From diagnosis to postoperative care, NYU Winthrop’s Breast Surgeons coordinate treatment plans with your entire healthcare team and keep in touch with each physician every step of the way. This interconnected multidisciplinary team makes all the difference in your outlook and recovery.
Surgery is used to remove a tumor from the breast and also to check lymph nodes in the underarm area to see if the cancer has spread. Following diagnosis, your breast surgeon will review your options in detail and help decide which procedure is best for you.
Breast conservation or lumpectomy is the removal of a tumor and a small area of tissue surrounding it. The amount removed depends on the size of the tumor and your surgeon will determine a plan to achieve the best cosmetic result. After surgery, a pathologist studies the tissue around the tumor called the margin. Close or positive margins indicate cancer cells and the need for another surgery.
If you have clear or negative margins, the tissue surrounding the tumor is free of cancer cells. When you have a lumpectomy, some of your breast remains and a majority of patients will need radiation therapy after healing to reduce the risk of a recurrence.
Your surgeon may suggest a lumpectomy if:
- The size of your tumor is small in relation to your breast size.
- You have cancer in only one area of your breast.
- You’ve agreed to post-surgery radiation treatment.
If you choose to have a mastectomy, which is the surgical removal of the entire breast, you may have two options: a nipple-sparing mastectomy or a skin-sparing mastectomy.
A nipple-sparing mastectomy is a procedure that preserves the entire skin overlying the breast (including the skin of the nipple and areola) while removing the breast and most of the ductal tissue beneath the nipple-areola complex.
A skin-sparing mastectomy is when the entire breast is removed with the nipple and areola, while preserving most of the skin.
These surgeries can be performed via hidden scars around the nipple or at the fold of the breast and are combined with immediate reconstruction to deliver excellent cosmetic results. The Women’s Health and Cancer Rights Act is a federal law that requires most group insurance plans that cover mastectomies to also cover breast reconstruction. Without reconstruction, the mastectomy area will be flat and you may choose to wear a prosthesis or breast form. In some cases, radiation therapy may be suggested following a mastectomy.
Your surgeon may suggest a mastectomy if:
- The cancer is large.
- There is cancer in more than one area of the breast.
- You cannot or choose not to have radiation therapy after a lumpectomy.
- You feel that a mastectomy is the best option for you.
Sentinel Lymph Node Biopsy
You have hundreds of lymph nodes throughout your body (called the lymphatic system) that clean your blood. Cancer uses this system as a way to spread to other parts of the body. The sentinel lymph node in the underarm area is the first lymph node cancer can spread to from the breast.
A sentinel lymph node biopsy is a procedure where your surgeon checks your lymph nodes for cancer. Before surgery, a dye is injected into your breast near the tumor to help locate the sentinel lymph node. Once the lymph node is removed, a pathologist examines it for cancer cells. If cancer is found then your surgeon will discuss whether you need additional surgery.