The most recommended breast cancer treatment is total or partial mastectomy. There are two types
- Partial mastectomy (also known as lumpectomy, breast-conserving surgery, excisional biopsy or quadrantectomy)
- Total mastectomy (full removal of the breast, also known as modified radical mastectomy)
Most patients undergo some form of this surgery, which removes cancer cells and makes for clear resection margins. In other words, the surgeon removes not only the tumour but also some of the surrounding tissue, to maximize chances of eliminating all the cancer cells. This tissue is then analyzed for cancer cells. Absence of malignant cells in this tissue indicates that the cancer has been removed and points to a good prognosis. During a total or partial mastectomy, surgeons also perform a biopsy on the sentinel or axillary lymph nodes to examine whether the disease has spread to the lymphatic system or other organs.
Whenever possible, surgeons try to preserve the breast by prioritizing lumpectomy. Surgery may be combined with neoadjuvant chemotherapy, which may decrease the size of a large tumour before surgery, or adjuvant chemotherapy, which may improve the effectiveness of the overall treatment.
Following a mastectomy, women may experience some side effects such as lymphedema, pain or numbness in the arm or shoulder, and diminished self-esteem stemming from changes to their body.
Research is underway to develop techniques (such as intraoperative frozen section consultation) to avoid a total mastectomy and perform a partial mastectomy instead.