Surgery is the oldest form of cancer treatment. Although it remains an important part of cancer treatment today, surgery is now typically combined with other types of treatment such as radiation, chemotherapy and hormone therapy to achieve greater success.
The main types of breast cancer surgeries include:
Lymphedema is a build-up of lymphatic fluid, causing swelling in the arm and hand, and occasionally in the chest/breast on the side of the surgery. When the lymphatic system is damaged, fluid collects in the tissue of the affected area, causing swelling. The surgical removal of the lymph nodes in the underarm area and/or radiation therapy to the affected area can interfere with normal lymph drainage.
For more information about lymphedema contact:
National Lymphedema Network
1 800.541.3259
Evergreen Physical Therapy provides a specialized lymphedema program to address the swelling and accumulation of lymph fluid that can occur following breast cancer. Thanks to a grant from the Evergreen Healthcare Foundation, Evergreen therapists have received training in massage techniques, bandaging and exercises and specialized equipment to reduce the discomfort.
For more information, contact Evergreen Physical Therapy at 425.899.1960.
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Breast conserving surgery is where the surgeon tries to spare and preserve as much breast tissue as possible.
- Lumpectomy: the surgeon removes the breast cancer and some normal tissue surrounding it.
- Partial, or Segmental Mastectomy: the surgeon removes the cancer, some of the breast tissue, and the lining over the chest muscles below the cancer.
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Mastectomy is where the entire breast is removed.
- Total (or simple) Mastectomy The surgeon removes the entire breast and usually some lymph nodes from under the arm.
- Modified Radical Mastectomy The surgeon removes the breast, most of the lower and middle lymph nodes, the lining over the chest muscles, and sometimes part of the chest wall muscles.
- Radical Mastectomy Rarely performed now, this involves removing the breast, chest muscles, and most of the lower, middle, and upper lymph nodes.
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An axillary lymph node dissection is performed to determine if breast cancer has migrated out of the original tumor to the axilla (armpit). At the time of surgery (lumpectomy or mastectomy), approximately 2/3 of the lymph nodes in the axilla are removed and sent to pathology for analysis.
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A sentinel lymph node biopsy is performed to determine if invasive breast cancer has migrated out of the original tumor location via a targeted lymph node under the armpit. This procedure prevents the necessity of surgically removing 2/3 of lymph nodes under the armpit, which is significantly more invasive. On the day of a patient’s breast surgery, if a sentinel node biopsy is recommended by a member of the breast cancer medical team, the patient will first undergo a lymposcintigraphy exam in diagnostic imaging, nuclear medicine.
A lymphoscintigraphy is performed by injecting radioactive material around the breast cancer or around the breast cancer biopsy site. The patient lies down on a table while images similar to X-ray pictures are taken of the breast cancer site. The patient is then taken to the operating room where a surgeon injects about a teaspoon of blue dye around the breast cancer or biopsy site to assist in localizing the sentinel node. The gamma probe will also be used to locate the targeted sentinel lymph node.
A standard lumpectomy or mastectomy will precede the sentinel node biopsy. The surgical wounds are closed using surgical techniques. The sentinel lymph node and breast tissue are sent to a pathologist for analysis. The doctor informs the patient whether the lymph node is positive or negative for cancer.
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This plastic surgery procedure rebuilds a breast that has been removed following a mastectomy. Reconstruction can be done at the time of the mastectomy, or at some point in time following a mastectomy. Breast reconstruction is something that should be discussed with your breast cancer medical team following a positive diagnosis.
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