Breast Surgery

There are two different types of breast surgery, and both are done under anesthesia. You will be given detailed instructions that will help you prepare, including when you should stop eating and drinking prior to surgery

It will be important that your surgeon and care team know about all of the medications you take, including all herbal remedies, supplements and over-the-counter medications. You will be advised if you need to stop taking any of your current medications before surgery, especially medications used to stop the formation of blood clots (blood thinners).

You'll need to plan ahead to make sure you have a trusted adult to drive you home after your surgery. Depending on the recovery time, you may also want to plan for meal preparation, child or pet care, help with housekeeping, etc. Usually, family members and friends are very willing to help. It is important to know that you may need some help, and to reach out to others if you do.

Lumpectomy

This surgical procedure is used to remove a cancerous tumor or other abnormal tissue from the breast. Lymph nodes under the arm (axillary lymph nodes) may also be removed at the same time. These nodes are where the cancer would be likely to first reach so they will be removed to check for any sign of cancer. This is known as a sentinel lymph node biopsy. If the nodes show that cancer is present, more axillary nodes will be removed.

Prior to surgery, patients will receive an injection of blue dye or a radioactive fluid, or both, near the site of the tumor. This will be absorbed by the lymph nodes making them more visible, which will help the surgeon locate the nodes during surgery.

Your doctor may recommend that you have radiation treatments after you are completely healed from the surgery.

Mastectomy

A mastectomy surgery will remove the entire breast. Some lymph nodes under the arm may also be removed during the procedure. Some women that meet certain criteria may elect to have reconstructive surgery at the same time. Your breast surgeon will discuss this option, and let you know what to expect during the surgery and afterwards.

Depending on your cancer and available options, other types of mastectomy can be done. These may be done to spare the nipple, areola, or some of the breast tissue. Your surgeon will explain these procedures and your surgical options.

The surgery will be done by making an incision. Depending on the breast size and location of the cancer, the size, shape and location of the incision may vary. The entire breast tissue (lobules, ducts and fatty tissue) will be removed. Sometimes, the lining of the chest wall muscle will also be removed.

Lymph nodes under the arm (axillary lymph nodes) may also be removed at the same time. These nodes are where the cancer would be likely to first reach so they will be removed to check for any sign of cancer. If the nodes show that cancer is present, more axillary nodes will be removed.

Prior to surgery, patients will receive an injection of blue dye or a radioactive fluid, or both, near the site of the tumor. This will be absorbed by the lymph nodes making them more visible, which will help the surgeon locate the nodes during surgery.

One or more drains (thin plastic tube with bulb attached) may be placed to collect excess fluid, and the incision will be closed with sutures. You will go home with these drains in place. They will be covered with a sterile dressing. You will receive discharge instructions that detail when and how the drains should be emptied. Fluids will need to be measured and reported back as directed to your surgeon’s office.

Breast tissue that is removed during surgical procedures including a biopsy, lumpectomy or mastectomy is sent to a pathology lab for testing. Your surgeon will give you the results of the surgery and pathology tests and recommend any additional follow up tests or treatments that may be necessary.

Surgery Risks and Complications

With any surgery, there are always risks and complications associated with these surgical procedures. With breast surgery these may include:

  • Anesthesia associated risks

  • Infection

  • Excessive bruising/bleeding

  • Poor incision healing/scarring

  • Change in your breast shape

  • Fluid collection

  • Swelling in the arm (lymphedema)

  • Numbness/loss of sensation

  • Shoulder stiffness (mastectomy patients)