Breast Cancer Surgery in Pittsburgh

Breast cancer surgery is performed to remove as much of the cancer as possible. Most women with breast cancer have some form of surgery to treat the breast tumor. Surgical procedures can also be performed to see if the cancer has spread to the lymph nodes under the arm or to restore the shape of the breast after a mastectomy.

What are the Most Common Types of Breast Cancer Surgery?

Surgery to treat breast cancer ranges from the very complex to simpler approaches that can preserve the breast structure or provide for its reconstruction. Surgical procedures include:

Breast-conserving surgery

Surgery of this type focuses on conserving as much of the breast as possible. These surgical procedures remove only a part of the breast depending upon the tumor size, location and other factors. The procedures include:

• Lumpectomy. This surgical procedure removes just the breast lump (tumor) and normal tissue surrounding it. Follow-up radiation therapy is generally administered.
• Partial (segmental) mastectomy or quadrantectomy. This surgical procedure removes more breast tissue than that with a lumpectomy. It can include up to one fourth of the breast and similar to a lumpectomy, follow-up radiation and chemotherapy can be administered.

Mastectomy

A Mastectomy is a surgical procedure performed to remove the entire breast. All of the breast tissue is removed and can include adjacent tissue. There are four types of mastectomies which include:

• Simple mastectomy. With this procedure the entire breast is removed. The lymph nodes under the arm or the muscle tissue beneath the breast are not removed. Occasionally both breasts are removed, most frequently in an effort to prevent cancer.
• Skin-sparing mastectomy. For some women who want breast reconstruction right away, most of the skin over the breast is left intact. The procedure works as well as the simple mastectomy with less scar tissue and a more natural looking reconstructed breast.
• Modified radical mastectomy. This surgical procedure is like the simple mastectomy in which the entire breast is removed but also includes the removal of some of the lymph nodes under the arm.
• Radical mastectomy. This surgical procedure involves the removal of the entire breast, the lymph nodes under the arm and the chest wall muscles under the breast. While this was once a very common procedure, it is rarely done now since the modified radical mastectomy has worked just as well. However for large tumors growing into the muscles under the breast, it may still be done.

Lymph nodes surgery

Axillary lymph node dissection. Usually performed at the same time as a mastectomy or lumpectomy, this procedure is used to find out if breast cancer has spread to lymph nodes under the arm. In most cases, less than 20 lymph nodes are removed. If cancer cells are found, there is a higher chance that cancer cells have also spread through the bloodstream to other parts of the body.
Sentinel lymph node biopsy. A sentinel lymph node biopsy helps to determine if cancer has spread to the lymph nodes under the arm without removing all of them. This procedure involves injecting a radioactive substance near the tumor which is then carried by the lymph system to the first nodes called the sentinel lymph nodes. If these nodes contain cancer, more lymph nodes may be removed. If they are free of cancer, further lymph node surgery is not usually needed.