Breast Conserving Surgery

Breast conserving surgery is typically referred to as a lumpectomy, but is also known as a segmental mastectomy, segmentectomy, partial mastectomy, or wide excision. Lumpectomy is a surgery to remove only the tumor and a small margin of the normal tissue around it. So, the breast looks as close as possible to how it did before surgery. Most often, the general shape of the breast and the nipple area are kept.

Radiation therapy is important following lumpectomy to reduce the risk of the cancer recurring (coming back) in the breast. Radiation lowers the chances of the cancer recurring in the breast to about 5-10%. Studies have shown that overall survival with lumpectomy plus radiation therapy is the same as with mastectomy.

Approximately 80-90% of the time, clear margins can be achieved at the first surgery. Some women require a second procedure (generally called a re-excision) to clear a margin. Often times, small metallic (titanium) clips are placed at the time of lumpectomy by the surgeon to mark the location of the tumor. This helps the radiation oncologist target the radiation treatment. It is also helpful for follow-up, since the location of the original tumor can be easily identified on mammogram by the clips. Lumpectomy is typically performed in an outpatient setting, and does not require staying in the hospital.

To determine if lumpectomy is an option for you, your doctor needs to consider several factors, including:

  • Whether the tumor can be removed with clear margins
  • Whether the remaining breast tissue can be preserved with a natural shape
  • Whether radiation therapy can be performed
  • Whether the breast can be followed reliably in the future for recurrence, and
  • Your personal preference.

Oncoplasty

A surgical technique performed at the time of lumpectomy by your breast surgeon or a plastic surgeon. In essence, it is reconstruction after lumpectomy, and involves locally advancing and moving parts of your remaining breast tissue to fill in the space left behind after the lumpectomy. Depending on the size and location of the tumor, this technique may be used to help achieve a better cosmetic result.

Neoadjuvant (Pre-Operative) Therapy

Sometimes, if the tumor is too big to remove with lumpectomy, your surgeon may consider giving you medications before surgery to reduce the size of the tumor. Medications may include chemotherapy or hormonal therapy.

Click here for a list of questions to ask your surgeon about a lumpectomy.

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