Breast cancer surgery

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Mayo Clinic's approach

Surgeons in an operating room

Experienced surgeons perform breast cancer operations at Mayo Clinic.

Mayo Clinic's highly trained breast cancer surgeons work in coordinated surgical teams using the latest advances to care for people with breast cancer and those with a high risk of developing the disease in the future.

Your Mayo Clinic care team

People with breast cancer who choose Mayo Clinic for breast cancer surgery will find highly experienced surgeons who provide expert care. Breast cancer surgeons work closely with other specialists to create a personalized treatment approach that provides you with comprehensive care.

Your care team might include:

Your appointments will be coordinated so that you can carefully consider your options and meet with a variety of specialists, often in a matter of days. If you choose surgery as your initial treatment, your operation is scheduled promptly, when possible, to avoid long wait times.

Surgeon meeting with a patient

Mayo Clinic surgeons provide compassionate care for people with breast cancer.

Expert care by world-class surgeons

Mayo Clinic breast cancer surgeons are highly trained and experienced. At Mayo Clinic:

  • More than 12,000 people seek breast cancer care each year.
  • Nearly 1,000 people undergo breast cancer surgery each year.

Research shows that people who are treated for breast cancer at medical centers that treat many cases of breast cancer have better outcomes than do people treated at medical centers that treat breast cancer less frequently.

Breast cancer surgeons draw on their extensive training to use the latest surgical techniques to provide expert care for:

Surgeons in an operating room

Mayo Clinic breast cancer surgeons use the latest operative techniques.

Advanced surgical techniques

Mayo Clinic breast cancer surgeons are trained in the latest operations and technology used to perform lumpectomy and mastectomy, including:

  • Nipple-sparing mastectomy for cancer prevention and cancer treatment.
  • Evaluating breast tumors during surgery using techniques such as intraoperative pathology and frozen section analysis to ensure all the cancer is removed and reduce the need for additional surgery.
  • Immediate breast reconstruction using operative techniques such as immediate implant reconstruction, when appropriate, and reconstruction using excess breast skin and fatty tissue (sometimes called a Goldilocks mastectomy) or total fat grafting.
  • All types of breast reconstruction using implants and your own tissue (flap surgery), including technically demanding microsurgical procedures that spare your muscle tissue such as deep inferior epigastric perforator (DIEP) flap surgery.
A surgeon discussing a case with a colleague

Mayo Clinic surgeons are working to improve outcomes for people with breast cancer.

Innovations in breast cancer surgery

Mayo Clinic surgeons are improving the outcomes of breast cancer surgery by creating treatments that are:

  • Reducing the time involved in treatment so you can return to daily life sooner. For example, immediate breast reconstruction combines mastectomy and reconstruction in one procedure. Lumpectomy with accelerated partial breast irradiation allows you to complete surgery and radiation therapy in less than two weeks.
  • Improving your confidence in your appearance by combining the best techniques for cancer control with approaches that maximize the natural appearance of your breasts (oncoplastic surgery). Examples include lumpectomy procedures that include breast lift and breast reduction.
  • Controlling pain after mastectomy to reduce the need for strong pain medicine by providing nonnarcotic medicines before surgery, placing long-acting anesthetic in the surgical site, and using massage and other integrative medicine techniques during recovery.
  • Reducing the risk of lymphedema by devising effective chemotherapy and hormone therapy regimens that can be used before surgery to reduce the need for lymph node dissection, routinely using sentinel node biopsy to test whether cancer has spread to the lymph nodes, and identifying the nodes vital to lymph drainage in the arms (axillary lymph node mapping).

Mayo Clinic breast surgeons are leaders in breast cancer and breast surgery research. This allows patients to receive the latest in treatment advances.

Expedited breast cancer treatment — brachytherapy

Jane Brandhagen: It was a shock, you know. I was already in my mind picking out wigs and thinking how much longer I'd have here. I was terrified.

Dennis Stoda: Jane Brandhagen was facing the news one in eight women will hear-- she had breast cancer. Her yearly mammogram had revealed a small tumor. She wanted to treat it very aggressively and wanted to wrap up her treatments as quickly as possible.

Jane Brandhagen: I could have gone with a full-out double mastectomy, and then I would be done.

Dennis Stoda: Mayo Clinic surgeon Dr. Tina Hieken says it's the main decision breast cancer patients have to make, to remove the entire breast in a mastectomy or have breast preserving surgery. Because Jane's cancer was caught early, Dr. Hieken says she was a good candidate for a new option which would also reduce her entire treatment to just a matter of days.

Tina J. Hieken, M.D., Breast/Melanoma Surgery, Mayo Clinic: So for those patients who have no evidence of disease in the lymph node and have small tumors that are completely removed with a lumpectomy, they leave the operating room with a catheter in place. It's an outpatient procedure.

Sean Park, M.D., Ph.D., Radiation Oncology, Mayo Clinic: So this is a breast model with the brachytherapy catheter device inserted into the lumpectomy cavity.

Dennis Stoda: Called brachytherapy, the catheter delivers the necessary follow-up radiation treatments internally in a fraction of the time of standard external radiation therapy.

Dr. Park: Treatments are done over five week days, twice a day, approximately six hours apart for a total of 10 treatments.

Dennis Stoda: Brachytherapy itself is not new, but patients routinely have to wait two to four weeks for a second surgery to implant the catheter, because that can't happen until a pathology report comes back saying it's OK to proceed. So Dr. Park and Dr. Hieken designed a treatment regimen to eliminate the waiting time by using a single surgery. First, special dyes are injected to identify any cancer cells that may have spread beyond the tumor site or to the lymph nodes under the arm. That allows a pathologist to immediately screen the lymph nodes and a safe margin of tissue removed from around the tumor while the patient is still under anesthesia. Once the all-clear is given, the surgery continues with a second incision to insert the brachytherapy catheter and expand it, filling the lumpectomy cavity. The very next day, the patient's radiation plan is mapped out during a simulation. The following morning, the brachytherapy begins using a computer-controlled robotic machine which manipulates a single radioactive seed smaller than a grain of rice within the implanted catheter.

Dr. Park: The radioactive seed will travel through the cable into the patient, into the catheter, and stop at different locations that we program it to for a different amount of time, and that shapes the radiation dose.

Dennis Stoda: Unlike externally-delivered radiation, Dr. Park says brachytherapy is delivered more precisely to the target area without passing through healthy tissue.

Dr. Park: Meaning the breast tissue, the chest wall, lung tissue, for left-sided cancer patients, importantly, the heart tissue.

Dennis Stoda: It's hoped the expedited brachytherapy option encourages more women to receive the full benefit of their recommended post-surgery radiation, particularly those living far from a treatment center.

Dr. Hieken: So with standard therapy, they're driving a couple hundred miles round trip each day for three, four, or six weeks. The actual rate of completing the radiation may be as low as 60% or 70%.

Dennis Stoda: Jane says she leaped at the chance to be part of a pilot study that completed her brachytherapy in just three sessions.

Jane Brandhagen: So from Monday to Friday, five days, that was surgery and radiation all in five days, which I think is amazing.

Dennis Stoda: Jane and other patients in the study will continue to be followed for five years to verify that their long-term health and survival is just as good as those receiving standard radiation procedures. For the Mayo Clinic News Network, I'm Dennis Stoda.

Expertise and rankings

Breast cancer surgeon discusses options with patient

Mayo Clinic breast cancer surgeons are widely respected for their experience and knowledge in advanced surgical techniques that improve cancer control and reduce the complications of breast cancer surgery.

Nationally recognized expertise

Outside organizations recognize Mayo Clinic breast cancer specialists through accreditations, grants and rankings:

  • Mayo Clinic Comprehensive Cancer Center meets the strict standards for a National Cancer Institute comprehensive cancer center. These standards recognize scientific excellence and a multispecialty approach focused on cancer prevention, diagnosis and treatment.
  • Mayo Clinic is accredited by the American College of Surgeons' Commission on Cancer.
  • Mayo Clinic is one of a select group of medical centers in the United States to be recognized as a Specialized Program of Research Excellence (SPORE) for breast cancer research, funded by the National Cancer Institute. To earn a highly competitive SPORE grant, institutions must demonstrate a high degree of collaboration between first-rate scientists and clinicians and show excellence in translational research projects. Learn more about the Mayo Clinic Breast Cancer SPORE.
  • Mayo Clinic doctors and researchers participate in research cooperatives, such as the Alliance for Clinical Trials in Oncology, which gives people with cancer access to the latest clinical trials.

Mayo Clinic in Rochester, Minnesota, Mayo Clinic in Jacksonville, Florida, and Mayo Clinic in Phoenix/Scottsdale, Arizona, are ranked among the Best Hospitals for cancer by U.S. News & World Report. Mayo Clinic in Rochester, Minnesota, is ranked as the top hospital in Minnesota, Mayo Clinic in Phoenix/Scottsdale, Arizona, is ranked as the top hospital in Arizona, and Mayo Clinic in Jacksonville, Florida, is ranked the top hospital in Florida.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

For more information on visiting Mayo Clinic, choose your location below:

Mayo Clinic's campus in Arizona

Mayo Clinic's campus in Florida

Mayo Clinic's campus in Minnesota

Mayo Clinic Health System

Mayo Clinic Healthcare, located in London

Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.

More information about billing and insurance:

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By Mayo Clinic Staff
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Doctors & Departments
April 10, 2024
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  1. Townsend CM Jr, et al. Diseases of the breast. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed Oct. 10, 2023.
  2. Breast cancer. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1419. Accessed Oct. 10, 2023.
  3. Breast cancer. Cancer.Net. https://www.cancer.net/cancer-types/breast-cancer/view-all. Accessed Oct. 20, 2023.
  4. Klimberg VS, et al., eds. Bland and Copeland's The Breast: Comprehensive Management of Benign and Malignant Diseases. 6th ed. Elsevier; 2024. https://www.clinicalkey.com. Accessed Oct. 10, 2023.
  5. Health Education & Content Services. Breast cancer guide. Mayo Clinic; 2017.
  6. After your operation. American College of Surgeons. https://www.facs.org/for-patients/home-skills-for-patients/breast-cancer-surgery/after-your-operation. Accessed Oct. 20, 2023.
  7. Jakub JW, et al. Oncological safety of prophylactic nipple-sparing mastectomy in a population with BRCA mutations. JAMA Surgery. 2018; doi:10.1001/jamasurg.2017.3422.
  8. Koelmeyer LA, et al. Risk factors for breast cancer-related lymphedema in patients undergoing 3 years of prospective surveillance with intervention. Cancer. 2022; doi:10.1002/cncr.34377.
  9. Fahy AS, et al. Paravertebral blocks in patients undergoing mastectomy with or without immediate reconstruction provides improved pain control and decreased postoperative nausea and vomiting. Annals of Surgical Oncology. 2014; doi:10.1245/s10434-014-3923-z.
  10. Armstrong VL, et al. The impact of same-day discharge and enhanced recovery on patient quality of life after mastectomy with implant reconstruction. Annals of Surgical Oncology. 2023; doi:10.1245/s10434-022-13019-5.
  11. Hieken TJ, et al. The breast tissue microbiome, stroma, immune cells and breast cancer. Neoplasia. 2022; doi:10.1016/j.neo.2022.100786.
  12. Breast SPOREs. National Cancer Institute. https://trp.cancer.gov/spores/breast.htm. Accessed Oct. 23, 2023.
  13. Ami TR. Allscripts EPSi. Mayo Clinic. Jan. 31, 2023.
  14. Ami TR. Allscripts EPSi. Mayo Clinic. April 5, 2023.
  15. McDermott AM, et al. Surgeon and breast unit volume-outcome relationships in breast cancer surgery and treatment. Annals of Surgery. 2013; doi:10.1097/SLA.0b013e3182a66eb0.
  16. Gray RJ, et al. Intraoperative margin management in breast-conserving surgery: A systematic review of the literature. Annals of Surgical Oncology. 2018; doi:10.1245/s10434-016-5756-4.
  17. Young WA, et al. Outcomes of >1300 nipple-sparing mastectomies with immediate reconstruction: The impact of expanding indications on complications. Annals of Surgical Oncology. 2019; doi:10.1245/s10434-019-07560-z.
  18. Manrique OJ, et al. Immediate breast reconstruction using the Goldilocks procedure: A balance between more surgery and patient satisfaction. Plastic and Reconstructive Surgery. 2022; doi:10.1097/PRS.0000000000008895.
  19. Hieken TJ, et al. A novel treatment schedule for rapid completion of surgery and radiation in early-stage breast cancer. Annals of Surgical Oncology. 2016; doi:10.1245/s10434-016-5321-1.
  20. Kim H, et al. Long-term outcomes of intraoperatively-placed applicator brachytherapy for rapid completion of breast conserving treatment: An analysis of prospective registry data. Clinical and Translational Radiation Oncology. 2023; doi:10.1016/j.ctro.2023.100639.
  21. Kaufman CS, et al. Oncoplastic breast surgery. https://www.uptodate.com/contents/search. Accessed Oct. 26, 2023.
  22. Abdelsattar JM, et al. Comparative study of liposomal bupivacaine versus paravertebral block for pain control following mastectomy with immediate tissue expander reconstruction. Annals of Surgical Oncology. 2016; doi:10.1245/s10434-015-4833-4.
  23. Drackley NL, et al. Effect of massage therapy for postsurgical mastectomy recipients. Clinical Journal of Oncology Nursing. 2012; doi:10.1188/12.CJON.121-124.
  24. Manrique OJ, et al. Overview of lymphedema for physicians and other clinicians: A review of fundamental concepts. Mayo Clinic Proceedings. 2022; doi:10.1016/j.mayocp.2020.01.006.
  25. Hospitals and facilities. American College of Surgeons. https://www.facs.org/hospital-and-facilities. Accessed Oct. 26, 2023.

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Breast cancer surgery