Breast Surgery

Surgical biopsies are occasionally required where incisions are actually made on the breast. These biopsy techniques include the needle (wire) localized biopsies that are particularly useful when microscopic calcium deposits are seen on the mammogram. These surgical biopsies are done in an operating room and are usually done with local anesthetic and sedation or full general anesthesia. The procedure is always done as an outpatient procedure.

If breast cancer is diagnosed, various therapeutic breast procedures and treatment plans are available. Some of these treatment plans start with surgery and others start with chemotherapy and finish with surgery.

Therapeutic Breast Procedures

A number of surgical options are available to the patient when breast cancer surgery is necessary.

Lumpectomy:

This surgery involves removing the cancerous area of the breast plus a surrounding area of noncancerous breast tissue. Every attempt is made to preserve breast shape and size. This approach is appropriate for most small breast cancers and some larger breast cancers. It is accompanied by removal of a portion of the lymph glands under the arm, where breast cancer tends to spread first. After healing is complete, radiation treatment is given to the remaining breast tissue to minimize the chance of recurrence. Radiation treatments are performed using the linear accelerators at the hospital. The linear accelerator delivers radiation in a much more precise and controlled fashion than the older cobalt units that were previously used. Lumpectomy is one of the most popular current surgical treatment plans for breast cancer. The lumpectomy procedure is usually done as an outpatient. Average recovery time is one week.

Simple Mastectomy:

This operation has been available in a number of forms for at least 100 years. It has been modified so that currently the operation removes only the nipple and a small amount of surrounding skin along with all the underlying breast tissue. Additionally, some lymph glands under the arm are removed. No muscles are affected and rarely are there any side effects that were often seen with some of the older forms of mastectomy. Seldom is radiation required. This operation is used often for very large or extensive tumors, or for people unwilling or unable to accept the requirements of a proper lumpectomy treatment plan such as radiation therapy. This surgery can be done with an overnight hospital stay, but usually it is done as an outpatient. Average recovery time is 7 to 10 days. Older forms of mastectomy, such as radical mastectomy, which involves the removal of a large amount of tissue and chest muscle are only rarely performed. Radical mastectomies are rarely indicated and rarely utilized.

Post-Mastectomy Reconstruction:

For patients who wish or require mastectomy, we work together with a Plastic Surgeon to allow breast reconstruction to be available. The breast reconstruction is done at the same time as the mastectomy or at a later time, if needed. All the most sophisticated forms of breast reconstruction are available. These procedures are done in an inpatient setting, with hospitalization averaging two to five days depending on the type of procedure performed. Recovery averages from two to six weeks for full recovery, again depending on the exact procedure performed.