Breast surgery

During a mastectomy, your surgeon removes all or part of your breast or breasts to treat breast cancer. Our surgeons perform the following mastectomy procedures:

• Total mastectomy, in which your surgeon removes your entire breast or breasts.
• Partial mastectomy, a breast-conserving surgery in which your surgeon only removes the tumor and a small amount of surrounding tissue. 
• Oncoplastic partial mastectomy, which involves a combination of tumor or cancer removal with immediate breast reconstruction to reshape your breast and prevent any irregularity.
• Hidden scar partial mastectomy, which uses a surgical technique after a partial mastectomy that removes the tumor or cancer from your breast. The procedure is performed in a way that leaves a scar where it can’t be seen.
• Nipple-sparing mastectomy, in which your surgeon will make a small incision to remove the affected breast tissue without removing your nipple(s). This often results in less scarring. This also allows for immediate breast reconstruction that will have a more natural look
• Skin-sparing mastectomy, in which your surgeon removes the breast tissue and glands while preserving your skin. This surgery also allows for immediate breast reconstruction.
• Prophylactic mastectomy, a preventive mastectomy that is also known as a bilateral or double mastectomy. This procedure involves removing one or both breasts to reduce the risk of developing breast cancer. For women who carry a BRCA1 or BRCA2 gene mutation, a preventive mastectomy can reduce the risk of developing breast cancer by 90 percent.
  
   

Also called "breast-conserving surgery," a lumpectomy can confirm or rule out a diagnosis of cancer. It’s also a way to remove just the cancerous tissue or lump from your breast and is an alternative to a mastectomy. A small amount of tissue around the lump or cancer is also removed to help prevent it from spreading.

If your tumor or lump can’t be felt through your skin, your surgeon will perform a localization to guide them to the tumor during surgery:

• A needle localization is performed to help guide your surgeon to the exact location of a tumor or lump in your breast. This thin needle is placed before surgery using local anesthesia on the same day as a breast biopsy or lumpectomy. Once the tumor or lump is located, the needle is removed and leaves behind a wire. This wire is kept in place with gauze and tape until the surgery to remove the tumor or lump is performed.
• A wireless localization allows your surgeon to locate the tumor during surgery without a wire. Instead, radar is used to locate the breast tissue that will be removed. This technology allows your surgeon to locate the tumor within 1mm of its location. 
  
  SAVISCOUT® is an advanced treatment for breast biopsy, tumors and lymph nodes. This technology allows your surgeon to pinpoint the exact location of your tumor and guides them when removing the affected tissue during minimally invasive surgery. This means less pain, less downtime and a faster recovery.

The lymph nodes in the arm are connected to those in the breast. Lymph nodes are the first place cancerous cells are likely to spread, so your surgeon may remove lymph nodes as part of breast cancer treatment.

Lymphedema (arm swelling) can develop when lymph nodes in your arms are removed, and radiation treatment can sometimes increase your chances lymphedema. We’ll monitor for any fluid buildup before and after surgery as well as any swelling, minimizing your risk of developing lymphedema.  

These lymph node surgeries help to prevent lymphedema:

• Sentinel lymph node biopsy is a procedure where a dye is injected into the breast to determine which lymph nodes spread cancer. Due is injected into your breast and the lymph nodes that pick up the dye are removed. By removing these sentinel lymph nodes, your doctor can determine if cancer has spread to the lymph nodes and remove them.
• Axillary lymph node dissection (ALND) is another procedure that removes lymph nodes in the armpit to prevent cancer from spreading. If a lymph node biopsy indicates that cancer has spread to three or more lymph nodes, your surgeon will perform an ALND. This surgery is often performed along at the same time as a mastectomy or lumpectomy.
• Axillary reverse mapping (ARM) is a technique that, by injecting dye into the arm, helps surgeons identify and protect or repair the lymph nodes that drain the arm to prevent lymphedema or swelling of the arm. 

SOZO is a device that detects lymphedema earlier than any other technique. SOZO can detect changes before any symptoms begin to show, which has greatly lowered the rate of lymphedema.

Breast reconstruction rebuilds the shape and look of your breast or breasts after a mastectomy. It can be done in tandem with your mastectomy or any time after surgery, either using implants or your own tissue. There are several ways to rebuild the breast including:

• Temporary expanders – This procedure involves placing a tissue expander beneath the skin to preserve the shape of the breast in preparation for a future implant. The tissue expander will stay in place for several months, then be replaced with the breast implant.
• Breast implants – Implants made with either a saline solution or silicone gel are placed behind breast tissue or breast muscle.
• Autologous tissue reconstruction – Also called a tissue flap procedure, this reconstruction restores the shape of the breast using tissue from other parts of the body.
• Nipple-areola reconstruction – This procedure can be done after a mastectomy to rebuild your nipple and areola. Skin from your chest is used to make the nipple, and a skin graft around the nipple is made to create the areola. In addition, some people chose to have tattooing after this procedure to create a realistic, 3-D areola around the nipple.

Most breast cancer patients are candidates for breast reconstruction. However, your doctor will be able to tell you which — if any — surgery is right for you.