Which breast cancer procedure you get depends on a few factors and your doctor’s recommendations. The cost of mastectomies, breast-conserving surgery (BCS), and breast reconstruction can also vary.
Most cases of breast cancer need surgery at some point in the treatment process.
If you have breast cancer, the potential role of surgery in your treatment plan will depend on:
- the stage of the cancer
- the location, number, and size of tumors
- your treatment priorities and goals
Breast cancer surgery can be costly, but many insurance plans cover some or all of the cost of surgery.
Keep reading to learn about different types of surgery for breast cancer.
If you’re living with breast cancer, your doctor may recommend surgery to:
- remove the known disease in the breast
- find out whether the cancer has spread to nearby lymph nodes
- relieve symptoms as a palliative operation (improve the quality of life)
Surgery tends to be most effective for treating breast cancer in its early stages when it’s easier to remove and before it has spread to other parts of the body.
Your doctor is less likely to recommend surgery if you have stage 4 cancer that has spread to the other parts of the body. However, doctors sometimes recommend surgery to ease symptoms.
Your doctor may recommend surgery to remove cancer from your breast, particularly if the cancer hasn’t yet spread to distant parts of your body.
They may also recommend radiation therapy after surgery to kill any cancer cells that remain.
Breast-conserving surgery
In BCS, a surgeon removes the tumor from the breast. They also remove a margin of healthy tissue surrounding the tumor to reduce the risk of cancer cells being left behind.
The surgeon doesn’t remove the breast itself during BCS.
Full mastectomy
In a full
A surgeon may often remove the nearby lymph nodes, but sometimes they may not.
Some people may also only have one breast removed. Others have a double mastectomy, in which both breasts are removed.
Which option is best?
Long answer short: It depends on what you and your doctor have decided will be best for you. Some cases may require a mastectomy — whether unilateral or bilateral — while others may only need a lumpectomy.
- 66 percent underwent BCS
- 21 percent underwent unilateral mastectomy (removal of one breast)
- 13 percent underwent bilateral mastectomy (removal of both breasts)
If you have breast cancer that’s detected early, BCS may be enough to remove the entire tumor. Your doctor will likely recommend radiation therapy following BCS to reduce the chances of the cancer returning.
Your doctor may recommend mastectomy instead of BCS if you:
- have a large tumor or multiple tumors in the same breast that can’t be removed through BCS without changing the look of your breast too much for your preferences
- have inflammatory breast cancer
- have a gene that raises your risk of developing a second breast cancer
- have previously had BCS that didn’t fully remove the cancer
- can’t receive radiation therapy or prefer not to receive it
A 2021 trial looked at multicentric breast cancer tumors in 236 patients. Researchers found that if there was no non-mass enhancement between the two tumors, then treatment could proceed with two lumpectomies.
The
- can’t have radiation therapy
- have had past breast treatment with radiation therapy
- had BCS that didn’t completely remove the cancer
- have a large tumor or multicentric tumors
- are pregnant and may require radiation therapy while pregnant
- at risk for a second cancer
- have a connective tissue disease, like lupus, which might increase your sensitivity to radiation therapy
- have inflammatory breast cancer
During a mastectomy, your surgeon may be able to leave the breast skin intact. This is known as a skin-sparing mastectomy.
If you would like to have breast reconstruction after a mastectomy, your surgeon will likely recommend a skin-sparing mastectomy.
Breast cancer may spread from your breast to lymph nodes under your arm, known as axillary lymph nodes. And then from lymph nodes to other parts of the body through your lymphatic system.
Your surgeon may remove a few lymph nodes initially and send them to a lab to determine if there is cancer in them. This procedure is called a sentinel lymph node biopsy.
From there, you have two options for
Sentinel lymph node biopsy
Sentinel lymph node biopsy (SLNB) is often a good option for early stage breast cancer.
In SLNB, the surgeon removes only a small number of lymph nodes. They remove the first lymph node or the first few lymph nodes where the cancer would likely spread first.
This lowers the risk of potential side effects, such as:
- pain
- numbness
- lymphedema
Lymphedema is swelling that occurs when the lymphatic system is not working properly.
Axillary lymph node dissection
During axillary lymph node dissection (ALND), the surgeon removes a larger number of underarm lymph nodes. They typically remove fewer than 20 lymph nodes.
A surgeon may perform an ALND if a woman has greater or equal to three lymph nodes with cancer in them after a sentinel lymph node biopsy or if there are multiple known positive nodes prior to surgery.
ALND may be performed with BCS or mastectomy surgery.
If you have a full mastectomy, you may wish to have surgery to
If you have a BCS or partial mastectomy, you may also wish to have surgery to reshape the breast.
Depending on your preferences and needs, your doctor may recommend:
- A breast implant: This is a flexible silicone shell filled with saline or silicone gel that may be inserted into the breast area during breast cancer surgery or later on.
- A tissue flap: In this procedure, the surgeon uses tissue from your stomach, buttocks, or other parts of your body to rebuild the breast.
- Nipple and areola reconstruction: This operation may be performed about 3 or 4 months after an implant or tissue flap surgery.
- Scar revision: This surgery reduces the appearance of surgical scars.
The cost of breast cancer surgery depends on:
- your location
- the type of surgery you get
- your insurance coverage
A mastectomy plus breast reconstruction can cost $90,000 or as much as $188,000.
Will insurance cover the surgery?
According to the
The Women’s Health and Cancer Rights Act requires all group health plans that cover mastectomy to also cover breast reconstruction.
You may need to meet a deductible before your insurance pays for surgery. Your deductible may be as low as $0 or as high as $7,500 per year.
You may also need to pay coinsurance or copays depending on your plan.
If you have Medicare, it will cover the cost of a breast reconstruction.
Contact your insurance provider to learn about your plan.
How to get insurance or financial assistance
If you’re employed, you may check with your employer to learn whether they offer health insurance.
You may be able to enroll in coverage through the Affordable Care Act marketplace. There you can also check whether you qualify for Medicaid.
If you don’t have health insurance, the costs of surgery may seem overwhelming. There are resources available to help you pay for treatment.
You can start by asking your medical team for a list of organizations that offer financial assistance for breast cancer surgery. Examples include:
Check with your cancer center to find out whether they have “financial navigators” or social workers to help patients manage the financial aspects of care.
If you receive a breast cancer diagnosis, your doctor may recommend surgery to treat it. The specific type of surgery will depend on your condition and treatment preferences. Options may include breast-conserving surgery or a mastectomy.
If you have part or all of your breast removed, you may decide to have the breast reconstructed or reshaped afterward.
The cost of surgery may also vary depending on your insurance provider and if you decide to get a breast reconstruction afterward. Talk with your healthcare provider to find out the costs.