Lumpectomy
During a lumpectomy (also called a wide local excision, segmental resection, or partial mastectomy), only the cancerous breast tissue, with a rim of normal tissue around it, is removed. Whether or not a woman can undergo a lumpectomy is determined by the size of her tumor, the size of her breast, the number of sites of cancer within the breast, and whether the patient can undergo subsequent radiation treatments, among other factors. Patients who choose lumpectomy will likely be advised to have radiation therapy to the breast area after surgery.
Mastectomy
With mastectomy, the entire breast (with the nipple) is removed. If a patient decides to undergo a mastectomy, she will also need to think about whether she wants reconstruction, and which type of reconstruction will work best for her. Breast reconstruction can be performed safely immediately during the mastectomy or as a second procedure at any time following mastectomy (even years later). Depending upon the stage of the breast cancer, some women are advised to undergo radiation therapy after mastectomy.
During a skin-sparing mastectomy, the surgeon removes the breast tissue and the nipple-areola complex, but leaves nearly all of the skin of the breast in place. In women who are candidates for this procedure, a skin-sparing mastectomy can often provide excellent breast reconstruction results. The nipple and areola may be reconstructed later. The new nipple won't have any sensation, and there will most likely be significant numbness in the remaining skin of the breast.
Lymph Node Biopsy
Sentinel node biopsy is now routinely used during breast surgery. During surgery to remove the cancer, the surgeon also removes one or more lymph nodes under the arm, which are examined by a pathologist to see if the breast cancer has spread to the lymph nodes. If the sentinel lymph node(s) are free of cancer, the remaining axillary lymph nodes are left alone. With sentinel lymph node biopsy, many women are spared more extensive surgery and have less discomfort, heal more quickly, and are at less risk for the development of lymphedema (swelling of the arm). If the sentinel lymph node(s) contain breast cancer cells, a number of the remaining axillary lymph nodes are also removed, a procedure called axillary lymph node dissection.
Prediction Tools Predict the chance of breast cancer's spread to the sentinel lymph nodes and from the sentinel lymph nodes to axillary lymph nodes 
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Sentinel Lymph Nodes Prediction Tools
Memorial Sloan-Kettering has developed tools called nomograms which predict the likelihood of breast cancer spreading to sentinel as well as nonsentinel lymph nodes. To use these these online prediction tools, click on the box to the right.
