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Breast-Conserving Surgery for Breast Cancer

Surgery Overview

Breast-conserving surgery, such as lumpectomy, removes the cancer and surrounding tissue. The goal is to take just enough tissue so that the breast looks as normal as possible after the surgery but the chance of the cancer coming back is low.

The size and location of tumors differs from one person to another, so the amount of tissue removed during surgery also differs.

Some of the lymph nodes under the arm may also be removed during breast-conserving surgery. This is done with a separate incision. If cancer is found in those lymph nodes, more lymph nodes may be removed.

Most people who have breast-conserving surgery also have radiation therapy. You may also have chemotherapy, hormone therapy, or both.

What To Expect

A lumpectomy may be done with local anesthesia or general anesthesia.

After your surgery, you will be taken to a recovery room. A nurse will be able to help with any nausea, pain, or anxiety you might have.

Most people go home the day of the surgery. Your doctor or nurse will give you instructions on pain control and caring for your incision. Typically, you can take a shower on the day after surgery. Women can wear a bra if it is comfortable. Some doctors recommend wearing a bra day and night for a few days for support.

Most people are able to get back to normal activity within a few days. But be sure to wait for your doctor to tell you when you can start with more strenuous physical activity. This will depend on the extent of the surgery and on other treatment you might be having.

If you are going to have radiation therapy, it will not start until your incision heals. This usually takes 4 to 6 weeks.

Why It Is Done

Breast-conserving surgery is done in early-stage breast cancer to remove as much cancer as possible and give the greatest chance of a cure.

How Well It Works

For early-stage breast cancer, breast-conserving surgery with radiation therapy has the same survival rate as mastectomy.footnote 1

Risks

Complications of breast-conserving surgery are unusual but include infection, bleeding, poor wound healing, or a reaction to the anesthesia used in surgery. Blood or clear fluid may also collect in the wound and need to be drained. You may have breast pain and feelings of pulling, pinching, tingling, or numbness.

Compared to women who have a mastectomy, women who have breast-conserving surgery have a slightly higher chance of the cancer returning.

What To Think About

The more breast tissue that is removed during this surgery, the more likely it is that there will be a noticeable change in the breast afterwards. Experts suggest that before having breast-conserving surgery, women talk with their doctors (and possibly a plastic surgeon) about what their breasts might look like after the surgery.

Breast-conserving surgery can be considered after the cancer has been staged. Breast-conserving surgery may not be the best choice in some cases, depending on the size of the tumor or if there are several tumors that are too far apart.

Breast-conserving surgery is usually followed by radiation. If you don't want to have radiation therapy or if you cannot have radiation treatment, breast-conserving surgery is not usually a good choice.

Radiation therapy has to be done on a set schedule and takes several weeks. If you do not think you can go to every appointment, talk to your doctor about other treatment options.

Surgery is almost always recommended to treat breast cancer. If breast-conserving surgery is not a good option for you, then one of the three types of mastectomy may be a better treatment choice.

References

Citations

  1. Fisher B, et al. (2002). Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. New England Journal of Medicine, 347(16): 1233–1241.

Credits

Current as ofDecember 19, 2018

Author: Healthwise Staff
Medical Review: Sarah Marshall MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Laura S. Dominici MD - General Surgery,