Surgery is a common part of many breast cancer treatment plans. Breast cancer surgery generally falls into one of two categories:
- Lumpectomy, which removes the tumor and the tissue around it, but not the whole breast.
- Mastectomy, which removes the whole breast which may or may not include the nipple and areola.
Both of these surgeries can be done using hidden scar surgery. Our surgeons always strive to deliver the best outcomes using the least invasive procedure possible.
Breast surgery may be the first step on your treatment path. But some women may have chemotherapy or radiation therapy before their surgery to reduce the size of a tumor. Your surgeon may also perform a sentinel lymph node biopsy to determine if your cancer has spread.
Many women who have a single or bilateral mastectomy also choose to have breast reconstruction. Under federal law, a group insurance plan that covers mastectomies must also cover breast reconstruction. Your UPMC Pinnacle Breast Care Center team will work with you to decide if breast reconstruction is an option for you.
Lumpectomy is performed under anesthesia. Your surgeon will remove only the cancer and not the whole breast. Your surgeon will also take a thin layer of normal breast tissue surrounding the cancer. This is called the surgical margin. Removing the margin reduces the risk of cancer recurrence. This surgical margin should be clear of all cancer cells.
Lumpectomy is often performed as an outpatient procedure. You will likely be up and moving the next day but your activity level will be limited for the first week. Pain or sensitivity, breast swelling, bruising or lump/firmness at the surgical site may occur after surgery.
Your surgeon may place a tiny “marker” called BioZorb® where the breast tissue was removed. This dissolves over time (usually within a year). The marker helps your doctors plan and target your radiation therapy if it is needed. There are some small marker clips that will remain permanently within your breast. These allow your doctor to easily identify and monitor the area of surgery in the future.
Mastectomy which removes the whole breast which may or may not include the nipple and breast tissue. This procedure is performed under anesthesia. You will be required to stay overnight. Your stay may be longer if you have breast reconstruction.
A surgical drain(s) will also be placed under your arm at the time of surgery. The drain removes fluids that build up in the breast area after surgery. The drain(s) will be removed about 7–10 days later. Removal is done in your physician’s office during a quick and often painless procedure.
You will have to limit your physical activity in the week or two following your surgery. The chest wall where you had surgery may be painful, numb or sensitive. A seroma, or collection of fluid, may develop after your drain is removed. This occurs when fluid from your lymph nodes collects under the arms or chest wall instead of draining through its normal route. This often goes away naturally. A large or uncomfortable seroma may need to be drained in your doctor’s office with a needle.
Some women may be candidates for skin-sparing mastectomy. The surgeon removes only the skin of the nipple, areola and the original biopsy scar. The rest of the skin remains. Your surgeon then removes the diseased breast tissue through the small opening that is created.
A surgical drain(s) will be placed under your arm at the time of surgery to remove fluids that build up in the breast area after surgery. The drain(s) will be removed about 7–10 days later. Removal is done in your physician’s office during a quick and often painless procedure.
Skin-sparing mastectomy allows for immediate reconstruction. Your surgeon can create a breast that is realistic and true-to-form. The reconstruction uses an implant or your own abdominal skin, fat or muscle tissue.
Skin-sparing mastectomy is used only if you have immediate breast reconstruction. It cannot be used if tumor cells are close to the skin surface.
You will have to limit your physical activity in the week or two following your surgery. The chest wall where you had surgery may be painful, numb or sensitive. A seroma, or collection of fluid, may develop after your drain is removed. This occurs when fluid from your lymph nodes collects under the arms or chest wall instead of draining through its normal route. This often goes away naturally. It may need to be drained in your doctor’s office with a needle if the seroma is large or uncomfortable.
Hidden Scar Surgery
Hidden scar surgery uses a small incision to remove the breast cancer or tissue. This incision is placed in a location that is hard to see. This makes the scar less obvious after you have healed. Hidden scar surgery also preserves the natural shape and look of the breast.
Hidden scar surgery can be used for a lumpectomy. It can also be used in certain cases with mastectomy. Your surgeon will help you determine if you are a candidate for hidden scar surgery.
Sentinel Lymph Node Biopsy
Our bodies have a network of lymph vessels and lymph nodes. This network is part of the body’s immune system. It collects fluid, waste material, and other things (like viruses and bacteria) that are in the body's tissues.
Your doctor may want to check your lymph nodes when you are diagnosed with breast cancer to see if the cancer has spread. This procedure is called sentinel lymph node biopsy. If your cancer has spread to your lymph nodes you may need more aggressive treatment.
Sentinel lymph node biopsy is done under anesthesia. A dye is injected into your breast at the site of the tumor. The lymphatic fluid that flows normally through your breast and travels to the local lymph nodes picks up the dye. The lymph nodes that are located closest to the tumor are then surgically removed. This does not mean that they are cancerous. Your surgeon will discuss the removal of additional nodes in the near future if cancer is found in the lymph nodes closest to the tumor.
A sentinel lymph node biopsy is often done as an outpatient procedure. The exception is when it is being done at the same time as another surgery. An overnight stay may be required if the biopsy and surgery are done at the same time. You may experience blue urine or greenish colored stool after the biopsy. This may last for the next day or so as the dye exits your body. You are not radioactive as a result of this dye.
You may have pain, numbness or sensitivity near the surgical site. A seroma, collection of fluid, may develop in the area where your lymph node(s) was removed. This occurs when fluid from your lymph nodes collects under the arms or chest wall instead of draining its normal route. This often goes away naturally. The seroma may need to be drained in your doctor’s office with a needle if it is large or uncomfortable.
There is a small risk that you could develop lymphedema. This is a chronic swelling in the arm, leg and/or breast on the side of the surgery. UPMC Pinnacle Breast Care Center’s lymphedema specialists will teach you how to prevent and manage this condition.
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UPMC Pinnacle Breast Care Center
Part of PinnacleHealth Breast Care Center
11 Sprint Drive
Carlisle, PA 17015
PinnacleHealth Breast Care Center
Located at UPMC Hillman Cancer Center at the Rocco and Nancy Ortenzio Cancer Pavilion
2035 Technology Parkway
Mechanicsburg, PA 17050
PinnacleHealth Breast Care Center
Located at Medical Sciences Pavilion
4300 Londonderry Road
Harrisburg, PA 17109