) and some of the normal tissue that surrounds it. Lumpectomy is a form of “breast-conserving” or “breast preservation” surgery. There are several names for breast-conserving surgery: biopsy, lumpectomy, partial mastectomy, re-excision, quadrantectomy, or wedge resection. Technically, a lumpectomy is a partial mastectomy, because part of the breast tissue is removed however, the amount of tissue removed can vary greatly. Quadrantectomy, for example, means that roughly a quarter of your breast will be removed. Make sure you have a clear understanding from your surgeon about how much of your breast may be gone after surgery and what kind of scar you will have.

With a lumpectomy, a surgeon removes the breast cancer, a little normal breast tissue around the lump, and some lymph nodes under the arm. This procedure tries to totally remove the cancer while leaving you with a breast that looks much the same as it did before your surgery. Women who choose a lumpectomy almost always have radiation therapy as well. Radiation decreases the risk of cancer recurring in the remaining breast tissue.

 

MASTECTOMY

A mastectomy is the removal of the whole breast. There are five different types of mastectomy—“simple” or “total” mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.

Simple or total mastectomy concentrates on the breast tissue itself:

  • The surgeon removes the entire breast.

  • The surgeon does not perform axillary lymph node dissection (removal of lymph nodes in the underarm area.) Sometimes, lymph nodes are occasionally removed because they happen to be located within the breast tissue taken during surgery.

  • No muscles are removed from beneath the breast.

  • A simple or total mastectomy is appropriate for women with multiple or large areas of ductal carcinoma in situ (DCIS) and for women seeking prophylactic mastectomies – that is, breast removal in order to prevent any possibility of breast cancer occurring.

Modified radical mastectomy involves the removal of both breast tissue and lymph nodes:

  • The surgeon removes the entire breast.

  • Axillary lymph node dissection is performed, during which levels I and II of underarm lymph nodes are removed.

  • No muscles are removed from beneath the breast.

  • Most people with invasive breast cancer who decide to have mastectomies will receive modified radical mastectomies so that the lymph nodes can be examined. Examining the lymph nodes helps to identify whether cancer cells may have spread beyond the breast.

Radical mastectomy is the most extensive type of mastectomy:

  • The surgeon removes the entire breast.

  • Levels I, II, and III of the underarm lymph nodes are removed.

  • The surgeon also removes the chest wall muscles under the breast.

  • Today, radical mastectomy is recommended only when the breast cancer has spread to the chest muscles under the breast. Although common in the past, radical mastectomy is now rarely performed because in most cases, modified radical mastectomy has proven to be just as effective and less disfiguring.

Partial mastectomy:

  • Partial mastectomy is the removal of the cancerous part of the breast tissue and some normal tissue around it.

  • While lumpectomy is technically a form of partial mastectomy, more tissue is removed in partial mastectomy than in lumpectomy.

Subcutaneous (“nipple-sparing”) mastectomy:

  • During subcutaneous (“nipple-sparing”) mastectomy, all of the breast tissue is removed, but the nipple is left alone.

  • Subcutaneous mastectomy is performed less often than simple or total mastectomy because more breast tissue is left behind afterwards that could later develop cancer.

  • Some physicians have also reported that breast reconstruction after subcutaneous mastectomy can result in distortion and possibly numbness of the nipple.

  • Because subcutaneous mastectomy is still an area of controversy among some physicians, your doctor may recommend simple or total mastectomy instead.

The Breast Center of Irvine is a comprehensive breast care center

dedicated to exceptional patient care

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16100 Sand Canyon Ave, Suite 100
Irvine, CA 92618

+(949) 502-3489
info@kskmedical.org

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