A surgeon with training and experience in both breast cancer and melanoma surgery can manage the surgical aspects of both conditions. Breast cancer and melanoma are different diseases, but some parts of their surgical management overlap, including removing cancer with an appropriate margin, assessing pathology and, in selected patients, performing a sentinel lymph node biopsy.
For people dealing with both a breast concern and a melanoma on the Gold Coast, understanding where the two treatment pathways overlap, and where different members of the cancer care team become involved, can make the process easier to understand.
The key point: one surgeon may be able to provide the surgery for both breast cancer and melanoma when they have appropriate training and experience in both areas. That does not mean one doctor manages every part of cancer treatment. Medical oncology, radiation oncology, radiology, pathology, dermatology and other services may also form part of your care.
Why Breast Cancer and Melanoma Surgery Can Overlap
Breast cancer and melanoma arise in different tissues, but several surgical principles are shared.
- The diagnosis needs to be established before definitive treatment is planned.
- The cancer may need to be removed with an appropriate margin of surrounding tissue.
- The removed tissue is examined by a pathologist.
- Lymph nodes may need to be assessed in selected patients.
- The location and extent of surgery need to be considered when planning wound closure and recovery.
- Further treatment depends on the final pathology and the individual cancer.
Different cancers, some shared surgical principles
Breast cancer surgery and melanoma surgery are not interchangeable treatments. The overlap is in surgical assessment, cancer removal, pathology, lymph-node assessment and coordinating further care where required.
How General Surgical Training Relates to Breast and Melanoma Surgery
Dr John Gault completed Fellowship in General Surgery with the Royal Australasian College of Surgeons and holds the qualification FRACS. His current professional profile also records experience in breast cancer surgery, melanoma surgery, sentinel lymph node biopsy and lymph node dissection.
Dr Gault has been a Staff Specialist at the Gold Coast Hospital Robina Campus since 2008 and was involved in establishing General, Breast and Melanoma services at Robina for the Gold Coast district.
What does FRACS mean? FRACS stands for Fellow of the Royal Australasian College of Surgeons. You can check a doctor's registration through the AHPRA public register.
Sources: Gault Surgery: Dr John Gault, Royal Australasian College of Surgeons and AHPRA.
Breast Cancer Surgery and Melanoma Surgery Side by Side
The comparison below shows some of the areas where the surgical pathways overlap and where they differ.
| Surgical step | Breast cancer | Melanoma |
|---|---|---|
| Establishing the diagnosis | Assessment generally combines clinical examination, breast imaging and biopsy. | A suspicious skin lesion is usually removed or sampled so it can be examined by a pathologist. |
| Main breast or skin operation | May involve breast-conserving surgery or mastectomy depending on the diagnosis and individual circumstances. | Wide local excision may be performed after melanoma has been diagnosed, with the required margin depending on the melanoma. |
| Lymph-node assessment | Sentinel node biopsy may be used when clinically indicated, usually assessing nodes in the armpit. | Sentinel node biopsy may be discussed for melanomas where the pathological features indicate it may provide useful staging information. |
| Pathology after surgery | The removed breast tissue and any lymph nodes are examined to provide information for further treatment planning. | The excision and any sentinel lymph nodes are examined to assess margins and melanoma stage. |
| Wound closure | Planning depends on the breast operation, amount and location of tissue removed and whether reconstruction is involved. | Some wounds can be closed directly. Larger defects may require a skin graft, local flap or input from another surgeon. |
| Additional treatment | May include radiotherapy, hormone-blocking treatment, chemotherapy or other systemic treatment depending on the cancer. | Depending on melanoma stage and other features, further surgery, immunotherapy, targeted therapy or radiotherapy may be considered. |
Treatment is not identical: although some surgical techniques overlap, breast cancer and melanoma have different staging systems, pathology features and additional treatments. Your treatment plan needs to be based on your own diagnosis.
Sources: Cancer Australia: Breast cancer surgery and Melanoma Institute Australia: Melanoma treatment.
Sentinel Lymph Node Biopsy: Where the Two Pathways Meet
A sentinel lymph node is one of the first lymph nodes to which cancer cells may travel from the original cancer site. Sentinel lymph node biopsy removes one or more of these nodes so they can be examined by a pathologist.
The principle is used in both breast cancer and melanoma, although the location of the nodes and the circumstances in which the procedure is recommended differ.
| Sentinel node question | Breast cancer | Melanoma |
|---|---|---|
| Where are the nodes? | Usually in the armpit on the same side as the breast cancer. | The drainage area depends on where the melanoma is located and may include the armpit, groin or neck. |
| Why is it performed? | To determine whether breast cancer has reached the first draining lymph nodes and help guide further treatment. | To provide staging information and assess whether melanoma cells are present in the first draining lymph nodes. |
| Does everyone need it? | No. Whether it is recommended depends on the breast diagnosis and clinical circumstances. | No. The melanoma's thickness and other pathological features help determine whether it should be discussed. |
Potential benefit: sentinel node biopsy can provide staging information using a smaller lymph-node operation than removing a larger group of nodes.
Risks and limitations: risks can include pain, infection, numbness, fluid collection, restricted movement and lymphoedema. Tracer or dye used during lymphatic mapping can also have side effects. Whether the information gained is useful depends on the individual diagnosis.
Sources: Cancer Australia: Sentinel node biopsy and Melanoma Institute Australia: Melanoma treatment.
What Happens After a Melanoma Is Diagnosed?
The first biopsy provides information that helps determine what happens next. The pathology report may include the melanoma thickness, ulceration and whether melanoma reaches the edge of the specimen.
1. Review the pathology.
The pathology report provides information used to stage the melanoma and plan further surgery.
2. Plan the wide local excision.
Additional skin around the original melanoma site may need to be removed. The required margin depends on the melanoma.
3. Consider lymph-node staging when appropriate.
A sentinel lymph node biopsy may be discussed when the melanoma's thickness and other pathological features make the information useful.
4. Review the final pathology.
The results help determine melanoma stage and whether additional treatment or referral is required.
Do not destroy a suspicious lesion before diagnosis. A lesion suspected of melanoma needs appropriate assessment and pathology. Procedures that destroy the tissue can make pathological assessment difficult or impossible. Ask your GP, dermatologist or treating doctor how the lesion should be investigated.
Source: Melanoma Institute Australia: Melanoma diagnosis.
Melanoma in Australia: Why Skin Changes Matter
Melanoma remains a significant cancer in Australia. Cancer Australia estimates that 17,443 new cases of melanoma of the skin were diagnosed nationally in 2025.
|
17,443 Estimated new cases of melanoma of the skin in Australia in 2025. |
3rd Melanoma was estimated to remain the third most commonly diagnosed cancer in Australia in 2025. |
94% Five-year relative survival for Australians diagnosed with melanoma during 2017-2021. |
About the survival figure: 94% is a population-level relative survival statistic. It cannot predict the outlook for an individual person. Melanoma stage, thickness, pathology, lymph-node involvement and other clinical factors affect an individual's prognosis.
Source: Cancer Australia: Melanoma of the skin statistics.
What Breast Cancer Surgery May Involve
Breast cancer surgery is planned according to the type and extent of the cancer, breast imaging, biopsy results and individual circumstances.
Breast-conserving surgeryThe cancer and an area of surrounding breast tissue are removed while the remainder of the breast is retained. Potential benefit: breast tissue is retained when breast-conserving surgery is clinically suitable. Risks and limitations: risks include bleeding, infection, changes to breast shape and the possibility of further surgery if the margin is not adequate. Radiotherapy is commonly part of treatment after breast-conserving surgery. Results vary from person to person. |
MastectomyMastectomy removes the breast and may be recommended or chosen depending on the extent of cancer and individual circumstances. Potential benefit: mastectomy can treat breast cancers where conserving the breast is not considered appropriate. Risks and limitations: risks include bleeding, infection, wound-healing problems, altered sensation and changes in body shape. Reconstruction options should be discussed where relevant. Results vary from person to person. |
Source: Cancer Australia: Surgery for breast cancer.
If You Have a Breast Concern and a Suspicious Skin Lesion at the Same Time
Two separate concerns can sometimes be investigated during the same period. This does not automatically mean they should be treated during the same operation.
The order and timing depend on factors including:
- whether either condition has already been confirmed as cancer;
- the type and extent of each operation;
- the pathology results available at the time;
- whether lymph-node surgery is required;
- anaesthetic and surgical considerations;
- wound location and recovery requirements; and
- whether another doctor needs to be involved.
Can both operations be done together? Sometimes procedures can be coordinated, but this needs to be decided individually. Combining procedures may reduce the number of separate operations in an appropriate case, while a longer or more extensive operation may also change surgical and anaesthetic risks. Your surgeon and anaesthetist can explain whether combining procedures is appropriate for you.
The Role of the Wider Cancer Care Team
Having one surgeon involved in breast cancer and melanoma surgery does not mean one doctor provides every type of cancer treatment.
Depending on the diagnosis, care may involve:
- a radiologist for breast imaging or other imaging;
- a pathologist who examines biopsy and surgical tissue;
- a medical oncologist when drug treatment is required;
- a radiation oncologist when radiotherapy is considered;
- a dermatologist or skin cancer doctor for skin surveillance;
- a breast care nurse;
- a physiotherapist;
- a psychologist or other supportive-care provider; and
- your GP, who remains an important part of ongoing care.
Multidisciplinary care: cancer treatment often involves input from several health professionals. The purpose is to bring together the imaging, pathology, surgery and other treatment information relevant to your diagnosis.
When Another Surgeon May Need to Be Involved
Managing both breast cancer and melanoma surgery does not mean every procedure is performed by the same surgeon.
For example, another surgeon may be involved when:
- a complex breast reconstruction is being considered;
- a large melanoma excision requires a more complex reconstruction;
- the cancer is in an anatomical area requiring another surgical discipline;
- the pathology or stage requires treatment outside the surgeon's scope of practice; or
- another clinician's input is appropriate for the individual treatment plan.
Dr Gault provides implant-based breast reconstruction. When another reconstructive approach or another area of care is required, referral to an appropriate doctor can form part of the treatment plan.
Questions to Ask a Surgeon About Breast Cancer and Melanoma
It is reasonable to ask how a surgeon's training and experience relate to the procedure being considered.
- What qualifications do you hold for general surgery?
- What experience do you have with breast cancer surgery?
- What experience do you have with melanoma surgery?
- Do you perform sentinel lymph node biopsy for breast cancer and melanoma?
- Why is sentinel lymph node biopsy being recommended, or not recommended, for me?
- What are the potential benefits and risks of the operation you are proposing?
- Could I need another operation after the final pathology is available?
- Which other doctors are likely to be involved in my treatment?
- How will my case be coordinated with my GP?
- What should I expect during recovery and follow-up?
Checking registration: you can search the AHPRA Register of Practitioners for registration information about Australian health practitioners.
Breast and Melanoma Surgery on the Gold Coast
Dr John Gault provides breast cancer and melanoma surgery on the Gold Coast. He completed Fellowship in General Surgery with the Royal Australasian College of Surgeons and has been a Staff Specialist at the Gold Coast Hospital Robina Campus since 2008.
His Gault Surgery profile records his involvement in establishing General, Breast and Melanoma services at Robina and his experience with sentinel lymph node biopsy and lymph node dissection.
Dr Gault consults at Gault Surgery in Pindara Place, Benowa. Breast care nurse support is available as part of the breast care team. The nurse is not named on this page so the information remains accurate if staffing changes.
Public and private care: Seeing Dr Gault privately does not change your place on a public hospital waiting list.
Preparing for your appointment
1. Bring your reports.
Bring available breast imaging, biopsy reports, melanoma pathology and other relevant medical information.
2. Tell your GP about both concerns.
If you have a breast concern and a skin lesion, make sure your GP knows about both so the available information can be included in the referral.
3. Arrange a referral.
A referral from your GP or another treating doctor allows eligible patients to claim the applicable Medicare rebate for a specialist medical consultation.
4. Write down your questions.
Bring a list of the issues you want to discuss, particularly if two diagnoses or investigations are being considered at the same time.
5. Contact the rooms.
Gault Surgery can be contacted on (07) 5539 3999. The rooms are at Suite 11, Pindara Place, 13 Carrara Street, Benowa QLD 4217.
Frequently Asked Questions About Breast Cancer and Melanoma Surgery
Can the same surgeon operate on breast cancer and melanoma?
A surgeon who has appropriate training and experience in both areas may provide surgery for breast cancer and melanoma. The two cancers still require different assessment, staging and treatment planning, and other doctors may be involved depending on the diagnosis.
Why do breast cancer surgery and melanoma surgery overlap?
Both can involve removing cancer with an appropriate margin, having the tissue examined by a pathologist and assessing sentinel lymph nodes in selected patients. The details of the operations, staging and additional treatments are different for each cancer.
Is sentinel lymph node biopsy used for both breast cancer and melanoma?
Yes, sentinel lymph node biopsy can be used in both conditions when clinically indicated. In breast cancer, the sentinel nodes are usually in the armpit. With melanoma, the draining nodes depend on the site of the melanoma and may be in areas such as the armpit, groin or neck.
The procedure can provide useful staging information but also carries risks including pain, infection, numbness, fluid collection and lymphoedema.
Does every melanoma require sentinel lymph node biopsy?
No. Whether sentinel lymph node biopsy is discussed depends on the melanoma's thickness and other pathological features. Your surgeon can explain whether the staging information is likely to be useful in your circumstances and discuss the risks of the procedure.
Can a breast operation and melanoma operation be performed at the same time?
Sometimes procedures can be coordinated, but this depends on the diagnoses, type and extent of each operation, pathology, anaesthetic considerations and other clinical factors. Combining procedures may reduce the need for separate operations in an appropriate case, but it can also create a longer or more extensive operation. The benefits and risks need to be considered individually.
Will the same surgeon provide all of my cancer treatment?
Not necessarily. Surgery is one part of cancer care. Depending on the diagnosis, medical oncologists, radiation oncologists, radiologists, pathologists, dermatologists and other health professionals may also be involved.
What are the risks of breast cancer or melanoma surgery?
Risks vary according to the operation. They can include bleeding, infection, wound-healing problems, pain, numbness and scarring. Lymph-node surgery can also cause fluid collection, restricted movement and lymphoedema. More extensive breast or skin surgery can affect body shape or require reconstruction. Your individual risks should be discussed before surgery. Results vary from person to person.
Where does Dr John Gault consult on the Gold Coast?
Dr John Gault consults at Gault Surgery, Suite 11, Pindara Place, 13 Carrara Street, Benowa QLD 4217. The rooms can be contacted on (07) 5539 3999.
Discussing Breast Cancer and Melanoma Surgery on the Gold Coast
Sources and Further Reading
- Cancer Australia: Breast cancer surgery
- Cancer Australia: Sentinel node biopsy
- Melanoma Institute Australia: Melanoma diagnosis
- Melanoma Institute Australia: Melanoma treatment
- Cancer Australia: Melanoma of the skin statistics
- AHPRA: Register of Practitioners
- Royal Australasian College of Surgeons
This page provides general information only. Your diagnosis, pathology, imaging, medical history and individual circumstances need to be considered by your treating medical team when treatment is planned.