If you are facing a breast cancer diagnosis, you have more treatment options than ever before. A big part of my responsibility as a doctor and a breast surgeon is to help women understand all of their options, so they can make decisions that are right for them.
The Pathway to Care
The role of surgery in the treatment of breast cancer has evolved dramatically. Years ago, when a woman felt a lump in her breast, she would go to her doctor, who would refer her to a surgeon. The surgeon would insert a needle to see if fluid came out, indicating a cyst. If not a cyst, the patient would be scheduled for surgery, not knowing she had breast cancer until she awoke from anesthesia with a mastectomy.
Today, a radiologist typically makes the initial diagnosis, which is confirmed by a pathologist. More sophisticated imaging technology enables us to detect tumors before they are felt. Women have biopsies before scheduling surgery, and surgery is one of several treatment options, along with chemotherapy and radiation therapy. Our knowledge of genetics and tumor biology helps inform our decisions. Survivorship is better than ever, as are cosmetic outcomes, thanks to advances in reconstructive plastic surgery.
Understanding Surgical Options
If surgery is your choice, you have a variety of options to consider, all dependent on your individual diagnosis and preferences:
- Lumpectomy—removal of the lump and a rim of normal tissue
- Partial mastectomy—removal of part of the breast
- Simple mastectomy (total mastectomy)—removal of the entire breast
- Modified radical mastectomy—removal of the breast and some underarm lymph nodes
- Axillary dissection—removal of the underarm lymph nodes.
- Oncoplastic surgery—for patients requiring substantial tissue removal, helps maintain breast contour and helps more women become candidates for MammoSite® radiation therapy, a post-surgical treatment with fewer side effects and a shorter treatment cycle than traditional radiation therapy.
The good news is our methods of treating breast cancer have improved and expanded. The challenging part is making sense of the many options. Ask questions. Talk with your doctor, other members of your medical team, and your family. Then make the care decisions that are right for you.
I’m constantly inspired by the courage and resilience of the women I treat. Their world is turned upside down by this diagnosis, and I watch them go through this experience and come out the other end stronger and with an incredible appreciation for life.