Breast Surgery

Surgical biopsies are occasionally required where incisions are actually made
on the breast. These biopsy techniques include the needle (wire) localized
biopsies that are particularly useful when microscopic calcium deposits are
seen on the mammogram. These surgical biopsies are done in an operating
room and are usually done with local anesthetic and sedation or full general
anesthesia. The procedure is always done as an outpatient procedure.

If breast cancer is diagnosed, various therapeutic breast procedures and
treatment plans are available. Some of these treatment plans start with surgery
and others start with chemotherapy and finish with surgery.

Therapeutic Breast Procedures
A number of surgical options are available to the patient when breast cancer
surgery is necessary.

Lumpectomy
This surgery involves removing the cancerous area of the breast plus a
surrounding area of noncancerous breast tissue. Every attempt is made
to preserve breast shape and size. This approach is appropriate for most
small breast cancers and some larger breast cancers. It is accompanied by
removal of a portion of the lymph glands under the arm, where breast cancer
tends to spread first. After healing is complete, radiation treatment is given
to the remaining breast tissue to minimize the chance of recurrence.
Radiation treatments are performed using the linear accelerators at the
hospital. The linear accelerator delivers radiation in a much more precise and
controlled fashion than the older cobalt units that were previously used.
Lumpectomy is one of the most popular current surgical treatment plans for
breast cancer. The lumpectomy procedure is usually done as an outpatient.
Average recovery time is one week.

Simple Mastectomy
This operation has been available in a number of forms for at least 100 years.
It has been modified so that currently the operation removes only the nipple
and a small amount of surrounding skin along with all the underlying breast
tissue. Additionally, some lymph glands under the arm are removed. No
muscles are affected and rarely are there any side effects that were often
seen with some of the older forms of mastectomy. Seldom is radiation required.
This operation is used often for very large or extensive tumors, or for people
unwilling or unable to accept the requirements of a proper lumpectomy treatment
plan such as radiation therapy. This surgery can be done with an overnight
hospital stay, but usually it is done as an outpatient. Average recovery time
is 7 to 10 days. Older forms of mastectomy, such as radical mastectomy, which
involves the removal of a large amount of tissue and chest muscle are only
rarely performed. Radical mastectomies are rarely indicated and rarely utilized.

Post-Mastectomy Reconstruction
For patients who wish or require mastectomy, we work together with a Plastic
Surgeon to allow breast reconstruction to be available. The breast reconstruction
is done at the same time as the mastectomy or at a later time, if needed. All the
most sophisticated forms of breast reconstruction are available. These procedures
are done in an inpatient setting, with hospitalization averaging two to five days
depending on the type of procedure performed. Recovery averages from two to
six weeks for full recovery, again depending on the exact procedure performed.