Most breast cancer treatment begins with surgery and the outcome of this initial surgery provides a foundation for your cancer treatments to follow. Our breast cancer specialists will work with you to determine the best surgical option for you based on your type and stage of cancer and various other elements. Surgery options for breast cancer treatment include:
Hidden Scar® Breast Cancer Surgery
The Hidden Scar Breast Cancer Surgery is an innovative surgical procedure using Invuity® lighted retractors which minimize incisions and hide scars when a mastectomy or lumpectomy is necessary. This results in more natural-looking breasts after healing. This technique is also known as oncoplastic breast surgery.
Patients who undergo the Hidden Scar approach do not have a higher risk of cancer recurrence than patients who undergo any other type of mastectomy technique. You may qualify for Hidden Scar Breast Cancer Surgery based on the size and location of your tumor, your breast shape, and your breast size.
A partial mastectomy, commonly known as a lumpectomy is a breast-conserving surgery which preserves most of the patient’s breast. It is a common surgical option for women with early-stage breast cancer. The cancerous tumor cells are removed while leaving as much of the normal breast tissue as possible. In most cases, a certain amount of surrounding healthy tissue and lymph nodes are also removed. Tumor size, location, and other factors determine how much of the breast may need to be excised. Most women who have breast-conserving surgery will also need radiation.
Dr. Ley, Arizona Oncology’s breast surgeon, is experienced in performing lumpectomies with great attention to the patient’s cosmetic outcome.
A simple or total mastectomy removes the entire breast, including the nipple, areola, and skin. Lymph nodes under the arm may also need to be removed.
A skin-sparing mastectomy removes only the breast tissue, nipple, and areola while preserving as much of the breast skin as possible. The same amount of breast tissue is removed as with a simple mastectomy. The breast is reconstructed at the time of surgery with implants or tissue from other parts of the body.
A nipple-sparing mastectomy is a variation of the skin-sparing mastectomy. The breast skin and nipple are left in place while the breast tissue is removed. Breast reconstruction usually immediately follows the procedure.
A preventative or prophylactic mastectomy removes one or both breasts to reduce the risk of developing breast cancer.
Simultaneous and staged reconstruction
Simultaneous reconstruction rebuilds the breast at the same time the surgery is done to remove the cancer. In staged reconstruction, our breast cancer surgeon works directly with a breast reconstruction plastic surgeon. During the mastectomy, a temporary tissue expander is put in place which stretches the skin and muscle to prepare it for an implant or reconstruction at a later date.
Lymph Node Surgery
Lymph nodes under the arm are removed and analyzed to determine how far the cancer has spread. This is a critical part of staging breast cancer, since the disease usually spreads to the glands under the arm first, and then may progress to other parts of the body.
Sentinel Lymph Node Biopsy
A sentinel lymph node biopsy involves the identification, removal, and examination of the lymph nodes in the armpit to determine whether cancer cells have spread. This biopsy is typically performed at the same time as the partial or total mastectomy procedure.
Axillary Lymph Node Dissection
An axillary lymph node dissection includes removal of most nodes in the armpit area. This procedure is performed when patients have one or more lymph nodes which already contain cancer cells. Many patients no longer need this extensive surgery, but instead, have radiation to the lymph node areas. Lymphedema (chronic swelling of the breast or arm) is the most common side effect of this procedure.
The SAVI® breast brachytherapy uses thin tubes to deliver radiation treatment directly to the lumpectomy site. The SAVI Brachy applicator is gently inserted into the tumor cavity through a small incision, a procedure that is typically done in your breast surgeon’s office. The radiation oncologist then delivers the radiation twice a day for five days.
Placement of a port involves a short outpatient surgery, which involves the surgeon inserting a small disc of plastic just under the skin on the chest, and a thin tube connects the port to a large vein in the chest. Port-a-cath placement allows chemotherapy to be delivered directly through the port.
A biopsy is used to detect and diagnose breast cancer and breast disease by removing cells from a suspicious area and examining them in a lab to see if cancer is present. Needing a biopsy does not necessarily mean that you have cancer. Many biopsies do not result in a cancer diagnosis. Local anesthesia is given before the biopsy.
Core needle biopsy
During a core biopsy, a hollow needle is inserted into the lesion to remove a sample of breast tissue for analysis under a microscope. Several samples may be taken at the same time. Since tissue is taken rather than cells, it gives more detailed information than some other types of biopsies.
Fine needle aspiration
A fine needle aspiration takes one or more samples of breast cells using a thin needle with a hollow center to remove cells from the suspicious area. This is the least invasive type of biopsy, and usually, there is no scarring. Local anesthesia may be given.
A breast ultrasound uses sound waves to make images of the breast. The technology is non-invasive and is commonly used as a follow-up test when an abnormal finding occurs on a mammogram, breast MRI, or clinical breast exam. It may also be used to help guide various needle biopsy procedures.