Breast Cancer is the most common cancer affecting women in Singapore. According to the Singapore Cancer Registry, over 13,000 new breast cancer diagnosis were made between 2018-2022 (over 29% of all cancer diagnosis in women). Breast cancer is also the most common cause of cancer deaths in women, account for over 17% of cancer deaths in women over the same period. The lower proportion may be attributable to the effect of national screening efforts, as well as to advances in breast cancer treatment. When it comes to breast cancer treatment, surgery remains a key modality. There are today several breast cancer surgery options available. Each type has its advantages, and their suitability will depend on the type of cancer, its stage, and the patient’s personal needs. Choosing the right surgery is a decision influenced by medical advice, overall health, and patient preference. This article explores the main types of surgery for breast cancer, their suitability, and the pros and cons of each approach.
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What Are The Surgeries For Treatment Of Breast Cancer?
Lumpectomy (Breast Cancer Surgery That Conserves The Breast)
A lumpectomy is also known as breast-conserving surgery that aims to preserve as much of the natural breast as possible. It involves removing only the tumour and a small margin of surrounding healthy tissue.
When It Is Suitable:
- For women with early-stage breast cancer.
- When the tumour is relatively small compared to the overall breast size.
- Often paired with radiotherapy to ensure that any remaining cancer cells are destroyed.
Pros:
- This type of breast cancer surgery allows the retention of the appearance and sensation of the breast.
- Shorter surgery and recovery time compared to mastectomy.
- Lower psychological impact as the breast is preserved.
Cons:
- Usually requires follow-up radiotherapy, which involves multiple hospital visits.
- Slightly higher risk of local recurrence compared to mastectomy.
- Not suitable for patients with multiple tumours or large tumour-to-breast size ratios.
Mastectomy Breast Cancer Surgery
A mastectomy involves the removal of the entire breast. It is sometimes necessary to achieve complete cancer control.
When It Is Suitable:
- In cases of large tumours or multiple tumours within the same breast.
- When there is widespread or recurrent breast cancer.
- If a patient is at high genetic risk (e.g., BRCA mutation carriers) and prefers preventive surgery.
Pros:
- Reduces the risk of recurrence significantly compared to lumpectomy.
- Radiotherapy may not be required in certain cases.
- Option for breast reconstruction is available.
Cons:
- Loss of the whole breast can be emotionally and physically challenging.
- Longer recovery time compared to breast-conserving surgery.
- May affect body image and self-confidence.
Surgeries For Diagnostic / Investigative Purposes
Sentinel Lymph Node Biopsy
The objective of this procedure is to check if cancer has spread beyond the breast. It removes only the first few lymph nodes into which a tumour drains (sentinel nodes) for testing.
When It Is Suitable:
- For patients with early-stage breast cancer.
- When there is no evidence of lymph node involvement on scans.
Pros:
- Minimally invasive compared to full lymph node removal.
- Fewer side effects such as swelling (lymphoedema).
Cons:
- If cancer is found in sentinel nodes, a second surgery may be needed.
- May still cause mild swelling or numbness in the arm.
Axillary Lymph Node Dissection
When cancer has spread to multiple lymph nodes, a full axillary dissection may be required, involving the removal of several nodes under the arm.
Pros:
- Provides a clearer picture of how far cancer has spread.
- Helps guide further treatment decisions.
Cons:
- Higher risk of lymphoedema, pain, and restricted arm movement.
- Longer recovery and greater physical impact than sentinel node biopsy.
Breast Cancer Surgery For Quality Of Life
Breast Reconstruction Surgery
For women undergoing mastectomy, breast reconstruction surgery can restore the breast’s shape and appearance. Reconstruction can be performed using implants or tissue from other parts of the body (autologous reconstruction).
When It Is Suitable:
- Immediately after mastectomy (immediate reconstruction).
- Months or years later (delayed reconstruction).
Pros:
- Restores body image and confidence.
- Can achieve natural-looking results.
Cons:
- More complex surgery with longer recovery.
- May involve multiple procedures.
- Potential complications such as infection or implant issues.
Choosing The Right Breast Cancer Surgery
The choice of breast cancer surgery depends on several considerations:
- Stage and type of cancer.
- Breast size relative to tumour size.
- Overall health and presence of other conditions.
- Desire for breast preservation or reconstruction.
- Willingness to undergo radiotherapy or additional treatment.
In Singapore, multidisciplinary cancer teams work closely with patients to ensure the best possible outcomes. Decisions are made with both medical effectiveness and personal preferences in mind, empowering women to feel confident in their treatment journey.
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Frequently Asked Questions (FAQs)
Not always. Surgery is often the main treatment for breast cancer, but in some cases, other therapies such as chemotherapy, targeted therapy, or hormonal treatment may be recommended first. Your doctor will advise the most suitable approach depending on the cancer type and stage.
Recovery time varies depending on the type of surgery. A lumpectomy may require only a few weeks of recovery, while a mastectomy or breast reconstruction can take several weeks to months. Following post-surgery care instructions is crucial for healing.
Many women who undergo lumpectomy will require radiotherapy to reduce the risk of cancer returning. After mastectomy, radiotherapy may or may not be necessary, depending on whether the cancer has spread to lymph nodes or other tissues.
Yes. Some women at high genetic risk, such as those carrying the BRCA1 or BRCA2 mutations, may choose a preventive double mastectomy. This reduces the risk of breast cancer but is a major decision that should be carefully discussed with a specialist.
It is common to experience some loss of sensation in the breast or chest area after surgery, especially with mastectomy. Over time, some sensation may return, but it may not be the same as before. Breast reconstruction may also affect sensation.
Get An Appointment With A Specialist
Breast Cancer Surgery remains a cornerstone of treatment, offering hope and effective outcomes for women across Singapore. Whether choosing lumpectomy, mastectomy, lymph node procedures, or reconstruction, each option has its own benefits and challenges. Consulting a breast specialist and understanding the full range of surgical approaches ensures that every woman receives care tailored to her unique situation.
Preferred Doctor: Dr Tan Yia Swam (Breast Surgeon)
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.