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First Step in Treating Early Stage Breast Cancer

The first step in treating early stage breast cancer usually involves surgical removal of the tumor, and assessment of the axillary (underam) lymph nodes on the side of the tumor.

Maria Pence, MD, Breast Disease and Surgery

Maria Pence, MD, Breast Disease and Surgery

Photo Credit: Contributed

There are two options for breast cancer surgery:

Mastectomy removes the entire breast.

Breast conservation surgery removes only the cancerous area and a small amount of surrounding normal tissue. This is called a partial or segmental  mastectomy, and is also most commonly known as a lumpectomy.  Breast conservation surgery is almost always followed by radiation therapy to the breast.

Survival outcomes are the same for lumpectomy with radiation and mastectomy.

The majority of women, approximately 75%, can be treated with breast conserving therapy.  One common misconception is that a woman will avoid chemotherapy if she chooses the more extensive surgery, mastectomy.  It is important to note that the majority of women with invasive breast cancer will be recommended to have either hormone therapy, chemotherapy, or both. However, the surgery decision, breast conservation or mastectomy, does not alter this recommendation.

For women who require or opt for mastectomy, many women will opt for a breast reconstruction.  Reconstruction is typically started immediately after the cancer operation.

When a reconstruction is planned, the mastectomy can often be performed with a skin sparing or nipple sparing approach. This surgery removes all of the breast tissue, but preserves the envelope of skin covering the breast, and allows for a very natural appearing reconstruction.  Some, but not all, patients may be candidates for this approach.

Most patients with invasive breast cancer will have a procedure to evaluate or manage lymph nodes in the axilla (underarm) on the side of the tumor.

For women with abnormal lymph nodes that are easily felt and known to contain cancer, the surgery involves removing most of the lymph nodes under the arm.  This is called an axillary lymph node dissection. There are known possible risks to this procedure, including pain or arm swelling  (lympedema).

Fortunately,  the majority of women with early stage breast cancer can be spared an axillary dissection.  When the lymph nodes appear normal, they are evaluated by a surgical procedure called a sentinel node biopsy.

The surgeon injects a small amount of a radioactive tracer and/or a blue dye into the breast before surgery. The dye travels in the small lymph vessels of the breast and flows to the underarm. The surgeon examines the axilla and identifies the first lymph node or nodes that contain the dye. These “sentinel” nodes are removed and evaluated by a pathologist.  If the sentinel nodes are normal, then no additional lymph nodes need be removed.

When a patient has a new diagnosis of breast cancer, she may often have choices in her surgical management.  These choices may be very different from one woman to the next.  A breast cancer surgeon will consider many factors, including tumor size, breast size, breast imaging findings, family history, medical history, patient expectations, and lifestyle when making recommendations for management of breast cancer.

This article is part of a paid Content Partnership with the advertiser, Mount Kisco Medical Group. Daily Voice has no involvement in the writing of the article and the statements and opinions contained in it are solely those of the advertiser.

To learn more about Content Partnerships, click here.

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