Breast Surgery

MEDICAL ANIMATION TRANSCRIPT: Surgical removal of the tumor is part of the treatment for the majority of breast cancers. There are a number of surgical options. Your doctor will help you decide which is best for your situation. In addition to surgery on the breast, it may be necessary to remove some or all of the lymph nodes under your arm. There are two main surgical procedures for breast cancer. The first is breast-conserving surgery, or a lumpectomy, which is always coupled with radiation treatment. The second is mastectomy, which is removal of the entire breast. It may be combined with breast reconstruction surgery. In both procedures, it may be necessary to remove some lymph nodes. A lumpectomy preserves the appearance of the breast. The tumor, along with a margin of surrounding normal breast tissue, is removed. In this procedure, your surgeon will make an incision in the skin and remove the tumor with a margin of healthy tissue. It will be sent to a pathologist for examination to make sure there is no cancer in the surrounding margin of tissue. The wound will be closed with sutures. In a mastectomy, the entire breast is removed. In a simple mastectomy, only the breast tissue is removed. Your surgeon will begin by making an incision to remove an oval of skin, including the nipple. The breast tissue will be separated from the skin, as well as the underlying muscle, and removed for examination. Finally, your surgeon will insert drains to prevent fluid collection. A modified radical mastectomy is a procedure where your breast tissue is removed, along with some or all of the lymph nodes under your arm. A sentinel lymph node biopsy is typically performed in addition to a lumpectomy or a mastectomy. It may be done if a clinical exam or imaging study shows no evidence that cancer has spread to the lymph nodes. The purpose of the biopsy is to identify and check the first draining lymph nodes from the breast to make sure cancer hasn't spread there. To do this, dye will be injected into your breast to determine which lymph nodes are the sentinel lymph nodes. Your surgeon will remove one to three sentinel lymph nodes for examination. If these nodes have no cancer, it is unlikely other lymph nodes have cancer. If these lymph nodes have cancer, the rest of the lymph nodes under your arm, called axillary lymph nodes, may also have cancer. In this case, a complete axillary lymph node dissection may be recommended to remove most of the nodes in this area. An additional option in the case of a mastectomy is reconstruction of the removed breast. Breast reconstruction makes use of implants or tissue from other parts of the body, such as the abdomen or buttocks, to create a new breast. In some cases, the surgeon is able to also preserve the nipple. The reconstruction can be performed right after a mastectomy, known as immediate reconstruction, or at a later date, called delayed reconstruction. If you are considering reconstructive surgery, your doctor can help you decide what approach is best for your situation.