Sometimes the language used around a situation itself can be overwhelming. We've provided here definitions of some terms you might have or may be hearing. A glossary follows.

Lumpectomy
In this procedure, the entire breast lump and portion of normal adjacent breast tissue is removed, followed by radiation therapy. The surgeon may remove and test some of the underarm lymph nodes to check for the spread of cancer. Because this procedure avoids the hollowness beneath the collarbone created by more extensive surgery, it permits women to wear clothes with lower necklines and can also make breast reconstruction easier.

Modified Radical Mastectomy
A Modified Radical Mastectomy is when the entire breast is removed including the nipple. The surgeon will remove some or all of the underarm lymph nodes (particularly those closest to the breast) to determine if the cancer has spread beyond the breast itself. It may be followed by radiation therapy.

Prophylactic or Subcutaneous Mastectomy
A preventive mastectomy for women who are at high risk of breast cancer. The surgeon removes as much of the breast tissue as possible, leaving the skin which has been covering the breast and the nipple intact. The surgeon then reconstructs the breast by placing an implant under the pectoralis muscle, or using the patient's own tissue on top of the muscle.

Mastectomy with Reconstruction
Women who have a mastectomy or lumpectomy have the option to choose surgical breast reconstruction. This can be done either at the time of mastectomy (immediate reconstruction) or later (delayed reconstruction). Breast reconstruction can be performed using either 'implants' or the patient's own tissue. Immediate reconstructive surgery may not be an option for all patients. It is best to talk with your doctor about the specifics of these procedures to see if they are appropriate. The doctor may refer a woman to a plastic surgeon for more information or consultation.

There are basically two types of reconstructive operations - Simple (non-flap) and flap. The choice depends on the amount and suitability of tissue remaining at the mastectomy site and the requirements to match the opposite breast. The physician will discuss these alternatives with the woman in terms of what best suits her situation.

• Simple Non-flap: A simple non-flap procedure is used when there is enough existing local healthy tissue, including muscle, at the mastectomy site. The breast implant is placed under the muscle. The existing mastectomy scar is usually used for the incision, or the surgeon may need to make a new incision. Another version of a non-flap procedure involves the tissue expansion technique. A temporary internal breast implant called a tissue expander is placed in the position of the new breast, and a saline solution is injected into the expander over a period of weeks. When the skin & muscle has stretched to the desired amount, the temporary implant is removed, and a permanent one inserted in its place.

• Flap Procedure: (also called Myocutaneous Flap): Several types of flap procedures are used when it is necessary to transfer additional tissue to the mastectomy site to reconstruct the breast. Latissimus Dorsi procedure is the most frequently used. This technique transfers the muscles and skin from the patient's back when additional tissue is needed after a mastectomy. It may also be used to provide soft tissue cover for a breast implant. When this technique is used, there is usually an elliptical-shaped scar at the site of the reconstruction and a linear scar on the back, which can often be covered with a bra.

Medical Glossary

Areola: The area of dark-colored skin around the nipple.

Axilla: The underarm.

Benign tumor: A growth that is not cancer; it does not spread to other parts of the body.

Bilateral mastectomy: Removal of both breasts.

Biopsy: The removal of a sample of tissue that is looked at under a microscope to see if cancer cells are present. An excisional biopsy is surgery to remove an entire lump. An incisional biopsy, which is less commonly performed for breast tumors, removes part of the tumor. Removing tissue or fluid with a needle is called needle biopsy or needle aspiration.

Cancer: A term for more than 100 diseases that have uncontrolled, abnormal growth of cells. Cancer cells can spread through the bloodstream and lymphatic system to other parts of the body.

Carcinoma: Cancer that begins in the lining or covering of an organ.

Carcinoma in-situ: Cancer that involves only the cells in which it began and has not spread to other tissues. Lobular carcinoma in-situ is found in the lobules of the breast. Ductal carcinoma in-situ (also called intraductal carcinoma) arises in the ducts.

Chemotherapy: Treatment with anti-cancer drugs.

Clinical trials: Studies of new cancer treatments. Each study is designed to answer scientific questions and to find better ways to treat patients.

Cyst: An abnormal sac within a tissue or organ, usually filled with fluid.

Duct: A tube in the breast through which milk passes from the lobes to the nipple.

Estrogen: A female hormone.

Hormone therapy: Treatment of cancer by removing, blocking or adding hormones.

Hormones: Chemicals produced by certain glands in the body. Hormones control the way certain cells or organs act.

Lobe: A part of the breast; each breast contains 15 to 20 lobes.

Lobule: A subdivision of the lobes of the breast.

Lumpectomy: Surgery that removes the breast lump; usually followed by radiation therapy.

Lymph: An almost colorless fluid that bathes body tissues and carries cells that help fight infection.

Lymph nodes: Small, bean shaped organs located along the lymphatic system. Nodes filter bacteria or cancer cells that may travel through the lymphatic system. Also called lymph glands.

Lymphatic system: The tissues and organs (including the bone marrow, spleen, thymus and lymph nodes) that produce and store cells that fight infection and the channels that carry lymph fluid.

Lymphedema: Swelling of the hand or arm caused by extra fluid that may collect in tissues when lymph nodes are removed or blocked.

Malignant: Cancerous.

Mammography: An x-ray procedure to detect breast tumors.

Mastectomy: Surgery to remove the breast.

Menopause: The time of a woman's life when menstrual periods stop; also called 'change of life.'

Metastasis: The spread of cancer from one part of the body to another. Cells in the metastatic tumor (the second tumor) are like those in the original cancer.

Oncologist: A doctor who specializes in treating cancer.

Palpation: A simple technique in which a doctor presses lightly on the surface of the body to feel the organs or tissues underneath.

Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope.

Progesterone: A female hormone.

Prosthesis: A breast form worn under clothing. (Prostheses is plural.)

Radiation therapy: Treatment with high-energy rays from x-rays or other sources to kill cancer cells.

Staging: The process of learning whether cancer has spread from its original site to another part of the body.

Stereotactic Needle Biopsy: A method of needle biopsy that is useful in cases in which a mass can be seen on a mammogram, but cannot be found by touch. A computer maps the location of the mass to guide the placement of the needle.

Thermography: A test that measures and displays heat patterns of breast tissues. Abnormal tissue generally is warmer than healthy tissue.

Tumor: An abnormal mass of tissue.

Ultrasound: A test that bounces sound waves off tissues and converts the echoes into pictures. Tissues with different densities reflect sound waves differently, making it possible to tell the difference between a fluid-filled cyst and a solid mass.

Unilateral mastectomy: Removal of one breast.