What are the types of breast cancer surgery?
Breast cancer surgery falls into two broad approaches: removing part of the breast, or removing all of it. Dr Melanie Seah, a Consultant Breast Surgeon in Singapore, performs breast-conserving surgery using oncoplastic techniques as well as each of the mastectomy options below.
Lumpectomy or wide excision
Removes the tumour and a rim of normal tissue. The surrounding breast tissue is reshaped to close the gap left behind. This is breast-conserving surgery.
Mastectomy
Removes all of the breast tissue. The wound is closed with stitches, so there is no open wound after surgery.
Skin-sparing mastectomy
Removes the breast tissue but keeps the skin envelope, with breast reconstruction following immediately using an implant or a tissue flap.
Nipple-sparing mastectomy
As above, with the nipple preserved as well. Suitable when the cancer is not near the nipple and breast shape and size allow, and a minimally invasive approach using endoscopic surgery may at times be possible.
Risk-reducing mastectomy
Removes a breast before cancer develops. Considered for women at high risk, such as those carrying the BRCA gene.
Axillary lymph node surgery
Sentinel lymph node biopsy or clearance, carried out alongside breast surgery to establish whether the cancer has spread.
Where a lump has not yet been diagnosed, a breast biopsy comes first, and most breast lumps turn out not to be cancer. Removal of a benign lump is handled as breast lump removal rather than cancer surgery.


