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LUMPECTOMY AND MASTECTOMY
Surgery is part of treatment for most breast cancers. A lumpectomy, also called breast-conserving surgery or partial mastectomy, removes the tumor with a rim of healthy tissue and keeps most of the breast. A mastectomy removes the whole breast. For most early-stage breast cancers, lumpectomy followed by radiation is as effective as mastectomy for long-term survival, so the choice often depends on the size and location of the tumor, your genetics and your preferences. At North Florida Surgeons in Jacksonville, FL, we also check the nearby lymph nodes during surgery when needed.
WHY CHOOSE US?
Breast surgery at North Florida Surgeons is led by Dr. Courtland Polley, who completed extra training in breast surgical oncology. We work closely with your oncologist, radiation oncologist and plastic surgeon.
Most lumpectomies are outpatient procedures, so you go home the same day.
Before surgery, we review your imaging, biopsy results and treatment plan with you and answer every question.
LUMPECTOMY OR MASTECTOMY?
LUMPECTOMY
The surgeon removes the tumor with a margin of normal tissue and keeps the shape of the breast as much as possible. Most patients then have radiation therapy to lower the chance of the cancer coming back.
WHEN A MASTECTOMY MAY BE BETTER
A mastectomy may be recommended for a large tumor compared with the breast size, cancer in more than one area of the breast, when radiation is not possible, for some inherited gene changes such as BRCA, or simply because you prefer it.
TYPES OF MASTECTOMY
A total (simple) mastectomy removes the breast tissue and nipple. Skin-sparing and nipple-sparing mastectomies keep more skin to help breast reconstruction surgery. A bilateral mastectomy removes both breasts, sometimes to lower the risk of a new cancer. Patients who choose not to have reconstruction can have an aesthetic flat closure, which leaves a smooth, flat chest wall.
BREAST RECONSTRUCTION
Reconstruction can be done at the same time as a mastectomy or later, working with a plastic surgeon. Learn more about all our breast surgery services, including care for benign breast lumps.
RISKS TO KNOW
Possible problems include infection, bleeding, a fluid collection (seroma), numbness, and arm swelling (lymphedema) after lymph node surgery. Some patients need a second operation if cancer cells are found at the edge of the removed tissue.
HOW THE SURGERY IS DONE
LOCATING THE TUMOR
For tumors that cannot be felt, a small wire, seed or marker is placed with imaging before surgery to guide the surgeon to the exact spot.
SENTINEL LYMPH NODE BIOPSY
A tracer is injected to find the first lymph nodes that drain the breast. These sentinel nodes are removed through a small incision under the arm and checked for cancer, which avoids removing many nodes in most patients.
CHECKING THE MARGINS
A pathologist examines the edges of the removed tissue. If cancer cells reach the edge, a second, smaller surgery may be needed to make sure all of the cancer is removed.
WHAT TO EXPECT
BEFORE SURGERY
You will have breast imaging, such as a mammogram, ultrasound or MRI, and a needle biopsy. Genetic testing may be recommended. Tell us about all your medicines, especially blood thinners. See our checklist for general surgery.
THE DAY OF SURGERY
Surgery is done under general anesthesia. A lumpectomy usually takes about an hour and you go home the same day. After a mastectomy, many patients stay one night and go home with one or more small drains near the surgical site.
CARE AT HOME
Wear a supportive bra, keep incisions clean and dry, and follow the instructions for drain care. Gentle arm exercises help you regain movement, especially after lymph node surgery.
RECOVERY
Most people return to normal activities one to two weeks after a lumpectomy and three to four weeks after a mastectomy, longer with reconstruction. We review your pathology results with you and coordinate the next steps of treatment.
OUR BREAST SURGEON
Lumpectomy and mastectomy at North Florida Surgeons are performed by Dr. Courtland Polley. Learn more about breast surgery and surgical oncology.
LUMPECTOMY AND MASTECTOMY FAQS
Is a lumpectomy as effective as a mastectomy?
For most early-stage breast cancers, a lumpectomy followed by radiation gives the same long-term survival as a mastectomy. The best choice depends on the tumor, your genetics and your preferences.
Will I need radiation after a lumpectomy?
Most patients do. Radiation lowers the chance of the cancer coming back in the breast. Some older patients with small, low-risk tumors may be able to skip it, which your oncologists will discuss with you.
How long is recovery after breast cancer surgery?
Most people recover from a lumpectomy in one to two weeks and from a mastectomy in three to four weeks. Recovery takes longer when reconstruction is done at the same time.
Will my lymph nodes be removed?
Many patients have a sentinel lymph node biopsy, which removes only the first few nodes. More nodes are removed only when cancer has spread to them.
Can I have breast reconstruction?
Yes. Reconstruction can be done during the mastectomy or later, and we coordinate with a plastic surgeon. Some patients choose not to have reconstruction, and that is a valid choice too.
Does insurance cover breast reconstruction?
Under the federal Women’s Health and Cancer Rights Act, most group health plans that cover mastectomy must also cover reconstruction. Coverage details depend on your plan. See the insurance plans we accept or call our office.
Should I have a bilateral mastectomy?
Removing both breasts reduces the risk of a new cancer in the other breast mainly for women with an inherited gene change, such as BRCA, or a strong family history. For most other women it does not improve survival. Your surgical team and care team will help you weigh the options.
What is an aesthetic flat closure?
It is a way of closing the chest after mastectomy without reconstruction, leaving a smooth, flat chest wall instead of extra skin. It is a good option for women who do not want breast reconstruction surgery.
How do I schedule a breast surgery consultation in Jacksonville?
Call (904) 398-0033 or use the contact form. Our office is at 836 Prudential Dr., Suite 1001, Jacksonville, FL 32207. Related: breast surgery, surgical oncology.
