Surgery for Breast Cancer
Whether you need a nonsurgical biopsy, treatment of an infection or an advanced surgical procedure, our board-certified surgeons will work side-by-side with you to deliver compassionate and personalized care. Every person has a unique relationship with their breasts. That’s why our surgeons emphasize a personalized surgical treatment plan based on your preferences.
There are three main categories of surgical treatment for breast cancer:
- Breast conservation surgery (lumpectomy), to remove the cancer and preserve the rest of the breast
- Mastectomy, to remove an entire breast, which may be followed by a reconstruction surgery
- Lymph node biopsy, to determine if the cancer has spread to other parts of your body
Breast Conservation (lumpectomy)
Breast-conserving surgery is an operation to remove the cancer and some normal tissue around it, but not the breast itself. In most instances, you may not need a total mastectomy; a lumpectomy is a viable treatment option.
Mastectomy and Reconstruction
At Northwestern Medicine, a multidisciplinary care team with a depth of breast surgery experience will help guide you through your mastectomy and potential subsequent reconstruction surgeries.
This surgery removes the whole breast that has cancer. Some of the lymph nodes under your arm may be removed and checked for cancer. This may be done at the same time as the breast surgery or later. This is done through a separate incision. Single mastectomy removes one breast. Double mastectomy removes both.
During these surgeries all breast tissue except skin and potentially the nipples is removed. If your surgeon finds cancer cells in the skin or nipples, they may recommend a total mastectomy.
Modified Radical Mastectomy
This surgery removes the whole breast that has cancer, many of the lymph nodes under your arm.
Treating your breast cancer is our top priority, but our expert team is also committed to making sure you can feel like yourself again and meet your future goals after treatment. Your physician and care team will work alongside you to prioritize your cancer treatment, while creating an individualized plan for reconstruction after mastectomy to rebuild the shape of your breasts.
It’s important to remember that breast reconstruction is always an option, but the timing is up to you and your care team based on your treatment plan, preference and health. Breast reconstruction is often a multi-step process.
There are two types of reconstruction surgery. Breast reconstruction may be performed as a partial surgery (one breast) or bilateral (both breasts) surgery.
Natural (Tissue Flap)
Natural, or tissue flap, reconstruction uses your own tissue to rebuild your breasts.
Natural Breast Reconstruction Surgery Types:
- Oncoplastic reconstruction: Involves reshaping breasts after lumpectomy to preserve or achieve good breast shape following lumpectomy and/or radiation. This may be performed alongside a breast lift or reduction during or after breast cancer treatment.
- Breast lift or reduction for symmetry after treatment.
- Reconstruction with flap: Involves using tissue from other areas of the body to replace breast tissue lost during breast cancer treatment or mastectomy.
Prosthetic, or implant-based, reconstruction involves an implant filled with saline or silicone gel to replace your breast tissue. You may need a subsequent implant exchange surgery in the future with prosthetic breast reconstruction.
Implant-Based Reconstruction Types:
- Staged Expander: Involves two surgeries. During the first surgery, your expert breast surgeon will put a tissue expander into the breast to make room for an implant. During the second surgery, your surgeon will insert the implant.
- Direct-to-Implant (DTI): Implant is placed during mastectomy.
Other Reconstruction Surgery Options
Breast Neurotization Surgery
Leading-edge technology involving reconnecting tiny nerves in breast to improve sensory recovery in natural breast reconstruction.
Surgical Treatment of Post-Mastectomy Pain Syndrome
It is very common for your reconstructed breasts to hurt. If your breasts hurt after reconstruction, outpatient surgical treatment is available to you to help with your pain. Surgical treatment in the hands of a multidisciplinary team can help you manage the pain and reduce the amount of pain medication you may need. Surgical treatment for breast reconstruction pain may include:
- Fat transfer
- Neuroma (pinched nerve) removal or repair
- Targeted motor reinnervation (TMR)
3D Nipple Areola Tattooing
Northwestern Medicine refers to trusted tattoo artists in the Chicago region nipple tattooing after surgery to help your breasts look how they did before surgery.
Lymphedema Prevention and Treatment
Some people experience swelling where their lymph nodes were removed after mastectomy, or lymphedema. Your expert breast cancer care team at Northwestern Medicine offers several surgical and non-surgical ways to prevent and treat lymphedema:
- Lymphatic venous bypass
- Lymph node transfer
- Reducing number of lymph nodes removed in surgery
- Lymphatic drainage massage and compression
- Occupational therapy
- Physical therapy
Lymph node biopsy
In breast cancer, the cancer stage is based on the size and location of the primary tumor, the spread of cancer to nearby lymph nodes or other parts of your body, the tumor grade, and whether certain biomarkers (measurable indicators) are present. Breast cancer is staged from 0 to IV (least to most severe).
A sentinel lymph node biopsy may be used to see if cancer cells have spread to your lymph nodes. This surgical procedure will help with breast cancer staging and may be done during a lumpectomy or mastectomy.
Northwestern Medicine provides surgical care for breast cancer across the Chicagoland area. You will have access to some of the best surgical specialists in the region located near you.