Breast Cancer Surgery: What You Need To Know

A breast cancer diagnosis can feel overwhelming — but there’s never been more reason to feel hopeful. With major advances in surgery, imaging and individualized care, most women have more options than ever for treatment and recovery.

For many, the journey begins after a routine mammogram, ultrasound or MRI shows something unusual, like a lump.

“Not every lump is something serious,” said Constanze Rayhrer, MD, FACS, a board-certified general surgeon who specializes in breast surgery at Franciscan Physician Network Breast Surgery Lafayette. “Most of the time, imaging abnormalities turn out to be noncancerous,” she said. “But we never want to miss the cancerous ones.”

The next step is typically a minimally invasive biopsy to determine exactly what the area is.

“We numb the breast and take a needle sample of the area to figure out what it is,” she explained.

At Franciscan Health, women facing breast cancer receive care from a team of specialists who understand both the medical and emotional weight of the diagnosis. Hearing the words ‘you have breast cancer’ is life-changing. It can stir up fear, uncertainty and a flood of questions. But you don’t have to go through it alone.

“Franciscan created a safe and supportive place where women feel cared for and confident in their treatment,” Dr. Rayhrer said.

What Are My Surgery Options After A Breast Cancer Diagnosis?

Thanks to decades of research and improved surgical techniques, most women today are eligible for breast-conserving surgery. One common option is a lumpectomy. A lumpectomy removes the tumor and a small rim of healthy tissue around it — while leaving most of the breast intact.

“We remove the area with the tumor and a little rim of normal tissue around it to make sure we get the cancer cells,” Dr. Rayhrer said.

A lumpectomy often has very little impact on appearance or function.

“That’s outpatient surgery — so minimal surgery, minimal impact on the body,” she said.

Specialists determine what other treatments you may need after lumpectomy to prevent the cancer from coming back. In some cases, your doctors may recommend or choose a mastectomy — removal of the entire breast.

“It can be a woman’s choice to choose this approach instead, and in some circumstances, it’s what’s required,” said Dr. Rayhrer. “It all depends on your preference and medical needs. We can combine a mastectomy with reconstruction surgery.”

Deciding between lumpectomy and mastectomy is deeply personal. Your team will guide you through the options, answering every question along the way.

Why Are Lymph Nodes Checked During Surgery?

During surgery, doctors often check whether the cancer has spread to nearby lymph nodes. This information helps guide treatment planning.

The approach has changed over the last two decades. Instead of removing multiple nodes, today’s surgeons use a more targeted technique called sentinel node biopsy.

“We usually don’t have to remove a group of lymph nodes,” said Dr. Rayhrer. “We remove a single lymph node called a sentinel node from the armpit.”

A sentinel node biopsy helps confirm whether cancer has spread — and reduces unnecessary surgery. The approach lowers the risk of complications and side effects, like lymphedema, which causes swelling, usually in the arm, due to the buildup of lymph fluid. While not everyone will develop side effects, your care team will help you understand what to watch for and how to manage recovery.

What Can I Expect Before And After Breast Cancer Surgery?

Most lumpectomies are outpatient procedures.

“You arrive in the morning, we perform the surgery — which is usually less than two hours — and then you go home the same day,” Dr. Rayhrer explained.

Recovery from a lumpectomy is especially quick. Advances in technology and surgical approaches over the years have been a powerful way to keep from interrupting your life and give you the best treatment possible.

“One of our goals is to minimize the impact on your lifestyle,” said Dr. Rayhrer. “We want to do everything to keep you moving forward.”

Women who undergo a mastectomy may need a short hospital stay to begin recovery. While the procedure is still major surgery, it has become more refined and less physically limiting than in years past.

“There is a difference in the type of mastectomy we do today compared to that of 20 years ago,” she said. “Most women can shower the next day, move their arm, wear a bra and gradually return to their daily routine within a few days.”

Still, recovery after a mastectomy — physical and emotional — can take time.

Recovery looks different for everyone, and the care team works closely with each patient to manage pain, mobility and emotional healing. The goal is to help every woman move forward with strength, support and the tools she needs to heal.

Is Breast Reconstruction Surgery An Option?

Yes, and it’s covered by insurance. The law mandates insurance cover any reconstruction.

“As breast surgeons, we work closely with specialists in breast reconstructive surgery to create a personalized plan,” Dr. Rayhrer said.

A reconstruction plan is based on your goals, medical needs and preferences.

“It’s a full conversation beforehand,” Dr. Rayhrer said, “and we can customize our surgical management and reconstruction to you.”

But breast reconstruction isn’t right for everyone, and it’s OK to take time with the decision. Your team will help you consider all the options at your own pace.

Will I Need Radiation And Chemotherapy?

We often recommend radiation therapy after a lumpectomy to help reduce the risk of the cancer returning.

“You can think of it a little bit like having the surgery — it’s focused at the area where the tumor was, not the whole body,” said Dr. Rayhrer.

Radiation therapy usually begins a month after the surgery. It’s evolved significantly, even over the last five years. It’s now more precise and causes less damage to surrounding tissues.

Chemotherapy is a medication given intravenously to treat cancer throughout the body. We may start chemotherapy before surgery to help reduce the tumor size and minimize the surgery needed. We can also give chemotherapy after surgery and in combination with radiation therapy.

“It’s very specific to the needs of each patient. We reserve chemotherapy for the more aggressive cancers, and not everybody needs it,” Dr. Rayhrer explained. “There’s been so much research and energy poured into breast cancer that we now customize treatment using specific testing — even before surgery.”

A Team Approach Backed By Research

“At Franciscan, every woman has access to an incredible team that uses the latest technology to guide care,” said Dr. Rayhrer. “We have everything we need — including state-of-the-art treatment options — and we use it to make a real difference.”

A multidisciplinary team of surgeons, oncologists, radiation oncologists, plastic and reconstructive surgeons and nurse navigators guides your care. Your team coordinates every step to help you feel informed, supported and empowered.

“Our therapies have gotten so much better over the years,” Dr. Rayhrer said. “It’s exciting.”

If you or a loved one has been diagnosed with breast cancer, we’re here for you. Explore your options for breast cancer care at Franciscan Health, get a second opinion and meet our compassionate, expert team.