Oncological breast surgery

This is surgery to remove breast cancer. It may involve

  • breast conserving surgery, where the cancer is removed with a 'safety rim' of normal breast tissue around it, and radiotherapy is usually given to the rest of the breast, or
  • mastectomy, which is the removal of the entire breast.

Some of the lymph nodes in your armpit may also need to be removed, to find out if the cancer has spread to the lymph nodes. We might need to carry out a sentinel node biopsy, where a few lymph nodes (usually between one and four) are removed. A pre-operative injection into the breast identifies which to remove. Part of the node or nodes are then analysed and if they contain cancer then the other nodes may need to be removed. This is called an axillary clearance.

In this unit we can assess the node during the operation, which means the axillary clearance can be performed during the same operation if necessary. However, if the sentinel node biopsy is clear, no further nodes need to be taken. The final results of the sentinel node biopsy will be available at your follow up outpatient appointment.

There are useful links to further information below

If you have a mastectomy, you may also want to have breast reconstruction (see breast reconstruction section).

There are additional treatments that may also be used to treat the breast cancer. These include radiotherapy, endocrine therapy and chemotherapy.

Radiotherapy

Radiotherapy is usually offered if you have had breast conserving surgery of an invasive breast cancer, to reduce the chances of the cancer coming back in the breast. It is also offered to some women with ductal carcinoma n situ (DCIS), where the cells have not developed the ability to invade, and sometimes after mastectomy under certain circumstances.

Please see our radiotherapy pages and the links below for more information

Endocrine therapy

Endocrine therapy involves taking a tablet for five to ten years after your operation, to reduce the chances of the cancer returning somewhere else. It is also sometimes given for a period before the operation to try to shrink the cancer. These tablets work by blocking oestrogen receptors. This type of therapy may be suitable for up to 75% of patients. Please see the links below for more information

Chemotherapy

We advise chemotherapy in selected cases after a careful discussion of the pros and cons with an oncologist. Chemotherapy aims to reduce the chances of the cancer returning both locally (in the breast or chest wall) and elsewhere in the body. Sometimes it may help to have chemotherapy before the cancer surgery, to try to reduce the size of the cancer and also to assess response to the chemotherapy.

Your case will be discussed in our team meeting with the oncologists (chemotherapy doctors) to see if you may benefit from chemotherapy. If so, we will arrange for you to see a member of the oncology team to discuss this further.

Please see our cancer pages and the links below for more information