Treatment for breast cancer depends on the subtype of breast cancer and how advanced the breast cancer is at the time of diagnosis. For breast cancers, which are diagnosed when they are small and confined to the breast, surgery is usually performed first, followed by additional treatments such as radiation therapy, estrogen-blocking/reducing medicines, and chemotherapy. For invasive breast cancers which are diagnosed when the tumor is larger, or there is the involvement of lymph nodes, or for those that are HER2 positive or triple negative, chemotherapy may be given first, followed by surgery and radiation. The options for treatment will be reviewed by your doctor.

Breast Cancer Surgery

For patients with breast cancer, which is non-invasive or invasive and confined to the breast and lymph nodes, surgery is part of the treatment. Surgery may also be performed in some patients with breast cancer, which has spread to other areas of the body, especially when the tumor in the breast and lymph nodes is growing, but disease in other areas of the body is well controlled with the treatment.

Mastectomy:
A mastectomy is a procedure where the entire breast is removed. Sometimes cancers are large or are in multiple areas of the breast, and the entire breast must be removed to treat the cancer. Sometimes, patients may choose to proceed with mastectomy for treatment of their cancer. A mastectomy can be done with or without reconstruction. When mastectomy and reconstruction are performed together, the skin and sometimes the nipple of the breast are preserved to help provide tissue for the reconstruction. These procedures are called skin-sparing and nipple-sparing mastectomy, and they are used when we are performing mastectomy with reconstruction. All of the surgeons at Sylvester Comprehensive Cancer Center who treat breast cancer patients have special training and experience in performing these mastectomy procedures.

Lumpectomy:
A lumpectomy is a procedure where the tumor is removed with a small amount of normal breast tissue around the tissue, and the remainder of the breast is left intact. The goal of the lumpectomy is to remove the tumor with no cancer present at the margin. A lumpectomy is usually used to treat tumors that are smaller. After lumpectomy, most patients will also require radiation therapy. Sometimes, a lumpectomy can be combined with breast reconstruction, especially if the area removed for the lumpectomy is larger. This is called an oncoplastic reconstruction and combines the lumpectomy procedure with reshaping of the breast on the cancer side and a procedure on the opposite breast to provide symmetry. When large oncoplastic reconstructions are performed, a plastic surgeon is involved in the procedure.

Lymph node evaluation:
At the time of surgery, an evaluation of the lymph nodes under the arm may also be performed. For patients with breast cancers that are diagnosed at an early stage, a sampling of the lymph nodes will be performed with a procedure called sentinel lymph node biopsy. The sentinel lymph node biopsy procedure utilizes tracers that are injected into the breast to identify and remove specific lymph nodes from under the arm. Usually, an average of 2-3 lymph nodes will be removed. If the lymph nodes have cancer, then sometimes more lymph nodes will need to be removed. This procedure is called an axillary lymph node dissection and removes 10-25 lymph nodes.

Lymphatic reconstruction:
At the time of surgery, if more lymph nodes need to be removed, a reconstruction of the lymphatics draining from the arm may be performed. Sometimes, these procedures are performed by the breast surgeon, or sometimes, they will be performed by a plastic surgeon with special training in microvascular surgery. This will help to reduce the risk of arm swelling (lymphedema), which can occur after removing lymph nodes.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has reaffirmed us as South Florida’s only NCI-designated cancer center. We have been recognized for our scientific leadership, our commitment to training the next generation of cancer researchers and providers, as well as our engagement with the communities that we serve. For patients, this designation translates into greater access to leading-edge treatment options, including clinical trials that prioritize your specific cancer.

Renowned Braman Family Breast Cancer Institute at Sylvester. We offer one of the nation's best breast cancer diagnosis and care programs offering treatments customized to your individual needs.

Breast Imaging Center of Excellence designation by the American College of Radiology. You get a more precise diagnosis, which then guides a more effective treatment plan.

Multidisciplinary breast cancer team. You receive care from a team of experts in all facets of breast cancer, offering you complete care for the best chance of success.

More breast reconstructive surgery options. As South Florida’s leader in post-surgical breast reconstruction, we help restore comfort and confidence after any breast cancer surgery.