When to Have Surgery After Breast Cancer Diagnosis

Every woman facing a breast cancer diagnosis deserves personalized, compassionate breast cancer care with the latest, most effective treatments available. But for each woman, treatment will depend on a number of factors, including stage and biological behavior of the cancer.

“Oftentimes, surgery is recommended as part of a customized treatment to remove the cancer before it can grow and spread,” says breast surgeon Roshani Patel, M.D., medical director for Breast Surgery at Jersey Shore University Medical Center. 

Types of Surgery for Breast Cancer

There are two main types of surgery to remove breast cancer:

• Breast-conserving surgery: Also called a lumpectomy or partial mastectomy, this surgery removes the cancer and some surrounding normal tissue. Only a portion of the breast that contains the cancer is removed. “How much breast has to be removed depends on several factors, including where the tumor is and the size of it,” Dr. Patel says.
• Mastectomy: During a mastectomy, the entire breast is removed, including all of the breast tissue. If both breasts are removed, this is called a double mastectomy.

“In determining the best type of surgery right for a woman facing breast cancer, the care team will review the imaging done as well as physical examination findings,” Dr. Patel says. “The type of surgery recommended is partially dependent on the volume of the cancer relative to the breast size.” 

Timing of Breast Surgery

Sometimes, chemotherapy is recommended before surgery. This is known as neoadjuvant therapy or preoperative chemotherapy. 

“For certain types of breast cancer, we may recommend chemotherapy first. Factors that we consider are size, type of breast cancer and whether the cancer has spread to the lymph nodes,” Dr. Patel says. “By giving chemotherapy upfront,  when indicated, we have potential to downstage a cancer and limit the amount of surgery needed. We can also gain prognostic information about the cancer based on how the cancer responds to chemotherapy.”

But not all women with breast cancer need chemotherapy. “There are some cancers that we will treat with surgery and estrogen blockers, a targeted treatment,” Dr. Patel says.

What to Ask Your Doctor About Surgery

Dr. Patel recommends women facing breast cancer ask their doctor these questions:

• Can you review the imaging and pathology reports with me?
• What type of cancer do I have, and what stage is it in?
• What side effects can I expect from treatment?
• Are there clinical trials I can participate in?
• What support services are available (i.e., counseling, peer support groups, nutrition services, physical therapy)?
• What surgical options are available for me?
• What reconstructive options are available if a mastectomy is needed?
• How are incisions planned? 
• What is entailed in removing the cancer and what can go wrong? 

“I recommend all women ask for reliable resources for more information about the cancer,” Dr. Patel says. “If you do not understand something, you should ask. It is also OK to ask for a second opinion—I encourage this.”

Next Steps & Resources:

• Meet our source: Roshani Patel, M.D.
• To make an appointment with a doctor near you, call 800-822-8905 or visit our website.
• Learn more about breast surgery at Hackensack Meridian Health

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.