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Breast Cancer Treatments> Types of Breast Surgery |
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In your decision making process about breast reconstruction versus wearing external products you may find it helpful to read a personal perspective in an article Linda Jackson wrote for 'Cure' Magazine. Also visit our medical terms page.
 Modified Radical Mastectomy
A Modified Radical Mastectomy is when the entire breast is removed including the nipple. The surgeon will remove some or all of the underarm lymph nodes (particularly those closest to the breast) to determine if the cancer has spread beyond the breast itself. It may be followed by radiation therapy.
Lumpectomy
In this procedure, the entire breast lump and portion of normal adjacent breast tissue is removed, followed by radiation therapy. The surgeon may remove and test some of the underarm lymph nodes to check for the spread of cancer. Because this procedure avoids the hollowness beneath the collarbone created by more extensive surgery, it permits women to wear clothes with lower necklines and can also make breast reconstruction easier.
Prophylactic or Subcutaneous Mastectomy
A preventive mastectomy for women who are at high risk of breast cancer. The surgeon removes as much of the breast tissue as possible, leaving the skin which has been covering the breast and the nipple intact. The surgeon then reconstructs the breast by placing an implant under the pectoralis muscle, or using the patient's own tissue on top of the muscle.
Mastectomy with Reconstruction
Women who have a mastectomy or lumpectomy have the option to choose surgical breast reconstruction. This can be done either at the time of mastectomy (immediate reconstruction) or later (delayed reconstruction). Breast reconstruction can be performed using either 'implants' or the patient's own tissue. Immediate reconstructive surgery may not be an option for all patients. It is best to talk with your doctor about the specifics of these procedures to see if they are appropriate. The doctor may refer a woman to a plastic surgeon for more information or consultation.
There are basically two types of reconstructive operations - Simple (non-flap) and flap. The choice depends on the amount and suitability of tissue remaining at the mastectomy site and the requirements to match the opposite breast. The physician will discuss these alternatives with the woman in terms of what best suits her situation.
- Simple Non-flap: A simple non-flap procedure is used when there is enough existing local healthy tissue, including muscle, at the mastectomy site. The breast implant is placed under the muscle. The existing mastectomy scar is usually used for the incision, or the surgeon may need to make a new incision. Another version of a non-flap procedure involves the tissue expansion technique. A temporary internal breast implant called a tissue expander is placed in the position of the new breast, and a saline solution is injected into the expander over a period of weeks. When the skin & muscle has stretched to the desired amount, the temporary implant is removed, and a permanent one inserted in its place.
- Flap Procedure: (also called Myocutaneous Flap): Several types of flap procedures are used when it is necessary to transfer additional tissue to the mastectomy site to reconstruct the breast. Latissimus Dorsi procedure is the most frequently used. This technique transfers the muscles and skin from the patient's back when additional tissue is needed after a mastectomy. It may also be used to provide soft tissue cover for a breast implant. When this technique is used, there is usually an elliptical-shaped scar at the site of the reconstruction and a linear scar on the back, which can often be covered with a bra.
For more information, or questions about breast reconstructive surgery and breast implants you may contact the following:
American Cancer Society:
Visit their website
or call: 1-800-227-2345
Y-ME National Breast Cancer Organization:
Visit their website
or call the 24 hour help line:
English 1-800-221-2141
Español 1-800-986-9505
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