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Breast Surgery

Custom Breast Prosthesis for Breast Cancer Patients - Jean Wainstock, CRNP - Mercy

Mercy Breast Center nurse practitioner, Jean Warner, CRNP, discusses custom breast prosthesis for breast cancer patients. Learn more at mdmercy.com.

Double Mastectomy - Dr. Neil Friedman - Mercy

Mercy breast cancer surgeon Dr. Neil B. Friedman discusses the pros and cons of a double mastectomy. Learn more at mdmercy.com.

Maggie: The Bald Ballerina

A ballerina in the elite Joffrey Concert Group in New York City, Maryland native Maggie Kudirka discovered she had stage 4 breast cancer in 2014. Renowned breast cancer surgeon Dr. Neil B. Friedman, Director, The Hoffberger Breast Center at Mercy Medical Center in Baltimore, MD, performed Maggie’s surgery and she receives outpatient chemotherapy treatment under the direction of Mercy medical oncologist Dr. David Riseberg in Mercy’s Institute for Cancer Care. Maggie continues to raise awareness as well as needed funds for her treatment through her website, http://www.baldballerina.org. Learn more about The Hoffberger Breast Center at Mercy at mdmercy.com.

Lumpectomy or Mastectomy Surgical Treatment Options for Breast Cancer

With many (especially early stage) breast cancer cases, surgery to remove the cancer is part of the treatment. Sometimes breast cancer surgery is performed after chemotherapy or hormonal therapy is given to shrink the tumor (neoadjuvant treatment). Breast cancer surgery removes the primary tumor and helps accurately stage the disease.

What is Breast Conserving Surgery (Lumpectomy or Partial Mastectomy)?

Breast conserving surgery involves removal of the cancer with a rim of normal tissue (negative margins). This leaves the breast intact, usually with a good cosmetic outcome. There is frequently some reduction in the size of the breast, or more frequently, a flattening of the contour of the breast in the area of the surgery.

There are two surgical options to remove the cancer but not the breast (breast conserving surgery):

  • Lumpectomy – removal of the tumor or lump and some of the normal tissue around it.
  • Partial Mastectomy – removal of the section of the breast that has cancer and some of the normal tissue around it.

Breast conserving surgery also typically includes a sentinel lymph node biopsy, in which the surgeon identifies and removes the sentinel lymph node (or first lymph node the cancer is likely to spread to) to determine whether or not cancer has spread.

Breast conserving surgery should be followed by radiation treatment in the majority of patients, otherwise there would be a very high risk of the cancer coming back in the same area (25-30% risk). Radiation treatment reduces this risk of local recurrence to 5-10% or less. Patients who receive a lumpectomy may be candidates for a one-time, targeted dose of radiation therapy called Intraoperative Radiotherapy (IORT). This treatment eliminates the need for patients to return to the hospital multiple times (typically an additional six) to receive radiation treatment.

All patients are not candidates for breast conserving surgery. In some cases, your doctor may recommend a mastectomy, or the removal of the entire breast that has cancer.

What is a Mastectomy?

A mastectomy is surgery to remove the entire breast that has cancer. A mastectomy is likely to be recommended if the breast cancer is too big, is located in the center of the breast, is large relative to the size of the breast, or is located in multiple different areas of the breast.

If a woman has to have a mastectomy, she can consider wearing a breast prosthesis in her bra, undergoing breast reconstruction surgery or neither one. Breast reconstruction surgery is performed to create a new breast using either implants or tissue from another area of the body.

The one benefit of a mastectomy is that most patients with early stage breast cancer do not require radiation. However with larger tumors, or if multiple lymph nodes are involved, patients need radiation treatment in addition to the mastectomy to reduce the risk of the cancer coming back.

A mastectomy also typically includes a sentinel lymph node biopsy, in which the surgeon identifies and removes the sentinel lymph node (or first lymph node the cancer is likely to spread to) to determine whether or not cancer has spread.

It is important to understand that there is no difference in survival with a mastectomy or lumpectomy. This is why patients are frequently given the choice, and they can decide which option suits them best. As noted above, there are instances where mastectomy is the only option.

The Hoffberger Breast Center at Mercy offers comprehensive breast care, thoughtfully designed for women undergoing the journey to overcome breast disease.