Lumpectomy / Partial or Segmental Mastectomy
The surgeon removes the lump containing the cancer without removing the entire breast. This procedure usually results in removing all the cancer, while leaving you with much of the remaining breast tissue, and is usually recommended for a smaller cancers. Depending on the size and location of the cancer, this surgery can conserve most of the breast. In addition, this procedure is usually coupled with a Sentinel Lymph Node biopsy (see below). Women who have lumpectomies almost always have radiation therapy as well. Radiation therapy is used to destroy any cancer cells that may not have been removed by surgery.
Lumpectomy/ Partial Mastectomy with Axillary Lymph Node Dissection (Removal of Lymph Nodes)
In addition to the Partial Mastectomy described above, the surgeon may also remove the lymph nodes under the armpit, usually through a separate incision. This additional dissection of the lymph nodes is carried out if the cancer has already spread to the lymph nodes as confirmed on physical examination or Sentinel Node Biopsy. In most cases, radiation therapy follows.
Total (or Simple) Mastectomy
The surgeon removes the entire breast. Some lymph nodes under the arm may be removed also, because it is hard to separate the breast tissue from the lymph nodes in the armpit. This option is usually recommended for cancers that are too large or are suspected of being in more than one part of the breast. Some women with smaller cancers that can be treated with lumpectomy alone choose to have a mastectomy instead. The two primary reasons for that are avoiding radiation and decreasing the recurrence rate (the chance of cancer returning to the breast months to years after lumpectomy). In addition, this procedure is usually coupled with a Sentinel Lymph Node biopsy (see below).
Modified Radical Mastectomy
The surgeon removes the breast, some of the lymph nodes under the arm including the Sentinel Lymph nodes (see below), along with the lining over the chest muscles and sometimes part of the chest muscles. This option is usually recommended for large invasive cancers. It can also be recommended for smaller invasive cancers instead of lumpectomy with axillary node dissection.
