Surgery

Your surgeon will discuss with you the most appropriate type of surgery, depending on the size and any spread of the cancer. Before any operation make sure that you have discussed it fully with your surgeon. Remember, no operation or procedure will be done without your consent. If a diagnosis of breast cancer has already been made, either by needle aspiration or biopsy, the surgeon will be able to discuss your operation with you in advance. For many women it is now possible to have a smaller operation to conserve the breast rather than a mastectomy. This is known as breast conserving surgery. All breast surgery, however, will leave some type of scar, and the cosmetic effect depends on the technique used. You may like to discuss with your doctor or nurse beforehand what your breast will look like after surgery. If a definite diagnosis of cancer has not been made, the surgeon will need to remove the lump or part of the lump and have it examined in the laboratory. If the lump shows there is cancer present and a further operation is necessary, this can be arranged for a few days afterwards. This allows you more time to prepare yourself.

Segmental excision/Wide local excision

This is the removal of the breast lump together with an area of surrounding tissue to ensure a clear edge of healthy tissue. Radiotherapy is given to the breast following recovery from the procedure.

Mastectomy

For some women, the most appropriate treatment is still a mastectomy (removal of the breast). A simple total mastectomy removes only the breast tissue. A modified radical mastectomy removes the breast and lymph nodes.

Lymph node removal

Removal of the lymph nodes from the armpit (axillary clearance) is appropriate where there is disease in lymph nodes. We always aim to do the most appropriate surgery, and in the vast majority of patients with early disease we recommend performing minimally invasive surgery; sentinel node biopsy. This sentinel node biopsy is an extremely accurate procedure which avoids and reduces the chance of some of the problems which can arise after lymph node surgery. For most women this operation can be performed without causing serious difficulty with shoulder movement, or arm swelling.

Breast reconstruction

It is often possible for women who have had a mastectomy to have breast reconstruction. Sometimes this can be done at the same time as the mastectomy or may be delayed and done some months, or even years after the original operation. If you would like to consider breast reconstruction, discuss it with your surgeon before surgery so that he or she can tell you about the different methods available.

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