Understanding breast cancer surgery: What women 55 and older should know

By Dr. Folasade Imeokparia, breast surgeon at the IU Health Joe & Shelly Schwarz Cancer Center in Carmel

A breast cancer diagnosis can feel overwhelming at any age, but many women over 55 find comfort in knowing that treatment options today are highly personalized and more advanced than ever. Surgery is often the first step in breast cancer treatment. At IU Health, breast cancer surgery is designed around the individual, considering not only the type of cancer, but also a woman’s overall health, lifestyle and personal preferences.

A Personalized Approach to Breast Cancer Surgery

No two breast cancer diagnoses are exactly alike. Breast surgeons work to understand each patient as a whole person, not just a diagnosis. Highly specialized cancer teams develop a treatment plan tailored to the individual. This personalized approach is especially important for women 55 and older, who may be managing other health conditions or weighing quality‑of‑life considerations alongside treatment decisions.

Common Types of Breast Cancer Surgery

The surgical approach to treat each breast cancer depends on factors such as tumor size and biology, location and individual health needs.

A lumpectomy, also known as breast‑conserving surgery or partial mastectomy, is often an ideal option for women with smaller tumors. This procedure removes the cancer with a normal rim, or margin, of healthy breast tissue. A lumpectomy works to preserve as much of the breast as possible. Lumpectomies are typically performed through a small incision to maintain the natural shape of the breast. Radiation therapy is usually recommended as part of the treatment plan for someone after lumpectomy.

For some women, a mastectomy may be recommended. This approach involves most of the breast tissue and may be necessary depending on the extent or location of the cancer. A mastectomy may focus on a flat closure, or maintenance of skin through skin-sparing or nipple sparing approaches with planned reconstruction.

Breast Reconstruction: An Option for Many Women

For women who undergo a mastectomy, breast reconstruction may be an important part of the recovery journey. IU Health offers advanced reconstruction techniques and consultation with our skilled plastic and reconstructive surgeons. Many women choose reconstruction to help regain a sense of wholeness and confidence after surgery, though it is a personal choice. Breast reconstruction can be discussed as part of the surgical planning process, allowing women to explore their options and decide what feels right for them among the recommendations given.

Understanding Lymph Nodes

Understanding lymph node status is an important part of breast cancer management. However, following lymph node surgery, lymphedema may develop. Lymphedema is chronic limb swelling caused by lymphatic dysfunction. It is often irreversible and can impact quality of life and add costs to treatment. With better understanding of the biology of breast cancers and advances in medical treatments, lymph node surgery is not a necessity in all cases. When it does develop, lymphedema management is a priority at IU Health. Our occupation and physical therapy teams offer expertise and compassion in interventions to manage the condition. Our plastics and reconstructive surgeons may be able to offer immediate lymphatic reconstruction as a strategy to prevent lymphedema in some patients.

What to Expect When Making Surgical Decisions

Choosing the right surgical option is a deeply personal decision. Women are encouraged to ask questions and take an active role in understanding their choices. Breast surgeons work closely with patients to explain recommended procedures and typical recovery. This collaborative process can help women feel more confident and supported as they move forward with treatment.

Moving Forward with Confidence and Support

Breast cancer surgery is typically the beginning of a larger healing journey, and IU Health’s breast cancer team supports women from diagnosis through treatment and into survivorship. With focused expertise, personalized care and access to advanced treatment options, women can feel reassured that they are not navigating this journey alone. Understanding your surgical options is an important step toward making informed decisions and moving forward with confidence. To learn more about breast cancer care at IU Health, visit iuhealth.org/breast.