Types of surgery

There are a number of different types of surgery used to treat breast cancer. The surgery that is right for you will depend on the type, grade and stage of your breast cancer, the risk of recurrence, your general health, age and your personal preferences.

Breast-conserving surgery

Breast-conserving surgery is also referred to as a lumpectomy, partial mastectomy or wide local incision. It involves removing the breast cancer as well as a small amount of surrounding healthy tissue. Most people who have breast-conserving surgery will be recommended to have radiotherapy treatment afterwards.

Mastectomy

A mastectomy involves the removal of the whole breast. It is usually recommended if the breast cancer is large or if there is more than one cancer in the breast. A double mastectomy refers to the removal of both breasts. If you need, or choose to have a mastectomy, you may also consider having breast reconstruction surgery.

Breast reconstruction

Breast reconstruction surgery can be done at the same time as your breast cancer surgery or at a later time. Some people leave it for a number of years. Breast reconstruction is a very personal decision. If you think you may be interested in having a reconstruction, it's important to talk to your breast surgeon before you have your breast cancer surgery. Ask your surgeon for referral to a breast reconstructive or plastic surgeon so that you can discuss your reconstruction options in advance.

Types of breast reconstruction

There are a number of different types of breast reconstruction, including:

• reconstruction using expanders and implants: a silicon or saline implant is placed under the skin and muscle of the chest
• reconstruction using tissue from another part of your body, called autologous reconstruction.

You can find more information at breast reconstruction.

Making the decision

Not all people who have a mastectomy choose to have a breast reconstruction. In fact, many people decide to have no further surgery. Some people who don’t want a reconstruction choose to wear an external breast prosthesis. Ultimately, the choice is yours and you should not feel pressured into making any decision that you are not comfortable with.

Removal of lymph nodes from the armpit

When cancer cells begin to spread from the breast, the first place they are usually found is in the lymph nodes in the armpit. If you are having surgery for breast cancer, your surgeon may remove one to three of your lymph nodes to determine if they also contain cancer cells (a sentinel node biopsy). Knowing whether or not the cancer has spread to the lymph nodes will help your doctor to determine the best treatment options for you.

There are two ways of removing lymph nodes:

• Sentinel node biopsy is a procedure which removes around 1-3 lymph nodes to test for signs of breast cancer. If there is no cancer in these sentinel nodes it means the remaining axillary lymph nodes are not likely to contain cancer cells and no further surgery to the nodes is needed. If cancer is found in the sentinel nodes, you may have further surgery to remove some or all of the remaining nodes. A sentinel node biopsy is often done at the same time as breast cancer surgery (breast-conserving surgery or mastectomy), but it can also be performed as a separate procedure depending on your circumstances.
• Axillary dissection (also known as axillary clearance). This involves removing several, or all, lymph nodes from the armpit. This is usually done at the same time as the breast cancer surgery.

Having your lymph nodes removed can increase your risk of developing a condition called lymphoedema. Lymphoedema is a swelling in the breast or arm.