What are the Surgical Options for Early Stage Breast Cancer

Surgery is usually the first treatment for early-stage breast cancer. Most women have two surgery options. One is called partial mastectomy, or breast-sparing or breast-conserving surgery, and the other is called mastectomy. Both surgeries have good survival rates.

Breast cancer is different for everyone, even in its early stage. The best treatment for one person might not be the best treatment for another. Learn as much as you can about your cancer and work closely with your health care providers to make the choice that produces the best results for you.

What is partial mastectomy?

Partial mastectomy, also called breast-sparing surgery or breast-conserving surgery, is surgery to remove the cancer along with some normal breast tissue that surrounds it. Lymph nodes from under the arm may also be removed and tested to find out if the cancer has spread. If cancer is located near the chest wall, part of the chest wall lining may also be removed.

What is a mastectomy?

A mastectomy is surgery to remove the cancer along with the entire breast tissue. There are several types of mastectomy:

• Simple or total mastectomy. In this surgery the entire breast is removed, including breast tissue, nipple, areola and skin around the breast. Some lymph nodes may also be removed from under the arm. If cancer is located near the chest wall, part of the chest wall lining may also be removed.
• Skin-sparing mastectomy. In this surgery the breast tissue, nipple, and areola are removed and most of the skin over the breast is left in place. This surgery results in less scar tissue than other mastectomy surgeries, which allows for a more natural breast reconstruction.
• Nipple-sparing mastectomy. In this surgery, breast tissue is removed but the skin and nipple is left in place. The tissue under the nipple and areola may be removed if cancer is found in the area. This may be an option for women who choose to have breast reconstruction after mastectomy.
• Modified radical mastectomy. This surgery is the same as a simple mastectomy but also includes removing lymph nodes from under the arm (axillary lymph node dissection).
• Radical mastectomy. In this surgery the entire breast, the lymph nodes under the arm, and the chest wall muscles under the breast are removed. This surgery is rarely done now. A modified radical mastectomy is preferred because it is just as effective, but with the added advantage of fewer side effects.

What are some advantages and disadvantages of these surgeries?

Partial mastectomy

Advantages of partial mastectomy include:

• Keeping most of your breast tissue intact, allowing for a more natural look to the breast.
• Easier recovery when compared to a mastectomy.
• Ability to go home on the day of the procedure.

Disadvantages of partial mastectomy include:

• Slightly higher risk that your cancer will come back.
• Needing more surgery at a later time.
• Requiring radiation therapy after surgery, which has side effects and possible complications. This is done to reduce the chances of breast cancer returning.

Mastectomy

Advantages of a mastectomy include:

• Not needing to have radiation therapy or other treatments after surgery.
• Lower chances of your cancer coming back.

Disadvantages of a mastectomy include:

• Longer recovery time compared to partial mastectomy.
• Possibility of more complications.
• Requiring additional surgeries to reconstruct your breast.

Where to find more information

• National Cancer Institute: https://www.cancer.gov  
• American Cancer Society: http://www.cancer.org  

Questions to ask

Here are some questions to ask about each surgery:

• What will my recovery be like?
• How will my breast look and feel?
• What are the possible risks and complications of the surgery?
• What additional treatment might I need after surgery?
• What are the risks and complications of radiation therapy?
• What are the risks and complications of chemotherapy?
• Will I be able to have breast reconstruction?

Summary

• Surgery is usually the first treatment for early-stage breast cancer. Most women have two surgery options.
• One option is called partial mastectomy, or breast-sparing or breast-conserving surgery, and the other is called mastectomy. Both surgeries have good survival rates.
• Each option has advantages and disadvantages to consider. The best treatment for one person might not be the best treatment for you.
• Learn as much as you can about your cancer and work closely with your health care providers to make the choice that produces the best results for you.