Surgery
Mastectomy
Lumpectomy
Sentinel Lymph Node Biopsy
Breast Reconstruction
Axillary Node Dissection
Informed Consent
Radiation Therapy
Treatment Decisions
Additional Therapy
Treatment Team
Radical Mastectomy
This type of surgery removes the breast, the chest muscles, all of the underarm lymph nodes, and some additional fat and skin. It is also called a "Halsted Mastectomy" (after the surgeon who developed the procedure). A radical mastectomy was the standard treatment for breast cancer for over 70 years and is, for all intents and purposes, never used for treatment.
Modified Radical Mastectomy or Total Mastectomy with Axillary Node Dissection
This procedure removes the breast, the underarm lymph nodes, and the lining over the chest muscles. It is also called "total mastectomy with axillary (or underarm) dissection." Today, it is the most common treatment of early stage breast cancer where lymph node involvement has been proven.
ADVANTAGES:
• Keeps the chest wall muscles and the muscle strength of the arm.
• In most cases, radiation treatments are not necessary after surgery.
• Since all the breast tissue has been removed, there is no need for follow-up mammograms after surgery.
DISADVANTAGES:
• The breast is removed.
• In some cases, there may be swelling of the arm because of the removal of the lymph nodes.
• 8 to 10% risk of lymph edema.
Total or Simple Mastectomy
This type of surgery removes only the breast. Ideally a few of the underarm lymph nodes closest to the breast are removed to assure complete removal of the axillary tail of the breast. This is most often used to treat non-invasive breast cancers or in prophylactic mastectomies.
ADVANTAGES:
• Most or all of the underarm lymph nodes remain, so the risk of swelling of the arm is greatly reduced.
• Breast reconstruction is easier.
DISADVANTAGES:
• The breast is removed.
• If cancer has spread to the underarm lymph nodes, it may remain undiscovered.
Skin Sparing Mastectomy
The mastectomy is performed through a small keyhole using the nipple/areola complex as the only skin that is removed. The cosmetic result of the reconstruction with this operation is sometimes better than with standard mastectomies. This is a common procedure performed by experienced breast surgeons when used in combination with immediate reconstruction.
