Comparing Types of Breast Cancer Surgeries
When it comes to breast cancer treatment, surgery is often one of the main options. Understanding the differences between lumpectomy, lumpectomy with reduction, and mastectomy can help you make an informed decision that aligns with your medical needs and personal preferences.
Lumpectomy: Breast-Conserving Surgery
What It Is: A lumpectomy removes the tumor and a small margin of surrounding healthy tissue, leaving most of the breast intact.
Best For: Patients with early-stage breast cancer or smaller tumors.
"Do all surgeons perform lumpectomies the same way? No, most surgeons make an incision directly over the tumor. However, Dr. Ellie Kraft takes a unique approach, combining her oncoplastic training with the Hidden Scar technique. She carefully places all incisions in discreet locations, such as around the areola, in the inframammary fold, or within the armpit crease."
Advantages:
Preserves the appearance and shape of the breast.
Shorter recovery time compared to mastectomy.
Often followed by radiation therapy to reduce the risk of recurrence.
Considerations: Radiation therapy is typically required, and there may be a slight change in the breast’s shape or size.
Lumpectomy with Reduction: Combining Cancer Treatment with Cosmetic Goals
What It Is: This procedure combines tumor removal with a breast reduction, often addressing both cancer and issues like discomfort from large breasts.
Best For: Patients with larger breasts who want to reduce size while treating cancer.
Advantages:
Addresses physical symptoms like back pain or shoulder discomfort from large breasts.
Maintains symmetry by performing a matching reduction on the other breast.
Combines oncologic and cosmetic benefits.
Considerations:
Requires coordination with a plastic surgeon.
Similar recovery time to a standard lumpectomy, though cosmetic goals may add complexity.
https://youtu.be/UqGwfE_6CwM?si=pPLI8R9gLFuEncXI (Video linked- warning contains surgical content)
Mastectomy: Complete Breast Removal (with or without the nipple)
What It Is: A mastectomy involves removing the entire breast and, in some cases, nearby lymph nodes. Types include simple, skin-sparing, and nipple-sparing mastectomies.
Best For: Patients with larger or more advanced tumors, genetic predispositions (BRCA1 or BRCA2 genetic mutations), or those seeking a preventive approach.
Advantages:
Eliminates the majority of breast tissue, significantly reducing the risk of recurrence in the treated breast.
Can be paired with immediate or delayed reconstruction to restore appearance.
Considerations:
Longer recovery time and more extensive surgery.
May result in loss of sensation in the chest area.
Can result in chronic pain to the mastectomy bed referred to as post-mastectomy pain syndrome
Sentinel Lymph Node Biopsy
An Axillary Sentinel Lymph Node Biopsy (SLNB) is a procedure used to determine whether breast cancer has spread to the lymph nodes under the arm (axilla). The sentinel lymph node is the first lymph node that drains the breast tissue and is often the first place cancer cells spread.
What is Axillary Sentinel Lymph Node Biopsy? SLNB is a minimally invasive procedure used to evaluate the status of lymph nodes in patients with breast cancer. It helps determine whether cancer has spread beyond the breast, which is important for staging and treatment planning.
Who Needs it? SLNB is typically recommended for ALL breast cancer patients with early-stage breast cancer patients age < 70 who have clinically negative lymph nodes (no visible signs of cancer in the lymph nodes). It is especially useful for patients with invasive breast cancer, where the sentinel lymph node(s) will be tested for the presence of cancer cells.
How is it Performed? The procedure is typically done under local anesthesia with or without sedation. It involves the following steps:
Injection of a tracer: A radioactive substance or blue dye is injected near the tumor site in the breast. This helps identify the sentinel lymph node(s).
Mapping the sentinel lymph node: The surgeon uses a special device to locate the sentinel lymph node(s), which are then removed for testing.
Pathological examination: The lymph nodes are examined to see if they contain cancer cells.
What are the Side Effects? While SLNB is generally safe, some potential side effects and risks include:
Swelling or infection at the biopsy site
Temporary numbness or tingling
Allergic reaction to the dye or radioactive tracer
Seroma (fluid buildup) at the site
Lymphedema (swelling of the arm) in rare cases, especially if multiple lymph nodes are removed
SLNB is a valuable tool in breast cancer treatment, allowing for more targeted therapies and sparing patients from more extensive lymph node surgery when possible.
Video: Sentinel Lymph Node Biopsy Video
Key Takeaway
Each type of surgery has unique benefits and considerations. Your care team will help guide you toward the best option based on your diagnosis, anatomy, and preferences. Open communication with your surgeon ensures the best outcomes and peace of mind during your breast cancer journey.
