Navigating breast cancer surgery

Feb. 22, 2024
nurse reviewing management options with a patient in regards to breast cancer surgery.
As soon as breast cancer is diagnosed, a patient is referred to a multidisciplinary team that reviews management options with the patient. Photo: Getty Images.

A breast cancer diagnosis is never welcome, but with advances in breast cancer surgery, it may be more manageable than many women assume.

“I think a lot of women historically think that if they have breast cancer, they’re going to need a mastectomy, which is not true in most cases,” said Dr. Zach Hartman, a general surgeon in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. “And they often look at it from a fairly morbid standpoint, when with modern treatment, women can often go on to live full, high-quality lives.”

When is surgery considered as a treatment option?

As soon as breast cancer is diagnosed, a patient is referred to a multidisciplinary team that typically includes a surgeon, an oncologist, a radiation oncologist, nurses and other staff members to review management options.

Surgery is often, but not always, part of the treatment plan.

“For some patients, surgery isn’t the answer,” Hartman said. “Our first job is to understand exactly what the diagnosis is, what stage the cancer is in and to pick out the most modern treatments that are most beneficial for the patient. Treatment depends on each woman’s goals for care, and we take that into account when we design a treatment plan.”

Improvements in surgery for breast cancer

“Breast surgery for cancer has come a long way over the years,” Hartman said. “It has become much less invasive and less disfiguring.”

Dr. Zach Hartman, who discusses breast cancer surgery.
Dr. Zach Hartman

In the past, a mastectomy – in which the entire breast is removed – was often recommended. Now, it’s much more common for women to have a lumpectomy, in which only the part of the breast with cancer is removed. In most cases, outcomes and survival rates of women who have a lumpectomy are on par with those of women who have a mastectomy.

“We target the specific area of the breast where the cancer is and just remove that,” Hartman said. “Normally, the contour of the breast is preserved, and we try to make the incisions as subtle and hidden as possible.”

Advances in technology play a key role in surgical outcomes. For instance, the SAVI SCOUT is a tiny locator the size of a grain of rice that a radiologist implants in the tumor.

“It acts like a little beacon, and we use it to target exactly what we need to take out,” Hartman said. “The goal is to take out all of the cancer, but nothing else.”

Before and after breast cancer surgery

Before surgery, the care team determines whether lymph nodes should be sampled to provide information on the stage of cancer and also reviews whether additional treatment, such as chemotherapy or radiation therapy, will be needed. A plastic surgeon may be involved in reviewing options for cosmetic reconstruction.

Most breast cancer surgeries are outpatient procedures, so patients can go home the same day. Follow-up appointments help ensure healing and additional treatments are on track.

Personalized approach to treatment for breast cancer

Treatment is customized for the individual.

“One thing that has changed over the years is an overall culture of how the surgical team and cancer team interact with patients and their families to really understand a patient’s goals,” Hartman said. “We tailor treatment for what women want and what will get them the best outcomes.”

Patients are often worried about other family members’ risks for breast cancer. Hartman encourages them to work with the genetic counseling team to assess risk and understand screening recommendations.

“It’s very important to do the screenings,” Hartman said. “The earlier you catch a problem, the easier it is to manage and the better the outcomes.”

But even if a breast cancer diagnosis occurs, Hartman reminds patients that the quality of local care is top-notch.

“We really do have advanced, multidisciplinary cancer care close to home right here in the Yampa Valley,” Hartman said. “We have the same capabilities and as good of clinical outcomes as many larger areas, and we have the convenience of being close to home.”

 This story first appeared in the Steamboat Pilot.

About the author

Susan Cunningham lives in the Colorado Rocky Mountains with her husband and two daughters. She enjoys science nearly as much as writing: she’s traveled to the bottom of the ocean via submarine to observe life at hydrothermal vents, camped out on an island of birds to study tern behavior, and now spends time in an office writing and analyzing data. She blogs about writing and science at