Key takeaways

  • Surgical procedures for breast cancer include a lumpectomy, which removes a tumor while conserving healthy breast tissue, or a mastectomy, which removes the entire breast.
  • People who undergo a mastectomy may be suitable for breast reconstruction surgery. This can occur during or after a mastectomy, and may involve implants or tissue from other body parts.
  • Recovery from breast cancer surgery depends on the type of surgery. People may be able to return to typical activities within 5 to 10 days of a lumpectomy or 6 to 8 weeks after a mastectomy with reconstruction.
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Secondary to skin cancers, breast cancer is the most common cancer in people assigned female at birth. It accounts for around 1 in 3 of all new female cancers each year.

People requiring surgery for breast cancer may have a lumpectomy or mastectomy, depending on the size and location of the tumor and other factors.

After a mastectomy, a person may want breast reconstruction surgery. This can happen after or during the mastectomy.

This article will discuss the different types of breast cancer surgery in more detail, how long it takes a person to recover from the procedure, and the cost.

Breast-conserving surgery (BCS), also called a lumpectomy or partial mastectomy, removes cancer but leaves most of the healthy breast tissue intact. In some people, the surgeon may also remove the lymph nodes for a biopsy. A biopsy involves removing the lymph nodes and analyzing them in a laboratory to see if they contain cancerous cells.

A surgeon may also remove part of the chest wall lining as a precaution if the tumor is particularly close to it.

A total or simple mastectomy procedure removes the entire breast. A modified radical mastectomy is the removal of the breast and nearby lymph nodes. A person may want reconstructive surgery during or after a mastectomy.

According to the American Cancer Society (ACS), many people with early stage breast cancer can choose between mastectomy or a lumpectomy. A lumpectomy will preserve most of the breast. However, doctors usually follow a lumpectomy with radiation therapy to make sure the remaining cancer cells are destroyed.

Those with early stage breast cancer who opt for a mastectomy are not as likely to need radiation therapy. A mastectomy may be a more appropriate option depending on the type of cancer, the tumor-to-breast size ratio, and previous radiation therapy treatment.

As with a lumpectomy, a person may also need additional treatment after a mastectomy. This could include chemotherapy, hormone therapy, and targeted therapy, especially if the cancer is at an advanced stage.

Some people may be concerned that not opting for a mastectomy makes it more likely that the cancer will return. The ACS reports that the survival and recurrence rates are the same for those who undergo a lumpectomy combined with radiation and those who opt for a mastectomy.

The National Cancer Institute notes that people with ductal carcinoma in situ (DCIS) may prefer a lumpectomy to preserve as much of the breast as possible. However, this often depends on the tumor-to-breast size ratio. DCIS is when the cancer is in the milk ducts only and has not spread elsewhere.

However, some people with DCIS may prefer a mastectomy. They may choose this option if:

  • their breasts are smaller
  • DCIS and other breast cancer cells are in most of the breast
  • DCIS or breast cancer is in multiple areas of the breast
  • DCIS or breast cancer is under the nipple
  • they cannot receive radiation therapy

Surgeons tend to recommend a simple mastectomy for males with breast cancer, as they have less breast tissue. A lumpectomy may also be suitabe.

A person can choose to have surgery to reconstruct the breast and nipples. If a person does not want to undergo breast reconstruction surgery, they can use prosthetics or opt for no reconstruction surgery at all. It is important to discuss these options with a healthcare professional.

According to Breastcancer.org, there are two techniques to reconstruct the breast — implant reconstruction and autologous reconstruction.

An implant reconstruction is when a surgeon inserts an implant that contains saline or silicone gel. An autologous reconstruction uses tissue from other parts of the body.

A person can choose to undergo breast reconstruction at the same time as the mastectomy. However, they can also opt for delayed breast reconstruction. This might be an option if a person requires additional treatment after surgery, such as radiation therapy or chemotherapy.

If a person has undergone a lumpectomy or partial mastectomy, a surgeon may recommend oncoplastic surgery. This can help to reshape the breast and may include:

  • smaller implants
  • breast reduction
  • fat grafting
  • breast lift
»Learn more:What to know about breast reconstruction surgery

Nipple and areola reconstruction

This is typically the final stage of breast reconstruction and takes place 3 to 4 months after the initial surgery.

A surgeon can use tissue from the breast or another part of the body to create a nipple. Some people may choose to get a tattoo.

Recovery from breast cancer surgery largely depends on the type of reconstruction a person has or does not have. As a general guide, the recovery times for the following breast cancer surgeries are:

  • Lumpectomy: Most people can get back to day-to-day activities within 5 to 10 days.
  • Mastectomy: People may feel better 3 to 4 weeks after surgery.
  • Mastectomy with reconstruction: This procedure has the longest recovery time, and takes up to 6 to 8 weeks.

There are side effects with all surgeries, and breast cancer surgery is no different. Possible side effects from any surgery include:

  • bleeding
  • infection
  • formation of a seroma or hematoma
  • numbness of the skin around the incision

The following side effects of these surgeries are:

  • Lumpectomy: A person may feel tired and notice their skin itches or peels after radiation therapy.
  • Mastectomy: A person may feel off balance and experience shoulder and neck pain while they adjust to carrying less weight on their chest. People with larger breasts may notice this more. Tightness of the chest wall may also occur.
  • Mastectomy with reconstruction: People may not like how the new breast looks. If they received an implant, the breast could toughen and harden, causing pain. A person may also need additional surgery if the implant splits in the future.

When breast cancer starts to spread, the cancer cells typically go to the lymph nodes under the arm first. To understand and monitor cancer progression, a surgeon may perform either a sentinel lymph node biopsy (SLNB) or an axillary lymph node dissection (ALND).

Sentinel lymph node surgery (SLNB)

A surgeon injects a dye or radioactive liquid into the tumor and the surrounding area. The dye then follows the path the cancer cells would take as they spread throughout the body. The first lymph nodes the dye reaches are the sentinel lymph nodes.

The surgeon cuts the skin where the lymph nodes are and removes several for analysis. If cancer cells are present, they may follow up with an ALND.

Axillary lymph node dissection (ALND)

According to the ACS, in this procedure, a surgeon removes between 10 to 40 lymph nodes at a time, although it is usually less than 20. When a person has a lumpectomy or mastectomy, a surgeon may do an ALND at the same time.

A person may need an ALND if:

  • the SNLB revealed cancer in three or more lymph nodes
  • the growth of cancer suggests it could go beyond the lymph nodes
  • the SNLB revealed cancer cells after chemotherapy

The recovery time for a lymph node dissection varies, and a wound may still leak fluid for several weeks after the operation.

A surgeon will place a drain in the armpit area to collect the fluid and will remove it when it contains less than 30 cubic centimeters (ccs) for 2 days. A person can remove the gauze covering the wound after 48 hours.

Side effects of lymph node surgery

The side effects of lymph node surgery include:

  • pain at the surgical site
  • limited movement or pain when moving the shoulder or arm
  • numbness in the upper arms
  • fluid buildup in the arms and hands, or lymphedema

As with any surgical procedure, a person is at risk of bleeding, blood clots, and infection after undergoing lymph node surgery.

The cost of breast cancer surgery varies depending on hospital location and the stage of the breast cancer.

An older 2016 study reported that the average per-patient allowed costs from insurance companies over the first 12 months after diagnosis were:

Breast cancer stageInpatient surgeryOutpatient surgery
0$4,291$12,618
1–2$4,722$11,783
3$6,573$12,637
4$3,180$4,480

Lower cost options

The Centers for Disease Control and Prevention (CDC) provides a breast cancer screening program called the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

This service provides breast cancer screening procedures for those who:

  • do not have insurance
  • have a yearly income that is below 250% of the federal poverty level
  • are ages 40 to 64 years

The Breast and Cervical Cancer Prevention and Treatment Act of 2000 allowed states to offer treatment through Medicaid to those who received a breast cancer diagnosis through the NBCCEDP program.

Medicare may also cover the cost of breast cancer surgery.

»More on this:Does Medicare cover a double mastectomy?

Surgeons perform a lumpectomy or mastectomy to remove cancer from the breast.

Doctors usually request lymph node surgery to monitor cancer progression and gauge the spread of cancer cells.

People with more advanced cancer usually undergo a mastectomy, where a surgeon removes the entire breast and sometimes part of the chest wall muscle. A lumpectomy leaves healthy breast tissue intact, so the recovery time is shorter than a mastectomy. The location of the hospital and the stage of breast cancer influence the cost of breast cancer surgery.