Breast Cancer Surgery

One of the first things most breast cancer patients consider as part of their treatment process is breast surgery. The type of breast surgery that is right for you depends on several factors, including the size and location of the tumor, as well as your overall health. Learn about different types of breast cancer surgeries and how to choose what's best for you by reviewing the information below and discussing your options with a breast surgeon.

WVCI offers breast cancer surgery in the Willamette Valley area through our partnership with Oregon Surgical Wellness.

Meet Our Breast Cancer Surgeons

The oncologists at Willamette Valley Cancer Institute partner with the breast cancer surgeons at Oregon Surgical Wellness (OSW), making it possible to provide the most advanced and comprehensive breast cancer treatments. The OSW breast cancer surgeons work closely with you and your WVCI medical oncologist to determine the most suitable type of breast cancer treatment, the right timing for the surgery, and what other treatments may be needed.

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Get to know our breast cancer surgeons who are dedicated to the treatment of breast cancer and perform hundreds of breast cancer surgeries every year.

Winnie Henderson, MD, PhD, FACS, CGRA

Breast Surgeon

Christine Kollmorgen, MD, FACS

Breast Surgeon

Your breast cancer surgeon will recommend the type of surgery that would be best for you based on scientific data and their experience.

Lumpectomy (Breast-Conserving Surgery)

Breast-conserving surgery, commonly known as lumpectomy or partial mastectomy, aims to remove as much cancer as possible while also preserving much of the surrounding healthy breast tissue. This procedure may also involve the removal of nearby lymph nodes to check for cancerous cells. Several factors influence how much breast tissue needs to be removed, including the size and specific location of the tumor. Our breast cancer surgeons perform lumpectomies that not only remove cancer but also help the patient look and feel better about their breasts afterwards.

Oncoplastic Lumpectomy

Oncoplastic lumpectomy combines lumpectomy surgery with plastic surgery techniques to improve the cosmetic outcome after the cancer removal. It is essentially a reconstructive surgery aimed at making the breast look better if the lumpectomy alters its appearance. The nipple can usually stay intact.

Various oncoplastic techniques can be used to reshape the breast after removing the cancer. The choice of approach the surgeon chooses will depend on the size and location of the cancer, as well as your breast size, body type, and personal preferences.

Oncoplastic surgery techniques are generally used to:

Prevent “dents” in the breast.
Place the scar where it’s less visible, often called "hidden scar surgery."
Combine the removal of cancerous breast tissue with a breast reduction, breast lift, or both.

If necessary, your OSW breast cancer surgeon can make adjustments to the other breast to ensure a balanced appearance. It's important to understand that oncoplastic lumpectomy is not suitable for those diagnosed with inflammatory breast cancer (IBC) due to its widespread nature. Individuals with IBC may need to undergo a mastectomy instead.

Cancer Localization Procedures

Localization procedures are performed prior to a lumpectomy. Using mammogram or ultrasound technology, the exact location of the abnormal tissue is identified, and a marker is placed in the breast. The surgeon can then follow the marker to the correct location during surgery. The localization procedure may be performed a few days before or on the same day as the lumpectomy.

There are several methods for localizing the cancer:

Wire-free localization. Advances in technology allow surgeons to locate the tumor accurately before surgery without wires.
- The SAVI SCOUT system is one option. Instead of using a wire, the radiologist places a small, one-centimeter device called a reflector in the breast tissue up to seven days before surgery. On the day of the operation, the surgeon uses a handheld device that emits a tiny radar signal to find the reflector and identify the exact area of the breast where tissue needs to be removed.
- Another wire-free option for localization is called Magseed®. This technique involves placing a small magnetic seed into the center of the tumor days or even weeks before surgery. During the procedure, the surgeon uses a magnetic probe to detect the seed and precisely locate and remove the tumor with minimal disruption to surrounding tissue.
Wire-guided localization. This procedure involves using a needle to place a wire into the breast on the same day as surgery. The wire serves as a guide, allowing the surgeon to locate the precise area of abnormal breast tissue or cancer. The wire is then removed from the site of the abnormal tissue.

Preparing for Radiation Therapy After a Lumpectomy

After the cancer is removed, the precise location may be marked by another device to let the radiation oncologist know where to deliver radiation to get rid of possible microscopic cancer cells left behind after surgery. The VeraForm® device is a flexible tissue marker placed inside the area where the tumor was removed during surgery. It helps clearly mark the exact area for follow-up radiation therapy treatment. Because VeraForm fits the shape of where the tumor was, it gives doctors a more accurate picture of how to form the radiation beams to the shape of the surgical site. This helps protect healthy tissue and improves cosmetic results after treatment.

Mastectomy (Breast Removal Surgery)

Mastectomy is a surgery that removes the entire breast. There are a few types of mastectomy, and the breast surgeon will recommend the most effective technique based on your unique circumstances.

The video below explains the different approaches to mastectomy that your OSW surgeon may discuss with you.

Mastectomy

This procedure involves removing breast tissue, nipple, areola, fascia (covering) of the pectoralis major muscle (main chest muscle), and skin. This usually leaves the patient with a flat appearance on the chest. If you wish to “go flat” after surgery, be sure to talk with your surgeon beforehand so they can ensure you achieve the look you’d like. Learn more about the Go Flat Movement.

Nipple-Sparing and Skin-Sparing Mastectomy

A nipple-sparing and skin-sparing approach is used whenever possible, allowing women to retain more of their own breast tissue and sensation. This technique offers both cosmetic and emotional benefits.

In a skin-sparing mastectomy, the nipple and areola are removed along with the breast, but only a small amount of skin is taken. A nipple-sparing mastectomy preserves the nipple and areola, along with the surrounding skin. When possible, your OSW breast surgeon will strategically place the incision to minimize visible scarring after healing. This approach helps you keep as much of the female form and sensation as possible, which is important to many patients.

Modified Radical Mastectomy

This procedure combines a total mastectomy with an axillary lymph node dissection to treat cancerous lymph nodes in your armpit area, called your axilla. An axillary lymph node dissection removes lymph nodes from the armpit (axilla) to check for the spread of cancer. This procedure also helps determine the extent of cancer spread and guides further treatment decisions. Our surgeons also use the axillary reverse lymphatic mapping technique to identify which lymph nodes drain to the arm. By doing this, patients can reduce side effects such as lymphedema.

Risk-Reduction Mastectomy

Risk-reducing mastectomy (RRM), also known as prophylactic mastectomy (PM), is performed to lower the risk of developing breast cancer or breast cancer recurrence. A prophylactic mastectomy involves removing one or both of the breasts. Women at high risk, including those with a strong family history of breast cancer and gene mutation carriers such as BRCA 1 or BRCA 2 and other high-risk gene mutations, may be candidates for this type of breast cancer surgery.

Sentinel Lymph Node Surgery

A sentinel lymph node biopsy may also be performed with your breast surgery (lumpectomy or mastectomy) to determine if cancer has spread beyond the breast and into nearby lymph nodes. This involves removing only a few nearby lymph nodes where cancer is likely to spread, and helps oncologists assess breast cancer staging and plan further treatment.

In most cases, this procedure is performed by removing the very specific lymph node draining from your breast cancer. It is then tested to see if cancer has spread to the lymph node closest to your breast. The presence or absence of cancer cells in the lymph nodes will guide future treatment options.

find a breast cancer surgeon in oregon at wvci and osw

Consider Reconstruction Options Before Cancer Removal Surgery

While breast cancer surgeons do not typically place implants at the time of the breast cancer removal surgery, they work with plastic surgeons and can help prepare your body for future reconstruction. Advanced oncoplastic techniques can be incorporated during cancer removal to prepare you for future surgery to re-form your breasts. Some women choose to “go flat,” which is also an option you should discuss beforehand because it affects the incisions that will be used. Discuss your thoughts on reconstruction to develop a plan before the surgery.

Breast Reconstruction Options

The Latest Treatments for Breast Cancer Available at Willamette Valley Cancer Institute

If you are newly diagnosed with breast cancer, the first step is to schedule a consultation with a breast cancer doctor. At Willamette Valley Cancer Institute (WVCI), we offer personalized treatment plans, including the latest cancer treatments available, as well as second opinions. Our clinics are located throughout the Willamette Valley and Central Coast - including Albany, Corvallis, Eugene, Springfield, Florence, Newport, and Lincoln City, Oregon.

Why do you need radiation after a lumpectomy?

Radiation therapy after breast sparing surgery is proven to reduce the risk of breast cancer recurrence. Only about 3-15% of patients have a breast cancer recurrence within 10 years of diagnosis when using this combination of treatments.

Learn more about radiation therapy for breast cancer.

Do you need to have radiation after a mastectomy?

Radiation therapy after a mastectomy is not usually required, but it may be recommended if the cancer was large, if it spread to nearby lymph nodes, or if cancer cells were found at the edges of the removed tissue (margins).

Read more in our blog: How is radiation used to treat breast cancer?

Will my breast cancer come back?

The possibility of breast cancer returning, or recurring, after initial treatment depends on several factors, including the breast cancer type and its stage when you were diagnosed. The type of surgery used does not impact the likelihood of it returning. While no one can predict with certainty whether cancer will come back, the earlier it's found and treated, the less likely it is to come back.

Learn more about breast cancer recurrence.

What is recovery like for breast cancer surgery?

Most women can generally resume their normal activities within two weeks after lumpectomy surgery. Mastectomies may require a longer recovery due to the extent of the surgery, with most people recovering in three to six weeks. You may need assistance at home during your recovery time. Most likely, you won’t be able to lift anything heavy or raise your arm(s) over your head for at least a week. You may also be extra tired as you heal. Your surgeon will give you specific instructions about your personal dos and don’ts before you leave the surgery center.

Will there be a scar on my breast after surgery?

Surgeons do all they can to minimize scarring, although some scarring is usually unavoidable. It tends to be easier to hide the scar for those who have a lumpectomy.

Talk with your surgeon before a mastectomy surgery to discuss whether you would prefer reconstruction, wearing a prosthetic, or “going flat” afterwards. This will impact the surgical closure. You may also be able to hide some of the scarring if you have breast reconstruction surgery. If the surgeon knows you want to go flat, they will use a different closure than if reconstruction is planned.

Learn more about breast reconstruction options and timing.

Breast Cancer Surgical Treatment Options