The first type of surgery is called breast conserving surgery. The aim of this surgery is to remove the cancer/abnormal tissue with a rim of normal breast tissue around it and to leave most of the breast intact. This is also called a wide local excision, or sometimes (not strictly correctly) a lumpectomy. This can be done if the lump is relatively small to the size of the breast.
Breast excision biopsy
An operation in which abnormal breast tissue or a lump is removed (excised) through the smallest and most appropriate incision. A small amount of your surrounding tissue (margins) may also be taken to ensure full clearance.
This tissue then undergoes an instant preliminary analysis in the operating theatre by a histopathologist (frozen section). The specimen will subsequently receive more detailed analysis in a laboratory.
Stereotactic or guidewire excision biopsy
This type of excision biopsy is indicated when you may have an abnormality that is visible on a mammogram or ultrasound but cannot be felt in clinical examination.
To assist the Surgeon, the site of the abnormality to be biopsied is marked by a Consultant Radiologist, with a guide-wire or skin marking (localisation), using either mammography or ultrasound.
Lymph nodes or glands are removed through the axilla or armpit, to ascertain whether the cancer has spread to the lymph glands. This is usually undertaken at the same time as surgery to remove a tumour. If the cancer is near the axilla a single incision can be used.
During a mastectomy, the gland will be removed through the mastectomy incision. The lymph nodes removed will be analysed by a Histopathologist.
Sentinel node biopsy
This technique has been the subject of a number of clinical trials around the world. It is used to identify whether cancer has spread to the lymph nodes. It involves injecting a small amount of radioactive material and a dye, which identifies the sentinel node, this is the first node to receive lymph fluid from a tumour.
If the sentinel node is clear, it usually means that the other nodes are clear and removal of further lymph nodes under the arm may not be necessary.