You find a lump while showering, notice a change in the shape of your breast, or receive an unexpected mammogram result. The word “cancer” enters the conversation, and suddenly the biggest question is: “What kind of surgery will I need?”
For many patients, surgery becomes the most frightening part of the diagnosis. But breast cancer treatment is not one-size-fits-all. A breast cancer surgeon looks at the tumour, its stage, its location, and other test results before deciding which surgical approach may be appropriate.
A breast cancer surgeon specialises in surgically treating breast cancer and evaluating the surrounding lymph nodes when necessary.
Depending on the diagnosis, surgery may involve removing only the tumour and some surrounding tissue or removing the entire breast.
The surgeon may also perform lymph node surgery to determine whether cancer has spread beyond the breast.
The objective is not simply to remove as much tissue as possible. It is to treat the cancer appropriately while considering the patient's health, treatment plan, and quality of life.
A referral may be made after a biopsy confirms breast cancer or when imaging identifies a suspicious lump that needs surgical assessment.
Some breast changes that deserve evaluation include a new lump, changes in breast shape, skin changes, nipple discharge, or an unusual change that persists.
These signs do not automatically mean cancer. Many breast conditions are benign. But getting them checked is much more useful than trying to diagnose the problem yourself.
No.
Surgery is an important part of treatment for many breast cancers, but some patients receive chemotherapy, hormone therapy, targeted treatment, or other treatment before surgery.
This may happen when the medical team believes that treatment before surgery could shrink the tumour or provide other benefits.
So, if surgery does not happen immediately, it does not necessarily mean that treatment is being delayed.
Patients often hear these two terms early in the treatment journey.
A lumpectomy, also called breast-conserving surgery, removes the cancer and a margin of surrounding tissue while keeping most of the breast.
For suitable patients, radiation therapy may be recommended afterward.
A mastectomy removes the entire breast.
It may be recommended in certain situations, such as when the tumour is extensive, there are multiple areas of cancer, or breast-conserving surgery would not provide an appropriate result.
The choice depends on the patient's cancer—not simply on which procedure sounds more or less aggressive.
Breast cancer can spread to lymph nodes, particularly those located under the arm.
Depending on the situation, the surgeon may perform a sentinel lymph node biopsy or another form of lymph node surgery.
The information obtained can help doctors understand the extent of the cancer and determine whether additional treatment may be needed.
Your surgeon should explain whether lymph node assessment is recommended and what the possible effects may be.
Yes.
Some women choose reconstruction after a mastectomy. Depending on the cancer treatment and the patient's circumstances, reconstruction may sometimes be performed during the same operation or at a later stage.
Reconstruction can involve implants or tissue from another part of the body.
But reconstruction is a personal decision. There is no requirement that every patient should choose it.
There is a common belief that more surgery means more protection from cancer.
That is not necessarily true.
A larger operation is not automatically better for every patient. The appropriate procedure depends on the tumour's characteristics and the overall treatment plan.
Likewise, choosing breast-conserving surgery simply because it preserves the breast is not appropriate if the cancer makes another approach more suitable.
The better question is: “Why is this operation right for my particular cancer?”
Imagine a woman diagnosed with a small breast tumour after a mammogram and biopsy.
Her immediate assumption is that she will need a mastectomy. After reviewing the imaging and pathology, however, the surgical team may determine that breast-conserving surgery is appropriate, followed by other recommended treatment.
Another patient may have a different tumour pattern and require a mastectomy.
Both have breast cancer, but their surgical plans can be completely different.
This is why comparing your treatment with another person's experience can create unnecessary worry.
Before surgery, ask:
What type of breast cancer do I have?
What stage is it?
Where is the tumour located?
Can breast-conserving surgery be considered?
Why are you recommending this operation?
Will my lymph nodes be examined?
Will I need chemotherapy or radiation?
Is reconstruction an option?
What will recovery involve?
Could the surgery affect my future treatment?
Bring someone with you if possible, especially if you find medical appointments overwhelming. A second pair of ears can be surprisingly helpful.
The International Agency for Research on Cancer estimated around 20 million new cancer cases globally in 2022, with breast cancer among the most commonly diagnosed cancers worldwide.
These figures show the scale of the disease, but they cannot determine what surgery an individual patient needs.
Your pathology, tumour biology, stage, imaging, overall health, and treatment goals are much more relevant.
Dr. Deepika Gupta is a cancer specialist involved in surgical cancer care. For women facing a breast cancer diagnosis, discussing breast-conserving surgery, mastectomy, lymph node assessment, reconstruction, and the wider treatment plan can help make an overwhelming set of decisions easier to understand.
No. Some patients may be suitable for breast-conserving surgery, while others may require a mastectomy depending on the cancer's characteristics.
Yes. Breast-conserving surgery can preserve much of the breast in selected patients. Additional treatment such as radiation may be recommended afterward.
Yes. Reconstruction may be possible during the initial surgery or at a later stage, depending on the patient's treatment plan and individual circumstances.
A breast cancer diagnosis can make surgery feel like the only thing that matters. But understanding why a particular operation is being recommended can make the entire treatment journey easier to navigate.
For women trying to understand their options, Dr. Deepika Gupta can help bring the conversation back to the individual cancer, the treatment goals, and the surgical choices that may be relevant.
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