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- Genetics of Breast Cancer
- High-Risk Breast Clinic
Breast Surgical Oncology in Portland and Vancouver
Next Steps After a Breast Cancer Diagnosis
Whether you've recently been diagnosed, are seeking a second opinion, or are exploring clinical trial options, the breast cancer specialists at Compass Oncology are here to guide you. Our team has developed a helpful resource to walk you through what to expect, from understanding your diagnosis to preparing for your first appointment. You'll also find practical tips and information to help you take confident steps as you begin your breast cancer treatment journey.
Does Everyone With Breast Cancer Have Surgery?
The majority of breast cancer patients will have some type of surgery as part of their treatment plan. Your surgeon will:
- Remove the cancerous tumor. In some cases, this means breast-conserving surgery, while it may require removing the entire breast for other patients.
- Biopsy nearby lymph nodes to determine if cancer has spread outside of the breast.
- Prepare the breast for reconstruction after surgery or close the surgery if the patient wishes to go flat.
Additional treatment may be required before or after surgery to make sure no breast cancer cells remain. Your Compass Oncology breast cancer surgeon will discuss your options for surgery based on multiple factors, including the tumor’s size, its location, and your overall health status, before recommending the best treatment plan for you.
Meet our Breast Cancer Surgeons in Portland-Vancouver
Compass Oncology is dedicated to providing exceptional, comprehensive cancer care to patients in the Portland and Vancouver areas. Our board-certified breast surgical oncologists use the latest surgical options, including nipple-sparing mastectomy and oncoplastic techniques, to achieve optimal cosmetic outcomes.
They work closely with our multidisciplinary team, including nurse navigators, medical oncologists, radiation oncologists, and palliative care specialists, to provide you with personalized care.
Types of Breast Cancer Surgery
Lumpectomy: Breast-Sparing Surgery
Lumpectomy is a breast-conserving surgical procedure that removes only the breast tumor and some of the normal tissue surrounding it, called a margin. The amount of tissue removed varies depending on the tumor size. Your surgeon will try to keep the nipple intact whenever possible. The surgeon may also remove lymph nodes under the arm during the procedure.
Lumpectomy is an excellent and safe option for the majority of breast cancer patients. Cancer is not more likely to recur among women who had breast-conserving surgery compared to women who had a mastectomy.
What Is an Oncoplastic Lumpectomy?
Oncoplastic lumpectomy is a surgical procedure that combines breast reconstruction with lumpectomy. During this procedure, the surgeon uses plastic surgery techniques to reshape the breast at the time of surgery, eliminating the need for reconstruction operations after surgery to remove the breast cancer. This approach also helps prevent "dents" in the breast and allows the surgeon to place the scar in a less visible location, a technique sometimes referred to as "Hidden Scar."
Localization Procedures for a Lumpectomy
Localization procedures are performed before a lumpectomy so the surgeon knows exactly where the tumor is located. The surgeon will follow the marker to the correct location during surgery.
- Wire-guided localization. A needle is used to place a wire into the breast on the same day as surgery. Your surgeon uses this wire as a guide to locate the abnormal breast tissue or cancer. The wire is removed along with the area of abnormal breast tissue.
- Wire-free localization. Advances in technology enable surgeons to locate lesions prior to surgery more accurately than ever before. One such technology is called the SAVI SCOUT system. Instead of using a wire, a small, 1 cm device called a reflector is placed in the breast tissue up to seven days before surgery. On the day of the operation, your surgeon uses a hand-held device that emits a tiny radar signal to locate the reflector inside your breast, allowing them to identify the exact area of breast tissue that needs to be removed.
Mastectomy: Breast Removal Surgery
Mastectomy is the surgical removal of the entire breast (or as much of the breast tissue as possible). There are several types of mastectomy. There are several types. Whenever possible, the Compass Oncology oncoplastic breast surgeons work to provide you with the best outcome for preserving the nipple and preparing for reconstruction.
Total (Simple) Mastectomy
In a total (simple) mastectomy, the surgeon removes the whole breast, which includes the nipple, areola, fascia (covering) of the pectoralis major muscle (main chest muscle), and skin. You may also have a sentinel lymph node biopsy done at this time, which removes the first lymph node that the breast drains to.
Modified Radical Mastectomy
In a modified radical mastectomy, the surgeon removes the whole breast and most or all of the lymph nodes under the arm, called an axillary lymph node dissection. Often, the lining over the chest muscles is removed.
Nipple-Sparing and Skin-Sparing Mastectomy
Advanced surgical options are also now available that allow us to preserve all or part of the original “breast envelope,” the skin overlying the breast mound. These are called nipple-sparing and skin-sparing mastectomies and allow for the reconstructive process to begin at the time of the mastectomy with excellent cosmetic results. Our oncoplastic breast surgeons will discuss your reconstruction preferences before surgery. If you want to “go flat” after surgery, they will perform a different closure to the surgery than if you plan to have reconstruction.
Risk-Reduction Mastectomy
Risk-reducing mastectomy (RRM), also known as prophylactic mastectomy (PM), is a procedure that removes both breasts as a preventative measure in women who are at high risk of developing breast cancer. This includes women with a strong family history of breast cancer and the BRCA 1 or BRCA 2 gene mutation.
Lymph Node Biopsy: Assessing Cancer Spread
A very important part of breast cancer surgery is assessing the lymph nodes for disease spread. The surgeon usually removes one or more lymph nodes from under the arm to check for cancer cells. If cancer cells are found in the lymph nodes, other cancer treatments will be needed.
We know that breast cancer spreads to the glands under the arm first, and, from there, can spread to other parts of the body. Using the least invasive methods possible, our surgeons perform a Sentinel Lymph Node Biopsy (SLNB) at the time of lumpectomy or mastectomy to check for the presence of disease.
Breast Reconstruction: Consider Restoring Appearance Before Cancer Removal Surgery
Most women who have a mastectomy and some who have a lumpectomy will also have reconstructive surgery to even out the breasts or replace the breast that was removed. It’s up to you if you choose to have breast reconstruction.
In some cases, it may be done at the same time as the cancer surgery, or it may need to be performed later, especially in the case of full breast reconstruction. Some women choose to “go flat,” meaning they will not have implants or other reconstructive surgery after a mastectomy. Talk to your breast cancer care team before your initial surgery about your concerns and what you would like to do.
At Compass Oncology, our breast surgeons work closely with leading plastic and reconstructive surgeons in the Portland area to prepare your body for future breast surgery. This partnership provides patients with access to a wide range of breast reconstructive and cosmetic surgical options. We encourage you to discuss your thoughts on reconstruction so we can develop a plan before your surgery. This may include incorporating advanced oncoplastic techniques during cancer removal to help ensure you are ready for any future breast reshaping surgeries.
Schedule a Consultation With Our Breast Surgeons
The breast cancer surgeons at Compass Oncology use the latest surgical techniques and serve the Portland, Oregon, and Vancouver, Washington region. If you are newly diagnosed with breast cancer, it is important to understand your options for surgery and any additional treatment that may be needed. Request a consultation with one of our breast cancer specialists.
Breast Cancer Surgery Frequently Asked Questions
How long does breast cancer surgery typically take?
The duration of surgery varies depending on the type of procedure being performed. A lumpectomy usually takes 1 to 2 hours, while a mastectomy can take 2 to 3 hours. If reconstruction is performed immediately, the surgery may last 6 to 8 hours.
How long is the recovery period after breast cancer surgery?
Recovery time varies based on the type of surgery performed. Most patients who undergo a lumpectomy typically recover and can return to their normal activities within two weeks, while those who have a mastectomy usually take about four weeks. If breast reconstruction is also performed, the recovery may take longer. Full recovery, including regaining arm strength and range of motion, may take anywhere from six weeks to several months and require some physical therapy.
Will I need radiation therapy after breast cancer surgery?
The need for additional treatments depends on the type and stage of your breast cancer, as well as the type of surgery performed. Radiation therapy after a lumpectomy is commonly recommended to destroy any cancer cells that could have been left in the breast after surgery. This lowers the likelihood of cancer coming back.
Because the entire breast and some of the chest wall muscle are removed in a mastectomy, radiation to the chest is less common for these patients.
Does breast cancer come back after a mastectomy?
While a mastectomy greatly reduces the risk of breast cancer recurrence, there is still a chance that it could come back in the other breast or another area of the body. The risk of recurrence depends on several factors, such as the type, size, location, and hormone status of the tumor at the time of diagnosis. Lymph node involvement may also increase the likelihood of recurrence after mastectomy.
What is the survival rate after breast cancer surgery?
According to the Surveillance, Epidemiology, and End Results (SEER) database, which is maintained by the National Cancer Institute (NCI), the five-year relative survival rate for individuals undergoing treatment for breast cancer is 91% when considering all stages combined. The average survival rates based on cancer stage are as follows: 99% for certain localized cancers, 87% for regional breast cancer, and 32% for distant breast cancers.
Keep in mind that these numbers can vary based on several factors, including the type of breast cancer, its stage when diagnosed, how well the cancer responds to treatment, and your age and overall health.
What are the side effects of breast cancer surgery?
Pain, tenderness, and swelling are common side effects of breast cancer surgery, whether a lumpectomy or a mastectomy is performed. However, each type of procedure has its own specific side effects.
A lumpectomy may result in indentations, dimpling, or other noticeable changes in the skin as it heals. Those who undergo a mastectomy may experience additional side effects, such as nerve pain, limited arm movement, numbness, and changes in sensation.
Will there be much scarring after breast surgery?
Scars are a natural outcome of any breast cancer surgery, but they can vary among individuals based on the type of surgery, the incisions made, and how well they heal. Initially, your scar may appear red and feel tight, tender, or uneven to the touch. However, over time, it will fade and become less noticeable. Your care team will teach you how to care for your scar(s) after surgery.
Will I lose my nipple with breast cancer surgery?
While a lumpectomy does not typically remove the nipple, a mastectomy often does, as it involves removing the entire breast. However, there are advanced surgical techniques, such as nipple-sparing mastectomy, which preserve the nipple and areola when breast reconstruction will follow. This option may be suitable for women diagnosed with breast cancer that is not located directly behind or in the nipple area.
How long does breast cancer surgery typically take?
How long does breast cancer surgery typically take?
The duration of surgery varies depending on the type of procedure being performed. A lumpectomy usually takes 1 to 2 hours, while a mastectomy can take 2 to 3 hours. If reconstruction is performed immediately, the surgery may last 6 to 8 hours.
How long is the recovery period after breast cancer surgery?
How long is the recovery period after breast cancer surgery?
Recovery time varies based on the type of surgery performed. Most patients who undergo a lumpectomy typically recover and can return to their normal activities within two weeks, while those who have a mastectomy usually take about four weeks. If breast reconstruction is also performed, the recovery may take longer. Full recovery, including regaining arm strength and range of motion, may take anywhere from six weeks to several months and require some physical therapy.
Will I need radiation therapy after breast cancer surgery?
Will I need radiation therapy after breast cancer surgery?
The need for additional treatments depends on the type and stage of your breast cancer, as well as the type of surgery performed. Radiation therapy after a lumpectomy is commonly recommended to destroy any cancer cells that could have been left in the breast after surgery. This lowers the likelihood of cancer coming back.
Because the entire breast and some of the chest wall muscle are removed in a mastectomy, radiation to the chest is less common for these patients.
Does breast cancer come back after a mastectomy?
Does breast cancer come back after a mastectomy?
While a mastectomy greatly reduces the risk of breast cancer recurrence, there is still a chance that it could come back in the other breast or another area of the body. The risk of recurrence depends on several factors, such as the type, size, location, and hormone status of the tumor at the time of diagnosis. Lymph node involvement may also increase the likelihood of recurrence after mastectomy.
What is the survival rate after breast cancer surgery?
What is the survival rate after breast cancer surgery?
According to the Surveillance, Epidemiology, and End Results (SEER) database, which is maintained by the National Cancer Institute (NCI), the five-year relative survival rate for individuals undergoing treatment for breast cancer is 91% when considering all stages combined. The average survival rates based on cancer stage are as follows: 99% for certain localized cancers, 87% for regional breast cancer, and 32% for distant breast cancers.
Keep in mind that these numbers can vary based on several factors, including the type of breast cancer, its stage when diagnosed, how well the cancer responds to treatment, and your age and overall health.
What are the side effects of breast cancer surgery?
What are the side effects of breast cancer surgery?
Pain, tenderness, and swelling are common side effects of breast cancer surgery, whether a lumpectomy or a mastectomy is performed. However, each type of procedure has its own specific side effects.
A lumpectomy may result in indentations, dimpling, or other noticeable changes in the skin as it heals. Those who undergo a mastectomy may experience additional side effects, such as nerve pain, limited arm movement, numbness, and changes in sensation.
Will there be much scarring after breast surgery?
Will there be much scarring after breast surgery?
Scars are a natural outcome of any breast cancer surgery, but they can vary among individuals based on the type of surgery, the incisions made, and how well they heal. Initially, your scar may appear red and feel tight, tender, or uneven to the touch. However, over time, it will fade and become less noticeable. Your care team will teach you how to care for your scar(s) after surgery.
Will I lose my nipple with breast cancer surgery?
Will I lose my nipple with breast cancer surgery?
While a lumpectomy does not typically remove the nipple, a mastectomy often does, as it involves removing the entire breast. However, there are advanced surgical techniques, such as nipple-sparing mastectomy, which preserve the nipple and areola when breast reconstruction will follow. This option may be suitable for women diagnosed with breast cancer that is not located directly behind or in the nipple area.