The best chance to cure breast cancer is surgery. In a world with great advances in science and great progress in medicine, surgery remains the most effective treatment for breast cancer. When breast cancer remains in the breast, surgery can be curative. When breast cancer leaves the breast, surgery remains as the best means to rid the body of the breast cancer nest. Other, or adjuvant, therapies are then used to seek out and destroy those breast cancer cells that flew from the nest.
The goal of mammography and breast imaging is to find cancers before they spread beyond the breast. But how do we know if a cancer has spread beyond the breast? The first place we look is in the lymph nodes under the arm (the axilla), because if cancer has spread to these lymph nodes, then there is a reasonable chance that there is more cancer elsewhere in the body and medical therapies are needed. By the same token, though, if there is no cancer in the lymph nodes under the arm , then there is a much lower chance of cancer having spread elsewhere in the body and a less toxic medical treatment may be necessary.
Radiation therapy makes surgery stronger. Just as cleaning the kitchen counter with a wet rag is very effective, adding soap to the wet rag can make the cleaning process much better. Radiation helps surgery in the same way in that radiation therapy will further reduce the risk of a local recurrence compared to surgery alone. Breast cancer can be like a paint splatter. Small, microscopic deposits of cancer, which we cannot see, may remain in the breast after surgery. That is why in surgery we try to get a margin of healthy tissue around the breast cancer, and why we need to add radiation to the breast: to treat the little spots not removed by surgery.
So, yes, if you have breast cancer you need surgery. We know that surgery will cut out that tumor and place it in the proverbial garbage can, where it belongs. Surgery is the primary and most effective treatment for breast cancer, but the successful treatment of breast cancer requires a team approach to coordinate surgery, radiation, chemotherapy and endocrine treatment. I participate in the KCBC Breast Cancer Team, where every cancer that we treat gets presented and discussed prior to treatment and after surgical treatment.
As the surgeon, I am the Captain of your ship, and in coordination with your whole team of physicians, nurses, allied health professionals, family and friends, we will sail your ship through the turbulence of treatment with the goal to arrive on the distant shores where breast cancer is no more.