When surgery is necessary to remove cancerous tissue from the breast, the doctor may recommend either a breast-conserving surgery or a non-breast-conserving surgery that's known as a mastectomy. The breast-conserving surgery is a type of operation that is intended to remove the cancer without removing the entire breast. While this is often the most desired method of removing cancer, it is not always the best option, depending on certain factors. There are two types of breast-conserving surgery, which are a lumpectomy and partial mastectomy.
During the process of determining if breast-conserving surgery is the appropriate surgery for a patient, a doctor must take into consideration certain things about the breast and the size of the cancer. Breast size is one factor that can affect whether or not this surgery is a viable option. If the breasts are small, removing a sizable tumor may take away too much of the healthy breast tissue as well. In addition, the location of the tumor may also play a large part in determining if the breast can be saved. Removal from certain locations may overly disfigure the breast, as can extracting a tumor that is too large.
The type and stage of cancer also plays a large part in determining if the breast can be saved. Breast-conserving surgery is often an option for people suffering from Stage I and Stage II breast cancer, which are considered the early stages. In stage III breast cancer the tumor is typically larger, approximately two inches (five cm) in width. For this stage, breast saving surgery is typically only an option if the tumor is smaller or if it has been shrunk enough by a treatment such as chemotherapy.
A lumpectomy is a common breast-conserving procedure that involves removing a cancerous tumor, or lump, from the breast. Although the majority of the breast is left in place, there is a small section of non-cancerous tissue surrounding the tumor that must also be excised. The additional amount of adjacent tissue that is removed is often less than other conserving surgeries.
Partial, or segmental mastectomies, are another form of breast-conserving surgery. This method also removes the cancer and a portion of the breast, in addition to some of the muscle tissue. Typically the amount of breast tissue removed is greater than what is removed during a lumpectomy, although a majority of the breast still remains intact. When a quarter of the breast tissue is removed, a partial mastectomy is called a quadrantectomy.
Lymph nodes are glands that act as filters for harmful substances, including cancer cells. As cancer can spread to other parts of the body through the lymph system, the doctor may also suggest removing some of these nodes for examination. Although they are located in various spots around the body, such as the neck, groin and underarms, it is the latter area where the doctor may need to remove them when performing either type of breast-conserving surgery.
Breast-conserving surgeries are also typically accompanied with radiation therapy. This is meant to help destroy remaining cancer cells and reduce the risk of recurrence. Certain people may not meet the criteria for, or be required to have, radiation following their surgery. This includes people who have tumors that are less than 0.78 inches (2 cm) and certain people who are over the age of 70.