Breast Cancer Treatment

Surgery for early stage breast cancer can be either a lumpectomy or a total mastectomy. A lumpectomy removes – literally – a lump of breast tissue: the tumor with normal tissue all around it (margins). This surgery is so short that women can go home the same day. Once the breast is fully healed, the next step is usually radiation therapy. Radiation is invisible energy directed to the breast, with special attention paid to the area where the cancer was. Lumpectomy and radiation go hand in hand.

The other option for breast cancer surgery is mastectomy. This removes almost all of the breast tissue – 98 or 99 percent of it. For most women who choose mastectomy, radiation therapy is not needed. Usually, a woman will stay in the hospital overnight after a mastectomy. Her recovery will be slower than with a lumpectomy – particularly if she has reconstruction of the breast at the time of the mastectomy.

So, which surgery is better for breast cancer? Neither! Studies have shown us over decades that the survival (length of life) for women with breast cancer treated by lumpectomy and radiation is equivalent to the survival of women treated with mastectomy. The type of surgery a woman has depends on what her surgeon recommends and what fits her own priorities.

In addition to treating the breast, surgery must involve evaluation of the lymph nodes. Lymph nodes in the axilla (armpit) are usually the first site of cancer spread. A procedure called sentinel lymph node biopsy removes a small number of representative lymph nodes. The pathologist determines if those nodes do, or do not, contain cancer. This information is combined with the information about the breast cancer to give a final stage. That stage can then answer questions such as: is chemotherapy needed? What are the chances that the cancer will return? How will this disease affect the woman’s length of life?