Treating Breast Cancer: Understanding Surgical Approaches to Treatment

Photo of Dr. Meeghan Lautner

Meeghan Lautner, MD, MSc

Published October 22, 2018

October is Breast Cancer Awareness Month, and while research continues to find a cure and get rid of the disease for good, the surgical approach to treatment has improved, allowing for better outcomes for patients. Most commonly, breast cancer is treated through two types of surgeries – mastectomy or lumpectomy.

Two Types of Procedures

“I can’t stress enough how important it is for women to talk to their doctor about when and how often to get a mammogram – and then go get the mammogram.”
Meeghan Lautner, MD, Chief of Breast Surgery, UBMD Surgery
Assistant Professor, UB

Breast cancer patients will typically be able to choose from either a mastectomy or lumpectomy, and both options are designed to remove a breast tumor or suspicious mass. But what are the differences?

“A lumpectomy removes the tumor or area of concern and preserves the breast,” explains Dr. Meeghan Lautner, a surgeon with UBMD Surgery who specializes in breast cancer and breast disease procedures. “A total mastectomy removes the whole breast mound and may be combined with reconstruction.”

For patients, the decision on which procedure to choose typically comes down to a personal preference.

“In most cases, both surgeries are good cancer treatment,” Lautner said. “Women often consider the cosmetic and sexual outcome of preserving their own breast versus having reconstruction, as well as the importance of their peace of mind when deciding on which surgery is best for them.”

What to Expect If You Find a Lump or Abnormality

Lautner works both with patients who have a cancer diagnosis and those with benign breast disease, taking a surgical approach to treating both conditions. For most individuals, they first meet with a surgeon following an abnormal mammogram and biopsy to confirm cancer. Other patients may be referred to Lautner after finding a mass in a self-exam or during their regular OB/GYN appointment, or after the appearance of other irregularities such as breast pain, skin puckering or nipple discharge. Lautner also sees patients who are visiting proactively to better understand their personal risks due to a strong family history of breast cancer.

During their appointment with the doctor, patients will discuss the two different surgical approaches and learn more about each procedure. Ultimately, the decision for most patients is a personal choice, though Lautner noted that in the U.S., lumpectomies are slightly more commonly performed than mastectomies.

Once the type of procedure is decided, a date will be scheduled to perform surgery. Patients with UBMD Surgery can also sign up at their appointment for a breast surgery class that is held weekly in advance of their procedure. This session helps to explain the surgery to individuals and helps them learn what to expect on the day of their procedure.

On the Day of Surgery

As with most surgeries, basic blood tests, a chest X-ray and an EKG are typically performed in preparation for either a mastectomy or lumpectomy. For some surgeries, a patient may also need to go to mammography on the day of the procedure to have a wire placed in the abnormal area that is being removed.

How long the procedure takes depends on the type of procedure, the extent of the mass or tissue being removed, and a variety of other factors.

“The length of surgery varies depending on which operation the patient is having,” Lautner said. “Lumpectomies can be as quick as one hour, and mastectomy with reconstruction can last up to eight hours at times.”

Post-Surgical Recovery and Support

Following surgery, patients will need time to recover and recuperate. At UBMD Surgery, patients can use the practice’s nurse navigator program that offers multiple support resources in the community. This can benefit patients who may need help with activities or support from peers during their recovery.

The length of time needed after surgery varies by patient and by procedure.

“The longer the surgery, the longer the recovery,” Lautner said, adding that patients who have a mastectomy usually are out of work for four to six weeks after surgery to allow enough time for them to completely recover.

Early Detection and Prevention

While it’s impossible to guarantee full avoidance of cancer, there are many steps that women can take to improve their chances of prevention.

“We know that obesity, sedentary lifestyle, daily tobacco and alcohol abuse all contribute to a higher risk of breast cancer,” said Lautner. “Women should maintain a healthy, well-balanced diet, exercise regularly, avoid tobacco and keep alcohol consumption to no more than one drink per day.”

In addition, women should also be proactive about screening themselves and looking for warning signs. Lautner recommends that every woman watch for any change in the size, shape or feel of their breasts, or for issues like nipple discharge or skin puckering. Any of these symptoms should be reported to your doctor right away. However, breast cancer often manifests without any visible symptoms.

“I can’t stress enough how important it is for women to talk to their doctor about when and how often to get a mammogram – and then go get the mammogram,” Lautner said. Mammograms offer the greatest ability to see signs of suspicious growths or early formation of tumorous tissues that may not be felt or seen otherwise.

“Breast cancer is much easier to treat and our survival rates are much better if we can find it early,” Lautner added.

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