Breast Cancer Surgery in Ankara, Turkey

Breast cancer surgery is a surgical procedure performed to remove the tumor and the affected breast tissue. The type of surgery is planned by considering the stage of cancer, the size of the tumor, and the patient’s overall health status.

Breast-conserving surgery, mastectomy, and sentinel lymph node biopsy are the main approaches used in breast cancer surgery. These procedures aim to control the cancer while preserving quality of life as much as possible.

After surgery, patients may experience pain, swelling, and limited arm movement. Physical therapy and exercise programs are important to protect arm mobility and to reduce the risk of lymphedema. Regular follow-ups are recommended.

Additional treatments may be planned after breast cancer surgery. Radiotherapy, chemotherapy, or hormonal therapy can support surgical outcomes and reduce the risk of recurrence. A multidisciplinary approach improves treatment success.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Breast Cancer Surgery in Ankara, to get information about Breast Cancer Surgery prices, the process, and the hospital where Breast Cancer Surgery is performed.

What Is Breast Cancer?

Breast cancer is a malignant tumor that develops when cells in breast tissue grow uncontrollably. It usually begins in the milk ducts or lobules and may spread over time to surrounding tissues or distant organs. With early diagnosis and treatment, success rates are high. It is one of the most common cancers in women, but it can also occur—rarely—in men.

What Are the Symptoms of Breast Cancer?

Breast cancer may not cause symptoms in early stages, but certain signs can be warning signals. Recognizing these symptoms is important for early diagnosis. Common symptoms include:

• A hard, painless lump in the breast or underarm
• A change in the shape or direction of the nipple
• Skin dimpling, redness, or an “orange peel” appearance on the breast
• Bloody or clear discharge from the nipple
• Changes in breast size or shape
• Sores or lesions on the skin that do not heal
• Swollen lymph nodes in the underarm

What Causes Breast Cancer?

Breast cancer can develop due to a combination of genetic and environmental factors. Common causes and risk factors include hormonal imbalance, genetic predisposition (especially BRCA1 and BRCA2 mutations), older age, exposure to radiation, obesity, alcohol use, and prolonged estrogen exposure. In some cases, no clear cause is identified, but understanding risk factors helps guide preventive measures.

What Are the Stages of Breast Cancer?

Breast cancer stages are defined by tumor size, lymph node involvement, and whether the cancer has metastasized to other organs. Early diagnosis significantly improves treatment success. The stages include:

• Stage 0 (Carcinoma in situ): Cancer cells are limited to the milk ducts or lobules.
• Stage I: The tumor is small (less than 2 cm) and has not spread to lymph nodes or has only minimal spread.
• Stage II: The tumor is 2–5 cm, and there may be spread to nearby lymph nodes.
• Stage III: Larger tumors and/or significant lymph node involvement, without distant metastasis.
• Stage IV: Cancer has metastasized to distant organs (bone, lung, liver, etc.).

What Is Breast Cancer Surgery?

Breast cancer surgery is not a single standard procedure. It includes a range of surgical techniques tailored to factors such as cancer type, tumor size and location, overall breast structure, and the patient’s expectations and preferences. In general, surgeries can be grouped into two main categories: breast-conserving procedures and procedures that remove the entire breast.

The first group is known as Breast-Conserving Surgery (BCS). As the name suggests, the entire breast is not removed. The surgeon removes only the cancerous tissue along with a margin of healthy tissue—often called a “safety rim.” This is commonly known as lumpectomy. The philosophy is to achieve complete cancer removal while preserving as much of the breast’s natural shape, tissue, and sensation as possible. After BCS, radiotherapy is almost always recommended to eliminate any microscopic cancer cells that may remain and to minimize recurrence risk.

The second main approach is Mastectomy, in which the entire breast tissue is surgically removed. However, mastectomy is no longer a single-type operation. Older radical procedures that removed chest wall muscles and caused major deformities are now largely abandoned in modern surgery. Today’s techniques emphasize aesthetic outcomes. For example, in skin-sparing mastectomy, the breast tissue is removed while most of the skin envelope is preserved. In nipple-sparing mastectomy, both the breast skin and the nipple-areola complex are preserved while the internal breast tissue is removed. These approaches can achieve more natural-looking results, especially when breast reconstruction is performed in the same session.

In addition to surgery on the breast itself, assessment of the axillary (underarm) lymph nodes is a key part of treatment. Cancer cells often first spread to axillary lymph nodes. Determining lymph node status is crucial for accurate staging and for deciding whether additional therapies are needed after surgery.

When Is Breast Cancer Surgery Performed?

Once a breast cancer diagnosis is established, surgery is almost always part of the treatment plan. Timing and technique are determined through a multidisciplinary approach involving the breast surgeon, medical oncologist, radiation oncologist, radiologist, and pathologist. Several factors influence this decision.

When choosing between breast-conserving surgery and mastectomy, many variables are considered. In early-stage cancer, scientific evidence shows that both approaches provide similar long-term survival. Therefore, the choice is guided by medical indications and the patient’s priorities.

To be eligible for BCS, the tumor should generally be small relative to breast size and removable with an acceptable cosmetic outcome. Another key requirement is that the patient must be able to receive radiotherapy after surgery.

In some situations, mastectomy becomes medically necessary or offers a clearer advantage. Situations where mastectomy is considered essential include:

• Multiple cancer foci in different parts of the breast
• A tumor that is too large to allow breast preservation
• Widespread suspicious microcalcifications
• Inability to receive radiotherapy (e.g., prior radiotherapy to the same region)
• Special cancer types such as inflammatory breast cancer

In patients with genetic predisposition such as BRCA1 or BRCA2, mastectomy—sometimes even bilateral mastectomy—may be considered to treat the current cancer and reduce future risk. Importantly, the final decision always belongs to the patient. Some patients choose mastectomy to avoid radiotherapy or to reduce anxiety about recurrence.

In certain cases, patients with tumors initially large enough to require mastectomy may receive chemotherapy or other systemic treatments before surgery. This “neoadjuvant therapy” can shrink the tumor and make breast-conserving surgery possible—highlighting how dynamic and individualized modern treatment planning can be.

What Are the Risks of Breast Cancer Surgery?

Like any surgical intervention, breast cancer surgeries may involve potential risks and unwanted effects. The severity and frequency depend on the scope of surgery (lumpectomy, mastectomy, axillary surgery, etc.) and the patient’s health profile (age, weight, smoking, comorbidities). It is helpful to consider general surgical risks and procedure-specific risks separately.

General surgical risks may include:

• Infection
• Bleeding (hematoma)
• Anesthesia-related complications
• Fluid collection at the surgical site (seroma)
• Blood clots (deep vein thrombosis)

Procedure-specific risks—both early and late—may include:

• Delayed wound healing
• Skin or nipple tissue loss (necrosis)
• Permanent scarring
• Sensory loss in the breast or chest wall
• Asymmetry or cosmetic concerns
• Chronic pain (post-mastectomy pain syndrome)
• Limited shoulder movement
• Persistent arm swelling (lymphedema)

Among these, lymphedema is one of the most important long-term complications. Removal of axillary lymph nodes can disrupt lymphatic drainage and cause permanent, progressive swelling of the arm, hand, or chest wall—significantly affecting quality of life. Although the risk has been reduced with tissue-sparing approaches such as sentinel lymph node biopsy, it still exists—especially when many lymph nodes are removed—and requires lifelong attention. Chronic pain is another relevant long-term issue that may occur due to nerve injury and can require specialized treatment.

How Is Breast Cancer Surgery Performed?

Breast cancer surgery is a delicate process in which breast and axillary procedures are performed in coordination—like a well-conducted symphony. Each step is carefully tailored to the patient.

Breast-Focused Procedures

This part of the operation focuses on removing cancerous tissue from the breast.

Breast-Conserving Surgery (Lumpectomy): The goal is to remove the tumor with a margin of healthy tissue. The surgeon chooses the incision site based on tumor location and cosmetic outcomes, then removes the tumor as a single specimen. The edges of the specimen are inked for the pathologist—these are the “surgical margins.” If cancer cells are found at the inked edge, this is called a positive margin and suggests residual cancer may remain, often requiring a second surgery to remove additional tissue.

Oncoplastic Surgery: This modern approach combines cancer surgery with plastic surgery principles. After tumor removal, the breast is reshaped using local tissue rearrangement to fill the defect and improve cosmetic outcomes. This can allow wider excision (reducing positive margin risk) while maintaining an aesthetically pleasing result. In some cases, balancing surgery (reduction or lift) may be performed on the other breast for symmetry.

• Mastectomy: The entire breast tissue is removed. Types include:
• Total (Simple) Mastectomy: Removes the breast tissue, nipple-areola complex, and some skin.
• Skin-Sparing Mastectomy: Preserves most of the breast skin while removing breast tissue (nipple typically removed).
• Nipple-Sparing Mastectomy: Preserves both the breast skin and the nipple-areola complex while removing internal tissue. These are often combined with immediate reconstruction.

Axillary (Underarm) Procedures

The axilla is one of the first places checked to assess spread and helps guide treatment decisions.

• Sentinel Lymph Node Biopsy (SLNB): This is the standard modern approach. “Sentinel” means “guard” node—the first lymph node(s) that drain the tumor area. If cancer spreads, it typically reaches these nodes first. If the sentinel nodes are cancer-free, the likelihood that the remaining nodes are also free is very high (over 95%).
• During surgery, a small amount of harmless radioactive tracer and a blue dye are injected near the tumor site. These travel through lymphatic channels and highlight the sentinel nodes. Through a small incision, the surgeon locates 1–3 sentinel nodes using a handheld gamma probe (detecting radioactivity) and by visually identifying blue-stained nodes. These nodes are removed for pathology. If negative, no further axillary surgery is performed—helping avoid lymphedema and other complications.
• Axillary Lymph Node Dissection (ALND): If cancer is found in sentinel nodes or if preoperative testing already shows axillary involvement, a more extensive procedure is performed—removing a larger number of nodes (often 10–20). While ALND carries a higher lymphedema risk, it is necessary in selected cases for disease control.

Recovery After Breast Cancer Surgery

The end of surgery marks the beginning of a new phase of healing and treatment. This period is important for rest, recovery, and defining the next steps of care.

Hospital Stay

Hospitalization depends on the extent of surgery. Patients undergoing limited procedures such as lumpectomy with sentinel node biopsy often go home the same day or after one night. Patients who have mastectomy typically stay 1–3 days. If complex reconstruction using the patient’s own tissue is performed, hospitalization may extend by a few more days.

Drains and Drain Care

After mastectomy and/or axillary surgery, soft plastic drains are often placed to prevent fluid and blood accumulation. These drains collect fluid into a small vacuum reservoir. Patients and caregivers are taught how to empty the drains and record daily output. Drains are usually removed in clinic about 1–2 weeks after surgery once output decreases (commonly below 20–30 ml/day).

Pain Management

Pain is expected and can be controlled with modern pain management. Stronger medications may be used in the hospital, and oral pain relievers are prescribed at discharge. Good pain control supports easier breathing, movement, and coughing—helping recovery.

Physical Activity and Arm Exercises

Walking as soon as possible reduces the risk of blood clots. However, the operated-side arm should be used carefully. For about 4–6 weeks, typical rules include:

• Avoid lifting more than 4–5 kg
• Avoid pushing, pulling, or jerking movements
• Avoid repetitive tasks that fatigue the arm

At the same time, gentle shoulder and arm exercises—usually started a few days after surgery under medical guidance—are crucial to prevent stiffness and frozen shoulder.

Waiting for the Pathology Report

All removed tissue is sent to pathology for detailed microscopic evaluation. Results typically take 7–10 days. The report is essentially the treatment roadmap: it confirms tumor size, type, grade, margin status, and lymph node involvement. Decisions about radiotherapy, chemotherapy, hormonal therapy, and targeted therapies are based on this report.

What to Pay Attention to After Breast Cancer Surgery

After surgery and active treatment, certain long-term habits and precautions help protect health and quality of life.

Lifelong Lymphedema Prevention

Especially for patients who had axillary lymph nodes removed, the following should become routine:

• Do not have blood drawn from that arm
• Do not have blood pressure measured on that arm
• Avoid vaccines or injections in that arm
• Avoid IV lines in that arm
• Protect the arm from cuts, burns, and insect bites
• Avoid cutting cuticles during manicures
• Avoid carrying heavy bags/loads on that side
• Keep the skin well moisturized
• Contact your doctor if swelling, tightness, or heaviness develops

The Importance of Physical Activity

• Shoulder Exercises: Continue range-of-motion exercises as advised to restore strength and flexibility.
• General Exercise: Walking, swimming, Pilates, or yoga supports weight control, increases energy, and reduces treatment-related fatigue. Research also suggests regular exercise may reduce recurrence risk.

Healthy Nutrition and Weight Management

• Eat plenty of vegetables and fruits
• Choose whole grains
• Avoid ultra-processed foods and excess sugar
• Select healthy protein sources (fish, poultry, legumes)
• Maintain a healthy weight (excess weight may increase recurrence risk)

Emotional and Psychological Well-Being

The breast cancer journey can be emotionally demanding. Changes in body image, anxiety about the future, and treatment burden may require support. Seeking help from family, friends, support groups, or mental health professionals is normal and beneficial.

Do Not Miss Regular Medical Follow-ups

After treatment, continuing follow-ups is essential. Exams, blood tests, and imaging such as mammography help detect recurrence early and manage late side effects. Adhering to the follow-up plan is one of the strongest safeguards for long-term health.