If it is determined that you have breast cancer, your doctor will discuss surgical options with you. There are two types of surgeries: lumpectomy and mastectomy. Surgical removal of lymph nodes also may be performed.
With lumpectomy, the entire tumor is removed as well as some bordering tissue. This is referred to as breast conserving surgery. Some lymph nodes under the arm can also be removed during lumpectomy to determine if cancer has spread to the lymph nodes. Other treatments may be required with breast conserving surgery, including radiation, chemotherapy and hormonal therapy. When the lump cannot be felt, the doctor may have the area localized prior to surgery to accurately identify the abnormality.
Wire localization uses images obtained with mammography or ultrasound to identify and pinpoint the area to be removed. The mammogram or ultrasound serves as a guide for the radiologist who inserts a small needle into the breast that, in turn, directs a special wire to the location of the abnormality. The wire guides the surgeon in identifying the lump and removing it.
A simple mastectomy involves removal of the entire breast as well as some lymph nodes, whereas a radical mastectomy involves the removal of breast tissue, as well as the chest wall muscle lining and most of the lymph nodes under the arm.
Sentinel Node Evaluation
A sentinel node evaluation involves removal of a single lymph node under the arm for examination by a pathologist. The sentinel lymph node is the first to receive drainage from the tumor. This procedure has fewer complications and is less invasive than a complete axillary node dissection.
Axillary Node Dissection
Sometimes a complete axillary lymph node dissection is necessary. The doctor will remove a number of lymph nodes from under the arm for examination by a pathologist. For 5 to 10 percent of women who undergo complete axillary lymph node dissection, swelling in their arms (lymphedema) occurs. Professionals at the Comprehensive Breast Center will work with you to treat lymphedema.