Breast cancer occurs when abnormal cells grow out of control in the breast. Early-stage means that cancer has not spread beyond the breast or beyond a few lymph nodes in the armpit.
Surgery options
Surgery to remove the tumor is a standard part of treatment for early-stage breast cancer. The goal is to keep cancer from spreading to other parts of the body, where it could become more dangerous. There are two main types of surgery for this.
- Breast-conserving surgery (lumpectomy), usually followed by radiation. This surgery tries to change the breast as little as possible while removing the cancer.
- Mastectomy. This surgery removes the whole breast. With this option, you are less likely to need radiation afterward.
Studies show that people live just as long with either approach. For many people, the decision comes down to how they feel about keeping their breast and the chance of cancer returning. Some want to keep as much of their breast as they can. For others, removing the entire breast gives them peace of mind.
Types of mastectomy
If you are thinking about mastectomy, know that there are several ways it can be done. These include:
- Total or simple mastectomy. This is the removal of the entire breast.
- Nipple-sparing mastectomy. The surgeon removes the whole breast but leaves the nipple, areola, and skin to be used in breast reconstruction.
- Skin-sparing mastectomy. The surgeon removes the whole breast, including the nipple, but leaves the skin to be used in breast reconstruction.
- Modified radical mastectomy. This is the removal of the entire breast and the lymph nodes under the arm (axillary lymph nodes).
A double mastectomy is the removal of both breasts. Sometimes people choose this because their genes (such as having the BRCA gene mutation) or family history increases their risk for future breast cancer. And sometimes people choose this because they prefer it, even though they are not at higher risk.
Breast reconstruction
Some people who have their breast removed decide to have their breast rebuilt. This may be done at the same time as the mastectomy. Or it can be done later. If your doctor thinks you will need radiation, it’s usually best to wait and do the reconstruction surgery later.
Other cancer treatments you may need before or after surgery
There are other treatments your doctor may recommend in addition to surgery. The most common ones are radiation, lymph node biopsy, lymph node removal, chemotherapy before or after the surgery, and hormone therapy.
What’s right for you depends on the specifics of your cancer (type, grade, size, location). It also depends on factors such as your age, health, past treatments, and genetics or family history. In some cases, your needs may change depending on which surgery you choose.
Your decision about surgery
There is a strong chance that the choice between breast-conserving surgery and mastectomy will be up to you. Your choice is not likely to affect your life span. But it may affect your quality of life in both the short term and the longer term.