Types of breast cancer surgeries:

  • Wide Excision/ Lumpectomy: Tumor along with normal surrounding tissue is excised. Sufficient for benign tumours of the breast. Benign phylloid tumours require a much wider resection margin of 2-3 cm.
  • Simple Mastectomy: A Breast tumour along with whole breast tissue and nipple areola are excised. Axilla is not addressed in this surgery. Usually done for ductal carcinoma in a situ and phylloid tumour.
  • Modified Radical Mastectomy: Breast with a tumour at appropriate margins and nipple-areola complex is excised along axillary lymph node dissection. 10-15 axillary lymph nodes are considered adequate as per the guidelines. All stations of lymph nodes (I-III) suspected of having lymph nodes should be excised.
  • Breast Conservation Surgery: As the understanding of tumour biology is increasing and as the technologies are increasing, oncology surgery has improved to provide more and more functional results. Patient sections play's a very important role. A suitable tumour with surrounding breast tumour with negative margins is excised. Axilla is addressed as standard.

Recent Advances:

  • Sentinel Lymph Node Biopsy: Sentinel lymph node is the first draining level lymph node of a breast tumour. Usually, a radioactive dye is injected around a tumour before surgery and blue dye is injected in breast tissue at the time of surgery. Gamma camera probe is used to identify the radioactivity and targeted node identified. It is excised and sent for the frozen section during surgery. If tumour cells are absent then there is no need to address higher axillary lymph nodes. If tumours cells are identified than complete axillary surgery is done.
  • Skin Sparing Mastectomy and immediate breast reconstruction: Preserve normal body image.