If cancer cells are found at or near the edge of the removed tissue (also called a positive or close margin), more surgery may be needed. The surgery done as part of the wire localization may be enough to count as breast-conserving surgery if all of the cancer is taken out and the margins are negative. Once in the operating room, the surgeon uses the wire as a guide to find the part of the breast to be removed. A small hook at the end of the wire keeps it in place. Once the tip of the needle is in the right spot, a thin wire is put in through the center of the needle. Rarely, an MRI might be used if using the mammogram or ultrasound is not successful.Īfter medicine is injected into your breast to numb the area, a mammogram or ultrasound is used to guide a thin hollow needle to the abnormal area. If a mammogram is used you may hear the term stereotactic wire localization. This is called wire localization or needle localization. Sometimes, if the cancer in your breast can’t be felt, is hard to find, and/or is difficult to get to, the surgeon might use a mammogram or ultrasound to guide a wire to the right spot. To learn more about these procedures, see Lymph Node Surgery for Breast Cancer. ALND is not done as often as it was in the past, but it might still be the best way to look at the lymph nodes in some situations. Axillary lymph node dissection (ALND) is a procedure that does not use a dye and in which the surgeon removes many (usually less than 20) underarm lymph nodes. Removing only one or a few lymph nodes lowers the risk of side effects that can happen after an axillary lymph node dissection (below), such as arm swelling that is also known as lymphedema. These lymph nodes are where the cancer would likely spread first. Sentinel lymph node biopsy (SLNB) is a procedure in which the surgeon injects a dye and then removes only the lymph node(s) under the arm that have taken up the dye.The two main types of surgery to remove lymph nodes are: Lymph nodes may be removed either as part of the surgery to remove the breast cancer or as a separate operation. This is important to figuring out the stage (how big and where it has spread) of the cancer. To find out if the breast cancer has spread to underarm (axillary) lymph nodes, one or more of these lymph nodes will be removed and looked at in the lab. But studies of thousands of women over more than 20 years show that when BCS is done with radiation, survival is the same as having a mastectomy, in people with early-stage cancer who are candidates for both types of surgery. Some women might worry that having a less extensive surgery might raise the risk of the cancer coming back. Women who have mastectomy for early-stage cancers are less likely to need radiation.įor some women, mastectomy may be a better option or the only option, because of the type of breast cancer, the large size of the tumor, previous treatment with radiation, or certain other factors. But most often, she will also need radiation. The main advantage of BCS is that a woman keeps most of her breast. Many women with early-stage cancers can choose between having breast-conserving surgery (BCS) and mastectomy. Some women may also have both breasts removed in a double mastectomy.Ĭhoosing between breast-conserving surgery and mastectomy There are several different types of mastectomies. Mastectomy is a surgery in which the entire breast is removed, including all of the breast tissue and sometimes other nearby tissues.This surgery is also called a lumpectomy, quadrantectomy, partial mastectomy, or segmental mastectomy. How much breast is removed depends on where and how big the tumor is, as well as other factors. Only the part of the breast containing the cancer is removed. Breast-conserving surgery is surgery to remove the cancer as well as some surrounding normal tissue.There are two main types of surgery to remove breast cancer: It’s important to know your options so you can talk about them with your doctor and make the choice that is right for you. Your doctor may recommend a certain operation based on your breast cancer features and your medical history, or you may have a choice about which type of surgery to have. Restore the breast’s shape after the cancer is removed (breast reconstruction).Find out whether the cancer has spread to the lymph nodes under the arm (sentinel lymph node biopsy or axillary lymph node dissection).Remove as much of the cancer as possible (breast-conserving surgery or mastectomy).There are different types of breast surgery, and they may be done for different reasons, depending on the situation. Most women with breast cancer have some type of surgery as part of their treatment.
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