Breast cancer surgery treatment

The Ultimate Guide to Breast Cancer Surgery

the ultimate guide to breast cancer surgery_BASS Cancer Center
We'll answer all your common Breast Cancer Surgery questions navigate quickly to each section

Breast cancer is a prevalent and serious disease that affects millions of individuals worldwide. Fortunately, advancements in medical science have led to various surgical options for the treatment of breast cancer, including lumpectomy, mastectomy, and axillary lymph node dissection. If you or a loved one has been diagnosed with breast cancer, understanding these surgical treatments is essential in making informed decisions about your treatment plan.

In this ultimate guide, we will provide you with comprehensive information about the best surgical treatments available for breast cancer. We will also discuss the factors to consider in decision-making and the importance of personalized treatment plans. Let's dive in!

What Causes Breast Cancer?

Breast cancer is influenced by various factors and causes that can contribute to its development. Among the most common ones are:

  • Age and gender: Breast cancer risk increases with age, and women are at a higher risk compared to men.
  • Family history and genetics: Having a family history of breast cancer or carrying certain gene mutations, such as BRCA1 and BRCA2, can increase the risk of developing breast cancer.
  • Hormonal factors: Hormonal factors such as early onset of menstruation, late menopause, and hormone replacement therapy (HRT) can influence breast cancer risk.
  • Lifestyle factors: Poor diet, lack of physical activity, excessive alcohol consumption, and smoking can contribute to an increased risk of breast cancer.
  • Environmental and occupational factors: Exposure to certain environmental and occupational factors, such as ionizing radiation and certain chemicals, may increase the risk of breast cancer.

It's important to note that having one or more of these risk factors does not necessarily mean that a person will develop breast cancer. This is why, it is crucial to discuss your personal risk factors with your healthcare provider and undergo regular breast cancer screenings as recommended. Early detection and timely treatment can greatly improve the chances of successful breast cancer management.

Here are some of the most common signs of breast cancer that you should look out for. 

Below, we have listed the three most effective surgical options for breast cancer.

How is Breast Cancer Diagnosed

When it comes to diagnosing breast cancer, various diagnostic procedures are available to provide valuable insights into the presence and characteristics of breast abnormalities. 

Here are some of the common diagnostic procedures that can help healthcare providers make informed decisions about treatment:

  • Mammogram: A mammogram is a low-dose X-ray of the breast that can detect early signs of breast cancer, such as lumps or microcalcifications. Mammograms are recommended for routine breast cancer screening and can help detect abnormalities before they can be felt. They are particularly effective for women over the age of 40 or those with a higher risk of breast cancer.
  • Breast Ultrasound: Breast ultrasound uses high-frequency sound waves to create detailed images of breast tissue. It is often used to further evaluate abnormalities detected on a mammogram or to assess breast lumps that can be felt but are not visible on a mammogram. Ultrasound helps differentiate between solid masses, which may be cancerous, and fluid-filled cysts, which are typically benign. It is a valuable tool for evaluating breast abnormalities in younger women or in cases where additional information is needed.
  • Breast MRI: Magnetic Resonance Imaging (MRI) of the breast provides detailed images using magnetic fields and radio waves. It is particularly useful for evaluating breast abnormalities and assessing the extent of cancer in certain situations. Breast MRI is commonly recommended for high-risk individuals, such as those with a strong family history of breast cancer or certain genetic mutations. It is also used to evaluate the extent of cancer in cases where mammography or ultrasound results are inconclusive.
  • Biopsy: A biopsy involves the removal of a small sample of tissue or cells from the breast for further examination. A biopsy is typically performed when a suspicious area is identified on imaging tests or during a physical examination. The obtained tissue is analyzed by a pathologist to confirm the presence of cancer and determine its characteristics, such as the type, grade, and hormone receptor status.


Lumpectomy, also known as breast-conserving surgery or partial mastectomy, is a surgical procedure that involves removing only the tumor or the abnormal tissue from the breast while preserving the majority of the breast tissue.


During a lumpectomy, your surgeon will make a small incision in the breast and remove the tumor along with a margin of healthy tissue around it to ensure complete removal. The extent of tissue removal depends on the size and location of the tumor, as well as other factors such as tumor type and patient preference.

Risks and Benefits:

Like any surgical procedure, lumpectomy has risks, which may include bleeding, infection, pain, scarring, changes in breast shape or size, and numbness in the breast or surrounding areas. However, lumpectomy generally has a shorter recovery time and fewer long-term effects on breast appearance and sensation.

One of the key benefits of lumpectomy is that it allows you to preserve breast tissue, which can have significant psychological and emotional benefits.

Recovery and Follow-up Care:

After your lumpectomy, you will likely be able to go home on the same day or the next day and gradually resume your normal activities. Your healthcare provider may prescribe pain medication and provide instructions for proper wound care to manage any post-operative discomfort.

Radiation therapy is often recommended after lumpectomy to target any remaining cancer cells in the breast and reduce the risk of recurrence. Depending on your individual case, hormonal therapy or chemotherapy may also be recommended as part of your overall treatment plan.

Make sure to have regular follow-up appointments with your healthcare provider to monitor your healing progress, assess treatment response, and detect any potential signs of recurrence. It's crucial to attend all scheduled appointments and communicate any concerns or questions you may have with your healthcare provider.


Mastectomy is a surgical procedure that involves the complete removal of the breast tissue. It is typically performed for various reasons, including treating breast cancer and reducing the risk of breast cancer in high-risk individuals.

Types of Mastectomy:

There are several types of mastectomy, including:

  • Total or Simple Mastectomy: In this procedure, the entire breast tissue, including the nipple and areola, is removed, but the muscles underneath are preserved.
  • Modified Radical Mastectomy: This involves the removal of the entire breast tissue, including the nipple and areola, as well as the axillary lymph nodes in the armpit.
  • Nipple-Sparing Mastectomy: This involves removing only the breast tissue while preserving the nipple and areola. It is often combined with breast reconstruction to achieve a natural-looking breast.


During a mastectomy, the surgeon makes an incision in the breast and removes the breast tissue according to the type of mastectomy being performed. In some cases, sentinel lymph node biopsy or axillary lymph node dissection may also be performed during the procedure to check for cancer spread to the lymph nodes.

Risks and Benefits:

The risks associated with mastectomy are quite similar to those we have discussed above for lumpectomy. These risks can include bleeding, infection, pain, scarring, and changes in breast shape or size. It is important to note that mastectomy is a more extensive surgical procedure, and therefore, the potential risks associated with it may be elevated compared to lumpectomy.

Recovery and Follow-up Care:

Recovery after mastectomy will vary depending on the type of mastectomy you have and your individual factors, but it typically takes 4-8 weeks to completely get back on track. Your healthcare provider will likely prescribe pain medication to help manage post-operative discomfort. You may also need wound care and drainage tubes to be inserted to aid in healing.

Additionally, physical therapy and exercises may be recommended to help restore the range of motion and strength in your affected arm. This can include gentle movements and exercises to gradually increase your arm's mobility and strength. It's essential to follow your healthcare provider's recommendations and guidelines for physical therapy and exercises to avoid any strain or injury.

Lymph Node Surgery

Lymph node surgery involves the removal and analysis of lymph nodes to determine if they contain abnormal cells or indicate the spread of disease.

Lymph node surgery begins with a careful examination of the lymph nodes to assess their size, texture, and overall appearance. In some cases, imaging techniques such as ultrasound, computed tomography (CT), or positron emission tomography (PET) scans may be used to identify enlarged or suspicious lymph nodes.

Once the need for lymph node removal is determined, you will undergo a surgical procedure. This is usually performed under general anesthesia to ensure your comfort throughout the operation. Your surgeon will make an incision in the area near the affected lymph nodes, providing access to the targeted region.

The number of nodes removed depends on the specific medical indication and the extent of lymph node involvement.

Types of Lymph Nodes Surgery

There are two main types of lymph node surgeries commonly performed: Sentinel Lymph Node Biopsy (SLNB) and Axillary Lymph Node Dissection.

Let's delve into each of these procedures in detail:

Sentinel Lymph Node Biopsy (SLNB):

Sentinel Lymph Node Biopsy is a minimally invasive procedure used to identify the first lymph nodes that cancer cells are most likely to spread to, known as the sentinel nodes. This technique allows healthcare providers to assess the extent of lymph node involvement while minimizing the need for more extensive lymph node removal. Here's an overview of the procedure:

  1. Preoperative Mapping: Before surgery, your healthcare team will inject a radioactive tracer and/or a blue dye near the tumor site. These substances will help identify the lymphatic pathways leading to the sentinel nodes.
  2. Localization and Removal: During surgery, your surgeon will use specialized tools and techniques to locate and remove the sentinel nodes. This is typically achieved through a small incision in the area near the tumor.
  3. Pathological Examination: The excised sentinel nodes are sent to the lab for detailed examination by a pathologist. They will examine the nodes under a microscope to determine if cancer cells are present, providing crucial information for staging and treatment decisions.

Sentinel Lymph Node Biopsy offers several benefits compared to more extensive lymph node surgeries. It is associated with smaller incisions, reduced risk of complications, faster recovery times, and fewer long-term side effects. By targeting the specific lymph nodes most likely to contain cancer cells, SLNB allows for accurate staging while minimizing unnecessary lymph node removal.

Axillary Lymph Node Dissection:

Axillary Lymph Node Dissection involves the removal of a greater number of lymph nodes from the axillary (underarm) region. This procedure is performed to provide a more comprehensive evaluation of lymph node involvement in cases where there is suspicion or evidence of cancer spread to the lymph nodes. Here's an overview of the procedure:

  1. Incision and Lymph Node Removal: Your surgeon will make an incision in the underarm area and carefully dissect and remove a varying number of lymph nodes, depending on the extent of lymph node involvement and the specific medical indication.
  2. Pathological Examination: The removed lymph nodes will be sent to the lab for thorough pathological examination. A pathologist will examine the nodes under a microscope to determine if cancer cells are present and assess the extent of lymph node involvement.

Axillary Lymph Node Dissection provides a more comprehensive assessment of lymph node involvement but may carry a higher risk profile compared to Sentinel Lymph Node Biopsy. It is often performed in conjunction with other breast cancer surgeries, such as lumpectomy or mastectomy, to determine the stage of cancer and guide further treatment decisions.

The specific type of lymph node surgery recommended for you will depend on various factors, including the stage of your condition, the location and extent of lymph node involvement, and other individual considerations. Your healthcare provider will thoroughly evaluate your case and discuss the most appropriate approach tailored to your needs.

Comparisons and Decision-Making in Breast Cancer Surgery

When considering breast cancer surgery, you and your healthcare provider will carefully assess various factors to determine the most suitable treatment approach. These factors include tumor size and location, cancer stage and lymph node involvement, personal preferences and goals, medical and health considerations, and a multidisciplinary approach involving input from different healthcare professionals.

The size and location of the tumor may influence the type of surgery recommended. Lumpectomy is typically recommended for smaller tumors, while mastectomy may be necessary for larger tumors or when multiple tumors are present. Lymph node dissection may be performed to determine the stage of breast cancer or assess lymph node involvement.

Your personal preferences and goals are important in the decision-making process. Some patients may prefer breast-conserving surgery (lumpectomy) to preserve the appearance of their breasts, while others may opt for mastectomy for peace of mind and to reduce the risk of cancer recurrence. Axillary lymph node dissection may be recommended but also carries potential risks and complications.

Other medical and health considerations, such as your overall health status, age, presence of other health conditions, and potential risks and benefits of each surgical option, should also be taken into account. Breast cancer treatment often involves a multidisciplinary approach with input from various healthcare professionals.

In short, it is crucial to have open and honest discussions with your healthcare provider about the different surgical options, their potential risks and benefits, and how they align with your personal preferences and overall health. Your healthcare provider can provide you with the necessary information and guidance to make the best decision for your specific situation.

Who Treats Breast Cancer?

At the BASS Cancer Center, we have a team of highly trained and experienced doctors who specialize in treating breast cancer. Our team of experts is dedicated to providing personalized care to meet the unique needs of each patient. 

With our multidisciplinary approach, we bring together specialists from various fields, including surgical oncologists, medical oncologists, radiation oncologists, and other healthcare professionals, to provide comprehensive and coordinated care.

Our doctors have extensive experience in diagnosing and treating breast cancer at different stages, from early to advanced cases. They stay updated with the latest advancements in breast cancer treatment and utilize state-of-the-art technology and techniques to deliver the best possible care to our patients.

At the BASS Cancer Center, our success rate in treating breast cancer is high, and we are committed to achieving the best possible outcomes for our patients. We strive to provide compassionate care, personalized treatment plans, and ongoing support to our patients throughout their breast cancer journey.

If you or a loved one has been diagnosed with breast cancer, trust our team of skilled doctors to provide exceptional care. Contact us today to schedule a consultation and learn more about how we can help you in your fight against breast cancer.

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Danielle Burtoni
Danielle Bertoni, MD, MPH
Breast Cancer Surgeon in Walnut Creek at BASS Cancer Center
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Specializing in Breast Cancer Treatments, helping thousands of breast cancer patients fight and eliminate their breast cancer for good.

You don’t fight breast cancer alone, Dr. Bertoni is here for you to help with you fight against cancer.

Danielle Bertoni, MD, MPH, is a breast surgeon at BASS Cancer Center who specializes in breast surgical oncology.

She has a reputation for using breast conservation techniques, performing nipple-sparing mastectomies and a wide range (and type) of breast biopsies and surgery for benign conditions, such as fibroadenomas and atypia, with successful cosmetic results. She also has expertise in management of the axilla and is passionate about reducing long term complications and focusing on survivorship.

Dr. Bertoni’s mother, grandmother, aunt and cousins have all had breast cancer, and that helped inspire her to become a breast surgeon. “I wanted to be in a field where I could help women get through this difficult time in their lives with as much comfort, reassurance and ease as possible. I wanted to be there to ‘hold their hand’ through the process,” she says.

Dr. Bertoni believes in making the patient the central focus of a team of doctors, nurses, social workers and other providers. Highly personalized care is important, she says, adding that she takes into account not only the patient’s diagnosis, but also their personal values and beliefs while guiding them through the process. “I take ownership of my patients,” she says. “This is a long-term relationship.”

Dr. Bertoni is passionate about providing the highest quality, most up to date and timely care to all of her patients. She supports participation in clinical trials if patients desire and will help patients with this. She is passionate about continuing to improve care and outcomes for patients with breast cancer. She is also an expert in caring for high risk patients with family history of breast and ovarian cancer and high risk breast lesions. She encourages all women to be proactive in talking with their doctor about any breast health questions or concerns.

Annual mammograms are key, as are ultrasounds if the doctor recommends them, she says.

Any woman who has multiple family members with breast or ovarian cancer should bring that history to their doctor’s attention, and ask how it might impact their personal risk or eligibility for genetic testing or special screening, she adds.

What Dr. Bertoni's Breast Cancer patients are saying...

"Dr. Danielle Bertoni was the Surgeon for my mom. Dr. Bertoni is the full package when it comes to being a doctor. She's very knowledgeable, personable and professional. She's a good listener and she made sure that we understood the process for surgery and after surgery. When we had questions she made sure that she called us back. This entire experience has been excellent from the front desk to the visit with Dr. Bertoni. My mom and I value and appreciate Dr. Bertoni."

"She was very warm and understanding, she never downplayed what I felt or what I was going through. She was very thorough and explained everything with intricate details. She was very compassionate and very optimistic with the perfect pinch of a realist as well. Overall I felt like Dr. Bertoni treated me with the utmost compassion and respect."

"Dr. Bertoni could be the best, most caring, nicest doctor we've ever worked with. We were presented with a very scary life/death stage 3 cancer diagnoses. Dr Bertoni worked with us day and night keeping us informed and updated as to what we should be expecting. She set our expectations and got us through the toughest experience in our lives. We will never forget her for the rest of our lives. We HIGHLY recommend her."


Frequently Asked Questions for Breast Cancer

Everything you need to know about Breast Cancer Surgery
What are the different types of Breast Cancer surgeries?
The different types of breast cancer surgeries include lumpectomy (breast-conserving surgery), mastectomy (removal of the entire breast), and lymph node surgery (such as sentinel lymph node biopsy or axillary lymph node dissection), depending on the stage and extent of the cancer.
What is the recovery process like after breast cancer surgery?
The recovery process after breast cancer surgery varies, but it generally involves managing post-operative discomfort, monitoring the surgical site for infection, gradually resuming normal activities, and potentially under going additional treatments like radiation therapy or chemotherapy.
What are the potential risks and complications associated with breast cancer surgery?
Potential risks and complications of breast cancer surgery may include bleeding, infection, pain, scarring, changes in breast shape or size, loss of sensation, lymphedema (swelling in the arm), and rare complications like seroma (fluid buildup) or hematoma (blood clot).
How will breast cancer surgery affect the appearance and sensation of my breast?
Breast cancer surgery can impact the appearance and sensation of the breast. Lumpectomy may cause minimal changes, while mastectomy results in the complete removal of breast tissue. Reconstruction options can help restore breast shape, and sensations may vary depending on the extent of surgery.
How long will I need to stay in the hospital after surgery?
The length of hospital stay after breast cancer surgery varies based on the specific procedure and individual circumstances. It can range from a same-day discharge for certain lumpectomies to a few days for more extensive surgeries like mastectomy or lymph node dissection.
Are there alternative treatments or therapies available instead of surgery?
Alternative treatments or therapies, such as targeted therapy, chemotherapy, radiation therapy, or hormonal therapy, may be considered based on the specific characteristics of breast cancer. However, the appropriateness of alternatives to surgery depends on individual factors and should be discussed with the healthcare provider.

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