Breast surgery is usually the primary treatment for women diagnosed with breast cancer. The aim of surgery is to remove the breast cancer in the hope of achieving control of the disease.
Where the breast cancer was found on imaging only (ie mammography with or without ultrasound) the radiologist and surgeon work together to correctly identify and remove the abnormal area. The equipment and expertise to perform image-guided localisation and surgery may not be available at all hospitals.
Surgery for breast cancer involves one of the following:
- Breast conserving surgery: surgery to remove the breast cancer and a small area of healthy tissue around it. This is also called a lumpectomy, complete local excision, or wide local excision.
- Mastectomy: surgery to remove the whole breast.
The recommendation about which type of breast surgery is most appropriate will depend on factors such as the size of the cancer in relation to the size of the breast, whether the cancer is in more than one area of the breast and the woman's preference.
Surgery for breast cancer almost always involves the removal of one or more lymph nodes from the armpit (axilla) to determine whether the cancer has spread beyond the breast. Surgery to remove the lymph nodes is usually performed at the same time as the breast cancer surgery.
A technique called sentinel node biopsy can be used to identify whether there is any evidence of spread to the armpit, through the identification of a ‘sentinel’ or marker node or nodes.
This technique has been shown to be at least as accurate as more extensive surgery to the armpit which removes many lymph nodes (axillary dissection or axillary clearance). Sentinel node biopsy has been shown to result in significantly fewer side effects such as arm swelling.
Surgeons performing sentinel node biopsy should have undergone an educational program and should regularly review their results of using this technique.
Surgeons with a major interest and an active practice in breast surgery can join the Breast Section of Surgery of the Royal Australasian College of Surgeons as full members. The Breast Section of Surgery provides education and training in the field of breast surgery and pursues up-to-date research on new technologies, promotes clinical trials and encourages best practice in breast surgery.
For further information about surgical treatment for breast cancer see A guide for women with early breast cancer (pdf) and the Clinical practice guidelines for the management of early breast cancer.
The Directory provides information on whether breast cancer surgery services are provided on site or through referral links.
Reconstructive surgery
The Directory provides information on whether breast reconstructive surgery services are provided on site or through referral links.
Following mastectomy, many women choose to have a breast reconstruction. Reconstructive breast surgery involves rebuilding the woman's breast using an implant or tissue from another part of the body. Sometimes reconstruction is performed at the same time as the mastectomy operation and sometimes it involves additional surgery at a later time
Over the last decade, techniques for breast reconstruction have greatly improved and there is now a better understanding of the risks and benefits of the procedures.
If breast reconstruction is a consideration, it is recommended the woman talks to her surgeon before the mastectomy. It may also be useful to talk to other women who have had breast reconstruction to give a realistic expectation about the results.
Click here for further information on breast reconstruction.