Breast Surgery: Options & Techniques

When a woman is diagnosed with breast cancer, surgical intervention is often necessary to remove the primary malignant tumor. Modern surgical oncology now offers various approaches to ensure both effective cancer removaland optimal aesthetic outcomes. While mastectomy remains a standard option, it is not the only choice.

Types of Breast Cancer Surgeries

 Breast-Conserving Surgery (Lumpectomy/Segmental Mastectomy)

✔ Removes only the tumor and a small margin of healthy tissue
✔ Preserves most of the breast
✔ Usually followed by radiation therapy to reduce recurrence risk
✔ Ideal for early-stage localized tumors

 Who is a candidate?

• Small, well-defined tumors
• No evidence of widespread disease
• Ability to undergo post-surgical radiotherapy

 Mastectomy (Total Breast Removal)

✔ Complete removal of breast tissue
✔ Required in larger, multifocal, or aggressive tumors
✔ Indicated in BRCA mutation carriers opting for risk-reducing surgery

 Types of mastectomy

• Total (Simple) Mastectomy: Removesentire breast but leaves lymph nodes intact
• Radical Mastectomy: Removes breast, lymph nodes, and chest muscles (rarely performed today)
• Skin-Sparing Mastectomy: Leaves breast skin intact for better reconstruction outcomes
• Nipple-Sparing Mastectomy: Preservesnipple and skin for a more natural look after reconstruction

Sentinel Lymph Node Biopsy & Axillary Dissection

• Sentinel Lymph Node Biopsy (SLNB): Removes the first lymph nodes draining the tumor to check for cancer spread
• Axillary Lymph Node Dissection (ALND): Removes multiple lymph nodes if cancer has already spread

Why is lymph node evaluation important?
✔ Helps determine cancer stage
✔ Guides treatment decisions (e.g., chemotherapy, radiotherapy)
✔ Reduces unnecessary removal of lymph nodes when possible

Oncoplastic Breast Surgery (Combining Oncology & Plastic Surgery)

Modern surgical techniques allow for oncological safety while preserving breast shape and aesthetic symmetry. Oncoplastic surgery combines tumor removal with plastic surgery techniques to reshape the remaining breast tissue.

✔ Partial mastectomy with volume redistribution
✔ Breast reduction & reshaping techniques
✔ Use of local tissue flaps to fill defects
✔ Simultaneous or delayed reconstruction

Benefits of Oncoplastic Surgery

• Removescancerous tissue effectively
• Enhancesbreast shape & symmetry
• Reduces the risk ofvisible deformities
• Improves psychological recovery

Breast Reconstruction Options

After a mastectomy, breast reconstruction restores the appearance of the breast. This can be done immediately (during the same surgery) or delayed after additional treatments.

Types of Breast Reconstruction
✔ Implant-based reconstruction: Uses silicone implants for reshaping
✔ Autologous tissue reconstruction: Uses body tissue (flaps) from the abdomen, thighs, or back
✔ Combination techniques: Uses implants + tissue transfer for a more natural look

Who is a candidate for immediate reconstruction?

• Patients undergoing skin-sparing mastectomy
• Those not requiring post-mastectomy radiation therapy
• Women prioritizing aesthetic outcomes

Making the Right Surgical Decision

Each patient requires a personalized surgical plan based on:
✔ Tumor characteristics (size, location, type)
✔ Breast size & shape
✔ Cancer stage & lymph node involvement
✔ Personal preference & reconstruction goals
✔ Genetic predisposition (BRCA carriers)

With advancements in oncoplastic & reconstructive techniques, breast cancer surgery is no longer just about survival—it’s about preserving femininity, confidence, and quality of life.