Surgical Treatment Offers New Options to Women With Breast Cancer

Surgical treatments have changed dramatically in the past 30 years when radical mastectomy was the treatment of choice for women with breast cancer. Today's treatment options include breast-conserving surgery, mastectomy, or mastectomy with reconstruction.

Even in breast conservation, or tissue sparing, surgery, women can have either a lumpectomy or a partial (segmental) mastectomy. In a lumpectomy, the breast cancer and a portion of normal tissue around the breast cancer lump are removed, whereas in partial mastectomy, a larger portion of the normal breast tissue around the lump is removed. The surgeon may also remove the lining over the chest muscles below the tumor and some of the lymph nodes under the arm. After breast-conserving surgery, most women receive radiation therapy to destroy cancer cells that remain in the area.

When non-conserving breast surgery is performed, women have either a total (or simple) mastectomy, modified radical mastectomy, or radical mastectomy. Physicians generally recommend a mastectomy when the cancer has spread to other parts of the breast tissue or has spread to the lymph nodes under the arm, or if the breast is very small and a lumpectomy would require removing additional breast tissue, resulting in a deformed breast.

Breast reconstruction is often an option at the same time as the mastectomy, or at a later time. It is recommended that women considering reconstruction discuss this with a plastic surgeon prior to undergoing mastectomy.

National Cancer Institute Recommendations for Seeking Second Opinion

While some insurance companies require a second opinion, a woman may want to seek a second opinion even if one is not required. While this may result in a slight delay in treatment, the National Cancer Institute (NCI) stresses that this does not make the treatment less effective.

The NCI recommends that a woman wanting a second opinion: