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.
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.