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Top 5 Breakthroughs in Breast Cancer Surgery

Cleveland Clinic
Stephen Grobmyer, MD

If there’s a common theme among the many breakthroughs in breast cancer surgery, it’s less and fewer.

Thanks to advances such as the ones below, woman can have surgical treatment with fewer side effects, fewer procedures required, less recovery time and less risk. Best of all, these advances make treatment more effective than ever.

1. Nipple-sparing mastectomy

In the past, most women who wanted to have breast reconstruction required additional procedures to recreate the nipple. That has changed thanks to nipple-sparing mastectomy.

For selected patients, surgeons can safely remove diseased breast tissue while saving both the nipple and skin of the breast. This approach makes breast reconstruction more effective and simpler. And because it is often done through small incisions, it minimizes scarring.

For selected patients, surgeons can safely remove diseased breast tissue while saving both the nipple and skin of the breast.

2. Better lymph node surgery

In the old days, we removed all of the lymph nodes under the arm for patients with breast cancer. Now we often can remove only a few nodes and still achieve excellent results. The process is called sentinel node biopsy.

This is a major advance because it reduces the chances of lymphedema, the arm swelling that affects many women after surgery. The fewer nodes we remove, the lower the risk of swelling.

3. Radiation during surgery

Women with early-stage breast cancer are benefitting from a combination of surgery and what we call intraoperative radiation therapy (IORT). The idea: They get a single dose of radiation during surgery rather than multiple doses over time. (See video below.)

For women, this means reduced recovery time — from weeks to days — and fewer side effects. For the healthcare system, it means a procedure that costs much less than traditional treatment without losing any of the effectiveness. In 80 percent of patients who undergo the procedure, one dose is all that’s needed to minimize the chance of recurrence of cancer.

4. Shrinking tumors before surgery

The concept here is simple — reduce the size of a tumor, and surgery gets easier for both the patient and the surgical team.

Advances in chemotherapy allow us to treat many women effectively before surgery. When treatment successfully shrinks a tumor, both the time and extent of surgery are reduced.

5. Advances in breast reconstruction

When a woman requires a mastectomy, her biggest questions often relate to what comes next. Advances in breast reconstruction provide answers.

In select cases, surgeons can even begin the reconstruction process at the same time as a mastectomy. There are many options, from implant-based reconstruction to surgeries that use a woman’s own tissue. The choice you make will depend on your specific case and careful consultation, but know this: You have options.

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