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Sibley Memorial Hospital

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Breast Cancer Surgery

The most advanced surgical techniques are available at the Sullivan Breast Center. Procedures include:

Sentinel lymph node biopsy:

A sentinel node biopsy determines if breast cancer has spread to the lymph nodes. An important part of staging cancer, it impacts recommendations for a patient's treatment.


A lumpectomy is a breast conserving surgery, where the tumor in the breast is removed along with a rim of surrounding normal tissue. This is usually appropriate for women who have a single small or medium size tumor.

Oncoplastic surgery:

This surgery combines the latest plastic surgery techniques with a lumpectomy. When a large lumpectomy is required (which will leave the breast distorted), the remaining tissue can be sculpted to restore natural appearance to the breast. The opposing breast will also be reduced to create symmetry.

Nipple sparing mastectomy:

A newer technique, this kind of mastectomy is reserved for a smaller number of women with tumors that are not near the nipple areola area. Your surgeon will make an incision on the outer side of the breast or around the edge of the areola and hollow out the breast, removing the areola and keeping the nipple intact. This method involves simultaneous reconstruction. Sometimes the completed reconstruction is done at the same time and in other cases, a tissue expander is inserted as a space holder for later reconstruction.

Skin sparing mastectomy: 

This is a fairly new form of surgery that was developed at Johns Hopkins and other major cancer centers. The affected breast is hollowed out. Whether done as skin sparing, nipple sparing, areola sparing or a combination, one goal of this surgery is to minimize the surgical incisions that are visible. It is not uncommon for an entire mastectomy procedure to be performed through an opening that is less than two inches in length.

Prophylactic mastectomy:

Prophylactic mastectomy is a surgery designed to remove one or both breasts in order to dramatically reduce the risk of developing breast cancer. Women who test positive for certain genetic mutations like BRCA1 and BRCA2, or who have a strong family history of breast cancer, may elect to do this kind of surgery. They may also elect to have their ovaries removed at the same time. Genetic counseling may help to confirm or eliminate any nagging suspicion about family history.

Total mastectomy: 

This surgery removes all of the breast, including the nipple, areola, and most of the overlying skin.. In some cases, mastectomy is performed prophylactically (to prevent cancer from occurring) in women with a high risk for developing breast cancer.

Modified radical mastectomy:

The entire breast is removed, including the nipple, the areola, the overlying skin, and the lining over the chest muscles. In addition, some of the lymph nodes under the arm, also called the axillary lymph nodes, may be removed. 

Axillary lymph node dissection: 

Lymph nodes serve as a filtering system for the lymphatic system (a system of vessels that collects fluids from cells for filtration and reentry into the blood). The first node in the armpit area (axillae) that is affected by breast cancer is also called the sentinel, or guard node. If the cancer is found to have spread to this specific lymph node or other nodes in the axillary area, an axillary node dissection (remove of the lymph nodes) is most often recommended.