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 treatments 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. Lumpectomy is one of the most popular current surgical treatment plans for breast cancer. The lumpectomy procedure is usually done with an overnight stay, but can be done as an outpatient. Average recovery time is one week.
This operation has been available in a variety of different forms for at least 100 years. The mastectomy 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 side effects are rare. Radiation is usually not required.
This operation is used often for very large or extensive tumors, or for people who cannot accept the requirements of a treatment plan such as radiation therapy. This surgery is also usually done with an overnight hospital stay, but can be done as an outpatient. Average recovery time is seven to ten 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.
For patients who wish or require mastectomy, our group has developed an association with the Plastic Surgery Department at Indiana University. This allows all forms of breast reconstruction to be available locally.
The plastic surgeons come to our office regularly and coordinate these surgeries so breast reconstruction can be performed at the same time as a mastectomy, if desired. The most sophisticated forms of breast reconstruction are available to our patients. These procedures require a typical hospital stay of two to five days. Recovery averages from two to six weeks for full recovery, depending on the procedure performed.
Sentinel Lymph Node Biopsy
Within the last two years, surgeons have developed a surgical technique to identify specific lymph nodes draining the area of the breast where cancer began. These lymph nodes can be precisely identified and removed by an injection of a radioactive tracer and a blue dye in the area of the cancer just before surgery. These lymph nodes bear a great deal of prognostic significance, but until now were difficult to locate. The lymph nodes located with this cutting-edge technique undergo extra testing to determine the stage of the cancer with the highest possible accuracy.
This staging process helps determine the likelihood that an individual's cancer cells have spread and allows our team of physicians to develop the most accurate recommendations for treatment. In some cases, sentinel lymph node removal will suffice for standard partial axillary lymph node removal. This very new and exciting procedure is available through our breast surgeons and integrated into our team approach with our radiologists, pathologists, radiation oncologists and medical oncologists.