Breast Cancer Surgery: Types, Cost, and More

Surgery for breast cancer

If you’re living with breast cancer, your doctor may recommend surgery to:

• remove as much of the cancer as possible
• find out whether the cancer has spread to nearby lymph nodes
• reconstruct or reshape your breast
• relieve symptoms

Surgery tends to be most effective for treating breast cancer in its early stages, before it has spread to other parts of the body. The cancer is easier to remove in the early stages.

Your doctor is less likely to recommend surgery if you have metastatic breast cancer (MBC) that has spread to distant parts of your body. However, doctors sometimes recommend surgery to remove tumors or treat symptoms.

Surgery to remove cancer from the breast

你的医生可能会建议手术切除肿瘤from your breast, particularly if the cancer hasn’t yet spread to distant parts of your body.

They may also recommend radiation therapy after surgery to kill any cancer cells that remain.

There are two main types of surgery to remove cancer from the breast.

Breast-conserving surgery

Breast-conserving surgery (BCS) is the least invasive type of surgery to remove cancer from the breast. It’s also called lumpectomy or partial mastectomy.

In BCS, a surgeon removes the tumor from the breast. They also remove a margin of healthy tissue surrounding the tumor to reduce the risk of cancer cells being left behind.

The surgeon doesn’t remove the breast itself.

Full mastectomy

In a full mastectomy, the surgeon removes the:

• entire breast, including the nipple and areola
• chest wall
• nearby lymph nodes

Some people only have one breast removed. Others have a double mastectomy, in which both breasts are removed.

Which option is best?

A 2015 study of adult women with early stage breast cancer found that 64.5 percent had BCS and 35.5 percent had mastectomy.

If you have breast cancer that’s detected early, BCS may be enough to remove the entire tumor. Your doctor will likely recommend radiation therapy following BCS to reduce the chances of the cancer returning.

Your doctor may recommend mastectomy instead of BCS if you:

• can’t receive radiation therapy or prefer not to receive it
• have previously had BCS that didn’t fully remove the cancer
• have a large tumor or multiple tumors in the same breast that can’t be removed through BCS without changing the look of your breast too much for your preferences
• have a gene that raises your risk of developing a second breast cancer
• have inflammatory breast cancer

During a mastectomy, your surgeon may be able to leave the breast skin intact. This is known as a skin-sparing mastectomy.

If you would like to have breast reconstruction after a mastectomy, your surgeon will likely recommend a skin-sparing mastectomy.

Surgery to remove lymph nodes

Breast cancer may spread from your breast to lymph nodes under your arm, known as axillary lymph nodes.

The cancer may spread from lymph nodes to other parts of the body through your lymphatic system.

Your surgeon may remove lymph nodes and send them to a lab to be examined. This will help them learn whether the cancer has spread.

There are two main types of surgery for lymph node removal.

Sentinel lymph node biopsy

In a sentinel lymph node biopsy (SLNB), the surgeon removes only a small number of lymph nodes.

They remove the first lymph node or the first few lymph nodes where the cancer would likely spread first.

This lowers the risk of potential side effects, such as:

• pain
• numbness
• lymphedema

Lymphedema is swelling that occurs when the lymphatic system is not working properly.

SLNB is often a good option for early stage breast cancer.

Axillary lymph node dissection

During axillary lymph node dissection (ALND), the surgeon removes a larger number of underarm lymph nodes.

They typically remove fewer than 20 lymph nodes.

A surgeon may perform ALND after learning from SLNB that the cancer has spread to axillary lymph nodes.

ALND may be performed with BCS or mastectomy surgery.

Breast reconstruction surgery

If you have a full mastectomy, you may wish to have surgery to reconstruct the breast afterward.

If you have a BCS or partial mastectomy, you may also wish to have surgery to reshape the breast.

Depending on your preferences and needs, your doctor may recommend:

• A breast implant.This is a flexible silicone shell filled with saline or silicone gel that may be inserted into the breast area during breast cancer surgery or later on.
• A tissue flap.In this procedure, the surgeon uses tissue from your stomach, buttocks, or other parts of your body to rebuild the breast.
• Nipple and areola reconstruction.This operation may be performed about 3 or 4 months after an implant or tissue flap surgery.
• Scar revision.This surgery reduces the appearance of surgical scars.

The cost of surgery

The cost of breast cancer surgery depends on:

• your location and healthcare provider
• the type of surgery you get
• your insurance coverage

A 2016 study found that the average cost of BCS along with radiation was more than $65,000. A mastectomy plus breast reconstruction cost upward of $88,000 on average. The costs were lower for people with Medicare.

Will insurance cover the surgery?

If you have health insurance, surgery for breast cancer is typically covered.

You may need to meet a deductible before your insurance pays for surgery. Your deductible may be as low as $0 or as high as $7,500 per year.

You may also need to pay coinsurance or copays depending on your plan.

你可以联系保险公司学习bout your plan.

TheWomen’s Health and Cancer Rights Actrequires all group health plans that cover mastectomy to also cover breast reconstruction.

Medicare covers breast reconstruction.

How to get insurance or financial assistance

If you’re employed, you may check with your employer to learn whether they offer health insurance.

You may be able to enroll in coverage through the Affordable Care Act marketplace. There you can also check whether you qualify for Medicaid.

If you don’t have health insurance, the costs of surgery may seem overwhelming. There are resources available to help you pay for treatment.

You can start by asking your medical team for a list of organizations that offer financial assistance for breast cancer surgery. Examples include:

• Komen Treatment Assistance Program
• The Pink Fund
• Patient Advocate Foundation

Check with your cancer center to learn whether they have “financial navigators” or social workers to help people manage the financial aspects of care.

The takeaway

If you receive a breast cancer diagnosis, your doctor may recommend surgery to treat it. The specific type of surgery will depend on your condition and treatment preferences.

Speak with your cancer care team to learn about your surgical options. They can help you understand the pros and cons of different surgeries.

If you have part or all of your breast removed, you may decide to have the breast reconstructed or reshaped afterward.