If the doctor identifies a tumor that's safe for removal, surgery is going to be an important part of the treatment. The oldest form of cancer treatment, surgery is still considered the best way to remove cancerous tissue, particularly when it's localized in one area of the body, such as the breast. The goal in surgery is to remove the entire tumor, including the cancerous cells spreading around the edge, or "margin," of the tumor.
The doctor may discuss one or a number of different types of surgery:
- Diagnostic surgery. Some types of surgery are used to diagnose and "stage" cancer when the doctor can't see what's going on from outside the body.
- Lumpectomy or mastectomy. Small tumors can be removed through a lumpectomy or partial mastectomy; larger or more aggressive tumors require a mastectomy, or removal of the whole breast.
- Surgery on surrounding areas. Breast cancer is often treated with surgery to remove the tumor in the breast and additional surgery or biopsy to remove the lymph nodes under the arm. The surgeon may also decide to remove blood vessels close to the tumor to prevent the cancer from spreading.
- Prophylactic surgery. This type of surgery is a proactive treatment used to prevent cancer from developing in people who are likely to develop the disease. Women with a strong family history of breast cancer or whose genetic testing shows they carry the breast cancer gene BRCA may choose to have a prophylactic mastectomy to protect themselves.
Biopsies are the most common type of diagnostic surgery. Using a needle, the doctor draws a tissue sample from a tumor. Biopsies can also be done by cutting through the tissue with a knife or laser. An excisional biopsy is one that cuts out the entire tumor, while an incisional biopsy removes a small part of a larger tumor. Unlike regular surgery, biopsies are often outpatient procedures performed using local anesthesia.
Laparoscopies or endoscopies, often done in tandem with biopsies, use a flexible tube and scope to examine a potentially cancerous area. These procedures aren't typically used for breast cancer and would only be done to check if the cancer has spread to another part of the body.
