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Who is a breast surgeon?

A breast surgeon is a certified doctor specializing in diagnosing and surgically treating disorders affecting the breasts. Most of their work is focused on cancer in the breasts, including breast cancer surgery and surgical breast reconstruction. They are also commonly called breast cancer surgeons.

What is breast cancer surgery?

Breast cancer surgery is a primary method of treating most breast cancer cases. If the cancerous tumor is confined to a specific breast area, the doctor will mostly recommend breast cancer surgery. However, surgery is ineffective in metastatic breast cancer cases, where cancer has spread to different body parts. In such cases, the breast surgeon may suggest radiation therapy or chemotherapy as a cancer treatment.

Types of breast cancer surgeries

Here are the different types of breast cancer surgeries:

1. Lumpectomy:

A lumpectomy, called breast conservation surgery, removes only the tumor or cancer-affected breast tissue. It is mainly used to treat the earliest stage of breast cancer. At this point, the tumor is small and has not spread to different areas of the breast. The surgery removes the lump and a part of the surrounding tissue to ensure the breast is free of cancer cells.

Lumpectomies help the patient keep most of their breast. However, the doctor may also recommend radiation therapy after surgery to stop breast cancer recurrence.

Types of lumpectomy may include the following:

• Excisional biopsy: It helps remove the tumor or lump for biopsy. The lump is further analyzed to detect the presence of cancer cells.
• Wide local excision: This procedure removes the cancerous tumor and part of the surrounding tissue, which is then checked for cancer cells.
• Quadrantectomy: It is a segmental mastectomy that removes about a quarter of the breast and the duct-lobular system. It is done if the cancer has spread to the ductal area. 
• Re-excision lumpectomy: This procedure is performed when the surrounding tissue removed during the wide local excision procedure tests positive for cancer. In this case, the surgeon reopens the surgical site and removes additional surrounding tissue. It is done until the surrounding tissues are found to be cancer-free. 

2. Mastectomy

A mastectomy is also called breast removal surgery and mainly helps to treat early-stage and late-stage breast cancers. It is the most commonly performed surgery for breast cancer and involves part or total removal of breast tissue.

Different types of mastectomy include:

• Total mastectomy: The procedure is done to remove the entire breast, excluding the chest muscles.
• Double mastectomy: The surgery helps remove both the breasts. It may be required if the cancer has spread to both breasts or as a preventive measure.
• Nipple spring or skin-sparing mastectomy: The surgical procedure helps remove all the breast tissue, sparing the nipple and skin to reconstruct the breast.
• Modified radical mastectomy: It helps remove the underarm lymph nodes and the breast tissue, as the cancer cells often spread first to these lymph nodes. 
• Radical mastectomy: It is a rare surgery that involves the removal of the breast muscles, underarm lymph nodes, and breasts. The surgery is suggested only when the cancer cells have spread to the chest muscles.

3, Reconstructive breast surgery

Reconstructive surgery can help restore the breast shape if a breast or both breasts are removed during breast cancer treatment. A surgeon can help rebuild the breast immediately after a mastectomy or lumpectomy with the help of plastic surgery. For patients undergoing radiation or chemotherapy, the reconstructive surgery could be performed later once the tissues have healed completely.

Breast surgeons may recommend additional follow-up surgery after the primary surgery to improve the outcome. These surgeries can happen in stages. They use a combination of methods to adjust the balance and size between the breasts or to add a reconstructed nipple. The breast cancer surgeon near you may conduct a detailed physical examination of your condition and ask your preference to determine the most suitable surgery method. Different methods of breast reconstruction include the following:

• Implant reconstruction: An implant or breast implant is added to the affected area to restore volume and shape. It is a silicone shell implant filled with silicone gel or saline. The implant is placed under the muscle and covered with the skin. 
• "Flap" or autologous reconstruction: In this method, muscle tissues are taken from a different body part for breast reconstruction. Fat, muscles, and skin tissues from the buttocks or belly are best suited to replace the breast tissue. Sometimes, the surgeon may combine implant and flap reconstruction to achieve a more realistic result. 
• Nipple reconstruction: The nipple could be preserved and used later for breast reconstruction surgery. Surgeons can also recreate the nipple through a skin graft by taking skin from different body parts. Nipple reconstruction is usually a follow-up surgery after the breast reconstructive surgery.

4. Lymph node dissection

The lymph nodes are the first place where cancer begins to spread. If cancerous cells are present in the lymph nodes, it is a warning that the cancer is spreading to other body parts. The surgeon may remove the lymph nodes from under the arms and next to the affected breast and analyze them for the presence of cancer cells.

Different types of lymph node procedures may include the following:

• Sentinel lymph node biopsy: This investigative procedure detects cancer in the lymph node network. The sentinel lymph node is the first to filter fluids draining from the breast, so it is a good indicator of cancer in the nodes. The surgeon often performs the biopsy during or before the surgical removal of the tumor from the breast. The sentinel node is removed and analyzed for cancer cells. 
• Axillary lymph node dissection: If cancerous cells are detected in the sentinel node biopsy or if the surgeon believes that the patient has pervasive cancer in the lymph nodes, they may recommend removing a more significant portion of the lymph nodes for further analysis. In the axillary lymph node dissection, the surgeon removes a patch of fatty tissue under the arms containing a set of axillary lymph nodes. Then, the doctors carefully examine the tissues for signs of cancer cells. 

Types of breast implants: A guide to your options

When considering breast implants, it's essential to understand the nuances of the different types of implants available. Each type offers unique benefits and characteristics tailored to various needs and preferences.

You must consult a qualified breast surgeon near you to discuss your needs and preferences.

Here's a guide to help you navigate your options:

• Saline breast implants

Saline breast implants contain sterile salt water. If the implant shell leaks, it collapses, and the body absorbs and expels the saline. These implants offer a consistent shape, firmness, and feel. They are Food and Drugs Association (FDA)-approved for use in women aged 18 and above.

• Structured saline breast implants

Structured saline implants are also filled with sterile salt water but contain an inner structure designed to make the implant feel natural and authentic. This added structure can enhance the overall feel of the implant.

• Silicone breast implants

Silicone breast implants have silicone gel, which feels like natural breast tissue. If the implant leaks, the gel may stay within the implant shell or trickle down into the breast implant pocket. A leaking silicone implant will not collapse. Women who choose silicone implants may need regular visits to their plastic surgeon to ensure the implants are functioning correctly, often requiring an ultrasound or MRI screening. These implants are FDA-approved for augmentation in women aged 22 or older.

• Gummy bear breast implants

Often called form-stable implants, gummy bear implants retain their shape even if the shell breaks. The silicone gel inside these implants is thicker than in traditional silicone implants, making them firmer. Shaped gummy bear implants have more projection at the bottom and taper toward the top. If a shaped implant rotates, it can lead to an unusual appearance that might require correction through surgery. However, the placement of these implants requires a slightly longer incision.

• Round breast implants

Round breast implants make breasts appear fuller compared to form-stable implants. Higher profile options can provide even more projection. Since round implants have a uniform shape, they reduce the concern about implants rotating out of place.

• Smooth breast implants

Smooth breast implants are known for their soft feel. They can move in sync with the breast implant pocket, potentially offering more natural movement. However, they may have some palpable or visible rippling under the skin.

• Textured breast implants

Textured breast implants develop scar tissue that sticks to the implant, reducing the likelihood of the implant moving around inside the breast. This texturing can also help diminish the risk of a tight scar capsule.

Finding the best breast cancer surgeon near you

With Zocdoc, you can easily find the best and most experienced board-certified breast cancer surgeon in your vicinity. The process is simple: Create a free account on Zocdoc. Next, choose your specialty or condition, location, date, and insurance plan. A comprehensive list of doctors based on your search criteria will appear. 

Zocdoc has partnered with qualified, experienced providers who provide comprehensive advice and treatment. You can even use the Zocdoc insurance detector if you need clarification on your insurance plan. Each board-certified oncologist on Zocdoc has a profile that includes a brief introduction, education qualification, practice location, patient reviews, and visit reasons. Therefore, you know everything you need about a particular breast cancer surgeon on a single platform. 

After completing an appointment, Zocdoc asks the patient to leave a review. Therefore, the best way to find the most trusted breast cancer surgeons is to read updated patient reviews on Zocdoc. Filter your search results by gender if you're specifically looking for a female or male oncologist near you. 

You can also book video appointments on Zocdoc before an in-person visit to better understand your breast cancer surgeon. Look for a purple video icon on providers' profiles or filter the video appointment selection. You can now book real-time appointments with surgeons who accept your insurance plan.

To find a doctor who accepts your insurance, enter your insurance details (provider and plan) into the Zocdoc search. This step ensures you get precise results for in-network breast surgeons near you who accept your plan. For additional assistance with insurance and other queries, visit Zocdoc's patient help center.

All Zocdoc bookings are simple, secure, and free!

Statistics on breast cancer

According to the 2023 cancer estimates published by the Cancer Statistics Center, almost 300,590 new breast cancer cases and around 43,700 deaths were estimated in the country. About 297,790 new cases will be diagnosed in women. Nearly 55,720 new ductal carcinomas in situ cancer cases will be detected. California has the highest estimate of new breast cancer cases and deaths among all states in the country (32,020 and 4,680, respectively). Wyoming has the lowest estimate of new breast cancer cases and deaths (460 and 70, respectively). 

According to the 2023 data published by the American Cancer Society, about 13% of the country's women were at risk of acquiring invasive breast cancer in their lifetime. More than 4 million women in the country have a history of breast cancer (including completely treated and currently ongoing treatment cases). About 30% of all cancers identified in women are breast cancer cases. 

Sources

Cleveland Clinic

News Medical Life Sciences

American Cancer Society[1]

American Cancer Society[2]

BreastCancer.Org

Cancer Statistics Center

American Society of Plastic Surgeons

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 immediately.