Surgical treatment options

Generally speaking, the patient can choose between radical or modified radical surgery and conservative breast surgery. In some cases, the patient also has the option of breast reconstruction.

Radical mastectomy
Here, the entire body of the mammary gland is removed, together with the relevant pectoral muscles and lymph
nodes. The incision runs from approximately the shoulder joint to the abdominal region. Consequently, the chest is
usually left very hollow. This method of treatment was commonly used up until the 1970s. Since then research has shown that less radical surgery is appropriate.

Modified radical mastectomy
With this operation, the entire body of the mammary gland is removed, together with the lymph nodes in the underarm area. The pectoral muscles are left intact. Only when the pectoral muscles are affected by tumours are they also removed. This is relatively rare nowadays, because breast cancer is generally diagnosed at an early stage.

Simple mastectomy
With this operating technique the mammary gland is removed in its entirety without interfering with the axillary lymph nodes.

Conservative breast surgery

Quadrant resection
The female breast is divided into quadrants. Most tumours occur in the upper outer quadrants. In quadrant resection, both the tumour and the tissue in the surrounding quadrants are removed. This promises greater certainty. However, the cosmetic result is not always optimal.

Tumorectomy, segmental mastectomy
With this breast-conserving operation, the tumour is removed with a safety margin from the healthy tissue. As a rule, a few lymph nodes are also removed from the underarm area for accurate diagnosis during conservative breast surgery. Generally speaking, it leaves only small, barely visible scars.
Whether conservative breast surgery is possible must ultimately be decided by the doctor in charge. In all cases, the ratio of tumour size to total mammary gland tissue is a relevant factor. If a few tumour cells have migrated into the surrounding tissue, a safety margin of some 2 cm of healthy tissue will be taken from around the tumour to ensure that all the malignent cells are removed.
Conservative breast surgery is often followed up with radiotherapy.