Surgical Treatment for Breast Cancer & Disease
Often when a breast abnormality or cancer is diagnosed surgery is the first treatment. There are options for surgical treatment and they should be discussed with your surgeon before making a decision. When surgery is performed the surgeon will send the specimen to pathology. The pathologist will review the complete specimen to determine the cancer size, margins, and if blood vessels or lymphatic tissue are involved.
WIDE LOCAL EXCISION
A wide local excision is a surgery performed to remove a palpable mass/lump within the breast tissue. If the mass is benign, the primary goal will be just to remove the palpable abnormality. If the mass is cancerous and a local excision is performed then there will be a margin of normal tissue removed around the mass to make sure the entire cancerous mass is removed.
NEEDLE LOCALIZATION WIDE LOCAL EXCISION
When a breast cancer, calcifications or another abnormality is present but not palpable a wire is placed in the breast tissue. This procedure is performed in the radiology department to determine where the abnormality or clip (from a previous biopsy) in the breast is located so the surgeon can find it in the operating room. Mammogram films will be performed after the wire has been placed to help the surgeon locate the area in the breast that has to be removed. You will then be taken to the operating room for surgical excision of the area. The films will be viewed in the operating room by the surgeon as the procedure is done. In the operating room, a bioptic machine will be used (like a mammogram) which will image the tissue removed, it will be able to determine if the complete wire was removed and the clip, while the surgery is being performed.
CENTRAL MASTECTOMY
When Paget’s disease, in situ or a breast cancer is so close to the nipple that the nipple has to be removed this is called a central mastectomy. The nipple and tissue surrounding it will be removed for evaluation, but the remaining breast tissue and contour of the breast will be maintained.
SIMPLE MASTECTOMY
A simple mastectomy is when breast tissue, some skin and nipple are removed. Breast tissue is present superiorly just under the clavicle, medially to the sternum, laterally to the axilla and serratus muscle and inferiorly to the inframammary fold. The goal is to remove all the breast tissue, however.
Our Practices
