At Memorial Sloan Kettering, we take a comprehensive approach to surgery for breast cancer. In many cases, we can offer innovative treatments that can save or reconstruct the breast.
Surgery is usually the first treatment for breast cancer. For most women, options include mastectomy (removal of the breast), mastectomy with breast reconstruction, and breast conserving surgery, in which the tumor and an area of normal tissue around it are removed, followed by radiation. The extent of the cancer, the size of your breast, and your preferences determine which of these is the right treatment for you.
If you have any physical problems after surgery or during treatment, tell your doctor or nurse. He or she can refer you to one of our rehabilitation professionals. An occupational therapist (a specialist who helps with daily living skills) and a physical therapist are available at the Evelyn H. Lauder Breast Center to educate and treat people with issues such as lymphedema or limited mobility after surgery.
Learn more about our approach to surgery at MSK, which focuses on the whole patient.
Our experienced and compassionate surgeons are highly skilled in performing mastectomy, a procedure that involves removing the entire breast. When the breast reconstruction process is begun at the same time as a mastectomy, the skin is left intact, to serve as an envelope with which to rebuild the breast. This is called skin-sparing mastectomy. In some patients it is also possible to save the nipple, a method known as nipple-sparing mastectomy.
Lumpectomy is the removal of the cancer and an area (called a margin) of normal breast tissue around it. This is an outpatient procedure, which means you don’t need to be admitted to the hospital overnight. Lumpectomy must be followed by radiation to the breast in order to adequately treat all the cancer. There are exceptions for selected groups of women such as those older than age 70 who have small estrogen receptor–positive cancers.
Lymph Node Biopsy (Sentinel Node Biopsy)
To plan an effective treatment strategy for you, we’ll have to know if the cancer has spread to your lymph nodes. The sentinel node or nodes are located in the underarm area and are the first lymph nodes cancer cells travel to when they leave the breast. We find the sentinel nodes by injecting a low dose of radioactivity into the breast the day before surgery, by putting a blue dye into the breast during surgery, or both. The nodes that are radioactive or blue are the sentinel nodes. If there is no cancer in the sentinel nodes, we know there is no cancer in the remaining nodes in the armpit and they can be left alone. Sentinel node biopsy is done with lumpectomy or mastectomy and is a much smaller operation than taking out all of the underarm lymph noes (called axillary dissection). The procedure also has fewer side effects.
If you’ve had a breast removed, we can offer many options for reconstruction. These include implant surgery and tissue transfers such as TRAM, DIEP, gluteal free, and latissimus dosi flap procedures.
Many women who’ve had a mastectomy to treat breast cancer choose to wear an artificial external breast prosthesis rather than have the breast reconstructed.