Breast Cancer Surgery
A breast cancer diagnosis can feel overwhelming. Our experienced breast surgeons provide advanced, personalized breast cancer treatment plans designed to prioritize your health and support your quality of life.
Breast cancer surgery is often a key part of treatment for breast cancer. While surgery removes cancer from the breast, additional breast cancer treatments may be recommended to reduce the risk of cancer returning and treat cancer cells that have spread beyond the breast.
Types of Breast Cancer Surgery
The type of breast cancer surgery depends on your diagnosis, stage of breast cancer, tumor size, genetics, reconstruction choices and your personal preferences. Whether you choose a lumpectomy or mastectomy with or without breast reconstruction, we'll guide you through every step of treatment with expertise and compassion.
Lumpectomy (Breast-Conserving Surgery)
Also called a partial mastectomy or breast-conserving surgery, a lumpectomy removes the tumor and a small margin of surrounding tissue while keeping the breast intact. This option is often recommended for early-stage breast cancer or DCIS (non-invasive breast cancer) and is typically followed by radiation therapy to significantly reduce the risk of the cancer returning.
Mastectomy
A mastectomy is a surgical procedure that removes the entire breast to treat or prevent breast cancer. Your doctor may recommend a mastectomy for several reasons, including:
- Cancer in multiple areas of the breast
- Genetic risk factors, such as BRCA mutations. For some patients with certain genetic markers, a mastectomy can reduce the risk of developing breast cancer in the future.
- Larger tumors
Types of Mastectomies
Several types of mastectomy surgeries are available. Your healthcare team will help guide you through the options to determine the approach that's right for you.
- Bilateral (Double) Mastectomy: A bilateral mastectomy removes both breasts. This procedure may be recommended for someone with breast cancer, those with a high genetic risk (such as BRCA mutations) or individuals who choose it to reduce their risk of future breast cancer.
- Nipple-Sparing Mastectomy: A nipple-sparing mastectomy removes the breast tissue while preserving the skin, nipple and areola when medically appropriate. This procedure can improve cosmetic outcomes and is performed when breast reconstruction is planned.
- Skin-Sparing Mastectomy: A skin-sparing mastectomy removes the breast tissue, nipple and areola but preserves most of the surrounding breast skin. Keeping the skin intact helps surgeons create a more natural appearance during breast reconstruction.
- Total (Simple) Mastectomy: A total mastectomy removes all breast tissue, including the nipple and areola. This procedure doesn’t require breast reconstruction but instead leaves the chest flat.
Lymph Node Removal for Breast Cancer
To determine whether cancer has spread beyond the breast, nearby lymph nodes in the underarm area (axilla) may be removed and examined during surgery. This helps guide treatment decisions and determine your breast cancer stage.
- Sentinel Lymph Node Biopsy: A sentinel lymph node biopsy is a minimally invasive procedure commonly used in early-stage breast cancer. The sentinel lymph nodes are the first lymph nodes breast cancer cells spread to from the primary tumor. During this procedure, the surgeon identifies and removes a small number of sentinel lymph nodes for testing. If cancer isn’t found in these nodes, it often means the cancer has not spread to other lymph nodes, and additional lymph node removal in breast cancer surgery may not be necessary.
- Axillary Lymph Node Dissection: In some cases, a more extensive procedure called an axillary lymph node dissection is recommended. This surgery removes multiple lymph nodes from the underarm area to check for the presence of cancer cells. Axillary lymph node dissection may be used when cancer is found in the sentinel lymph nodes or when imaging or other tests suggest the cancer has already spread to nearby lymph nodes.
What are the risks of removing lymph nodes?
Removing lymph nodes can sometimes disrupt the flow of lymph fluid, leading to a condition called lymphedema. While modern techniques like sentinel lymph node biopsies have made this less common, your team will provide education on how to monitor and manage this risk after surgery.
Breast Reconstruction Surgery
Breast reconstruction surgery restores the shape and appearance of the breast after a mastectomy or lumpectomy for breast cancer treatment. For many patients, reconstruction helps improve physical comfort, body image and emotional recovery during the healing process.
Breast reconstruction can be performed at the same time as your mastectomy (immediate reconstruction) or later during recovery (delayed reconstruction). Your care team will work with you to determine the best timing and surgical approach based on your cancer treatment plan, health history and personal goals.
Our breast surgeons collaborate closely with plastic and reconstructive surgeons to create a personalized treatment plan that supports both your medical care and aesthetic outcomes.
Types of Breast Reconstruction Surgery
Autologous reconstruction, also called flap reconstruction surgery, uses tissue from another part of your body — such as the abdomen, back or thighs — to recreate the breast. Your plastic surgeon will determine if you are a good candidate for this type of reconstruction.
Implant reconstruction uses saline or silicone implants to rebuild the breast shape after a mastectomy. This is one of the most common forms of breast reconstruction after mastectomy and may involve placing the implant during the mastectomy procedure or in a later surgery.
Oncoplastic breast surgery combines cancer removal (lumpectomy) with plastic surgery techniques to reshape the breast during the same procedure. This approach can help maintain breast appearance while ensuring effective breast cancer treatment.
What to Expect from Breast Cancer Surgery
Understanding what happens before, during and after breast cancer surgery can help you feel more prepared and confident as you move forward with care.
Before Breast Cancer Surgery
Before your breast cancer surgery, your care team will review your diagnosis and develop a personalized surgical plan. This preparation may include:
- Imaging and biopsy review
- A pre-surgical consultation with your breast surgeon
- Discussion of breast reconstruction options (if applicable)
- Genetic counseling if hereditary cancer risk is suspected
- Need for medical therapy prior to surgical treatment
During Breast Cancer Surgery
Most breast cancer surgery procedures are performed using general anesthesia and may involve an outpatient procedure or a short hospital stay. During surgery, your surgeon may perform:
- Removal of the tumor (lumpectomy) or breast tissue (mastectomy)
- Sentinel lymph node biopsy or lymph node evaluation, if needed
After Breast Cancer Surgery
Recovery after breast cancer surgery focuses on healing, comfort and follow-up care. Most patients can return to normal daily activities within a few weeks, although recovery time varies depending on the type of breast surgery performed and whether additional treatments are needed. Your medical team will provide detailed instructions and support, which may include:
- Pain management: Guidance on medications to keep you comfortable.
- Pathology results: Final pathology results, which confirm if clear margins were achieved and help determine the next steps of your treatment, are usually available within 7-10 business days.
- Surgical drains: Mastectomy patients require temporary drains to prevent fluid buildup. These are typically removed two weeks after surgery.
- Follow-up: Appointments to monitor healing and discuss further therapies, like chemotherapy or radiation therapy.
Lumpectomy Recovery
Recovery after a lumpectomy tends to be quicker than after a mastectomy. Most patients return home the same day and resume normal activities within two to four weeks.
- Mild to moderate soreness, swelling, bruising and temporary numbness around the incision are common, especially if a sentinel lymph node biopsy was performed.
- Pain is usually manageable with medication.
- Light activity, such as walking, is encouraged while avoiding heavy lifting for the first two weeks.
- Most people return to work within one to two weeks, depending on job demands.
- It’s important to follow incision care instructions and contact your care team if you experience fever, increasing redness, drainage or worsening pain.
Breast Cancer Surgery FAQs
The most common breast cancer surgeries are lumpectomy (breast-conserving surgery) and mastectomy. The best option depends on tumor size, stage, genetics and personal preference.
For many patients with early-stage breast cancer, a lumpectomy followed by radiation therapy can be as effective as a mastectomy in preventing recurrence.
Many patients undergo a sentinel lymph node biopsy to determine whether cancer has spread. Some may require an axillary lymph node dissection based on pathology results.
Yes. Immediate breast reconstruction can be performed during the same surgery as a mastectomy. Delayed reconstruction is also an option, depending on your treatment plan, overall health and whether radiation therapy is needed.
Yes. Oncoplastic surgery combines a lumpectomy with plastic surgery techniques to reshape the breast during the same procedure. This approach helps maintain breast symmetry and appearance while effectively treating cancer.
Both implant reconstruction and flap reconstruction surgery are effective. Implants typically involve shorter surgery and recovery, while flap reconstruction uses your own tissue and may feel more natural. Your surgeon will discuss which option best suits your needs.
Modern techniques — like flap reconstruction surgery and nipple-sparing mastectomy — allow surgeons to create natural-looking results. Your surgeon will help choose a reconstruction method that aligns with your expectations and medical needs.
Removing and testing lymph nodes helps determine whether breast cancer has spread, which is critical for staging the disease and planning treatment.
Because it removes fewer lymph nodes, a sentinel lymph node biopsy carries a lower risk of side effects such as lymphedema while still providing important information about cancer spread.
Lymphedema is swelling in the arm or chest that can occur if lymph nodes are removed or damaged during surgery. Sentinel node techniques are used whenever possible to minimize this risk.
Recovery varies by procedure. Most patients resume normal activities within 2–4 weeks after a lumpectomy and 4–8 weeks after a mastectomy, depending on whether breast reconstruction was performed and individual health factors.
Drains are common after a mastectomy or lymph node dissection but rarely needed for a simple lumpectomy. They’re removed during your follow-up visit.
After breast surgery, it’s best to sleep on your back with your upper body slightly elevated using pillows. This helps reduce swelling, minimizes pressure on your chest and is a more comfortable position while you heal. Avoid sleeping on your stomach or side until your surgeon gives the OK.
Most people can drive once they’re no longer taking prescription pain medication and have regained a comfortable range of motion in their arm. For example, you should be able to sharply turn the wheel in an emergency and see into your blind spot. This is usually 1–2 weeks after a lumpectomy but is longer after a mastectomy with or without reconstruction.
When to See a Breast Surgeon
If you’ve recently noticed changes in your breast or received abnormal breast screening results, you may be referred to a breast surgeon for further evaluation. Breast surgeons specialize in diagnosing and treating conditions of the breast, including breast cancer, and can help guide you through the next steps in care.
You may need to see a breast surgeon if you have:
- A high genetic risk for breast cancer, such as BRCA mutations
- A new breast cancer diagnosis
- A suspicious breast lump or breast changes
- Abnormal mammogram results
Meeting with a breast surgeon early in the process can help ensure a timely diagnosis, expand your breast cancer treatment options and support better long-term outcomes. Your surgeon will work closely with other specialists to create a personalized care plan based on your diagnosis and overall health.
Questions to Ask Your Breast Surgeon
Asking your breast surgeon the right questions can help you better understand your diagnosis, treatment options and recovery expectations. It can also help you feel more confident and prepared as you move forward with your care. Consider asking your surgeon the following questions:
- What type of breast cancer surgery do you recommend for me and why?
- Am I a candidate for a lumpectomy or mastectomy?
- Will I need a sentinel lymph node biopsy or lymph node removal?
- What are my options for breast reconstruction surgery?
- Will I need additional treatments such as chemotherapy, radiation therapy or hormone therapy after surgery?
- What risks or complications are associated with this procedure?
- How long will recovery take after breast cancer surgery?
- When can I return to normal activities, work or exercise?
- Will surgery affect the appearance or sensation of my breast?
- What follow-up care or monitoring will I need after surgery?
It may also be helpful to bring a family member or friend to your appointment, take notes during your visit or write down questions ahead of time. Open communication with your breast cancer care team ensures you feel supported and informed throughout your treatment journey.
Schedule a Breast Cancer Surgery Consultation
A breast cancer diagnosis is a life-changing moment, and you don’t have to face it alone. At UnityPoint Health, our breast surgeons combine surgical expertise with compassionate support to guide you through every stage of your journey.