The very disfiguring radical mastectomy, in which the breast, lymph nodes, and chest wall muscles under the breast are removed, is rarely performed today because doctors believe that a modified radical mastectomy is just as effective. While removing underarm lymph nodes after surgery is important in order to determine if the cancer has spread, this procedure may add chronic arm swelling and restricted shoulder motion to the discomforts of the overall treatment. To locate the sentinel node, the physician injects a radioactive tracer in the area around the tumor before the mastectomy. The tracer travels the same path to the lymph nodes that cancer cells would take, making it possible for the surgeon to determine the one or two nodes most likely to test positive. The surgeon will then remove the nodes most likely to be cancerous.
Radiation therapy is treatment with high-energy rays or particles given to destroy cancer.
In almost all cases, lumpectomy is followed by six to seven weeks of radiation, an integral part of breast-conserving treatment. Although radiation therapy damages both normal cells and cancerous cells, most of the normal cells are able to repair themselves and function properly. While doctors once believed that the spread of breast cancer could be controlled with extensive surgery, they now believe that cancer cells may break away from the primary tumor and spread through the bloodstream, even in the earliest stages of the disease. These cells cannot be felt by examination or seen on x-rays or other imaging methods, and they cause no symptoms. But they can establish new tumors in other organs or the bones.