Types of breast cancer surgery

There are different types of surgery for breast cancer. The type you have depends on:

the size of the cancer
where the cancer is in your breast
the size of your breasts
your personal wishes and feelings

Surgery to remove just the area of cancer

Surgery to remove the area of cancer in the breast is called breast conserving surgery or a wide local excision.

The surgeon takes away the cancer and a border of healthy tissue all around it. They leave behind as much healthy breast tissue as possible.

You usually have radiotherapy to the breast after this type of surgery.

Surgery to remove your whole breast

Some women need surgery to remove their whole breast (mastectomy). Or they might choose to have this operation. The surgeon removes the breast tissue (including the skin and nipple) and the tissues that cover the chest muscles.

Very rarely, the surgeon removes the muscles of the chest wall as well. This is called a radical mastectomy.

You may choose to have breast reconstruction after a mastectomy. Instead of reconstruction, some women prefer to go flat or wear a breast shape (prosthesis).

You might have radiotherapy after a mastectomy if:

there are cancerous lymph nodes in the armpit
the margins are not clear
the cancer is locally advanced

Breast reconstruction

After a mastectomy, you might want to have breast reconstruction. This means the surgeon creates a new breast shape for you.

Your surgeon will talk to you about the different options for breast reconstruction before your operation.

You might have it at the same time as the operation to remove the breast (immediate reconstruction), or sometime later (delayed reconstruction).

Choosing to go flat after a mastectomy

You might decide that you don’t want to wear a prosthesis or have a breast reconstruction after having a mastectomy. You may choose to be flat.

Women decide to do this for various reasons. It might be because you:

don’t want to have more surgery
want to get back to everyday life as soon as possible
don’t want to wear prosthesis, or find them uncomfortable

Your surgeon and breast care nurse will talk to you about all your options. They will explain the pros and cons to help you make the right decision for you. You may need time to make your decision. Talking to family and friends about how you feel can help.

A charity called Flat Friends supports ladies living without reconstruction after a mastectomy.

Removing the lymph nodes

Cancer cells might have spread into the lymph nodes close to the breast.

Lymph nodes are found in many parts of the body. They filter out bacteria and damaged cells from the lymphatic fluid, and contain cells that fight infection.

Diagram showing the network of lymph nodes in and around the breast

Before your surgery you have an ultrasound scan to check the lymph nodes in the armpit close to the breast. You will have a biopsy of the lymph nodes if they look abnormal. This is to see if they contain cancer cells

Doctors need to know if the lymph nodes in the armpit contain cancer as this helps them to plan your surgery.

You may have a sentinel lymph node biopsy or an axillary lymph node dissection. You usually have one of these at the same time as your breast surgery. But some people might have an axillary lymph node dissection at a second operation.

Treatment options

Your doctor might give you a choice of treatments. This may be a choice between removing the whole breast (mastectomy) or having just the area of cancer removed (breast conserving surgery) and then having radiotherapy.

Having your operation

You have surgery for breast cancer under general anaesthetic. You are asleep the whole time.

Many people now have breast surgery as a day case or go home the following day.

If you have breast reconstruction at the same time you are more likely to be in hospital for 4 to 7 days.

Everyone having treatment for breast cancer should have a specialist nurse or key worker. They will support you throughout diagnosis, treatment and follow up. Do ask your surgeon about this if you have not been introduced to someone.

Davina's story

Davina had a lumpecomy and lymph nodes removed.

“I’m getting stronger every day by doing the exercises I was shown at the hospital.”