What is a Lumpectomy?
A lumpectomy is a surgery to remove cancer from the breast. Unlike a mastectomy, a lumpectomy removes only the tumor and a small rim of normal tissue around it. It leaves most of the breast skin and tissue in place.
With a lumpectomy, 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 preserved.
A lumpectomy is also called a breast-conserving surgery, a partial mastectomy or a wide excision.
Radiation therapy after lumpectomy
Radiation therapy is usually given after a lumpectomy to get rid of any cancer cells that might be left in the breast. These cells are too small to see on mammograms or other imaging tests, or to measure with lab tests.
Radiation therapy can lower the risk of [4]:
- Breast cancer recurrence (a return of breast cancer)
- Breast cancer death
If a lumpectomy and a mastectomy are both options for surgery, survival with a lumpectomy plus radiation therapy is the same as with a mastectomy [2-3].
After a lumpectomy, chemotherapy, hormone therapy, HER2-targeted therapy and/or other drug therapies may be given.
When is lumpectomy plus radiation therapy an option?
Radiation therapy is usually given after a lumpectomy to get rid of any cancer cells that might be left in the breast.
A lumpectomy is an option for most people who have early breast cancer or ductal carcinoma in situ (a non-invasive breast cancer).
A lumpectomy may also be an option for some people with locally advanced breast cancer after treatment with neoadjuvant therapy (drug therapy given before surgery). In some cases, neoadjuvant therapy can shrink a tumor enough so a lumpectomy becomes an option, instead of a mastectomy.
When may mastectomy be the best surgical option?
A mastectomy may be the best surgical option when:
- There are 2 or more tumors in different areas of the breast (multi-centric tumors).
- The tumor is large (relative to breast size) and neoadjuvant therapy won’t be given.
- The tumor has spread throughout the breast (diffuse tumor).
- The mammogram showed large areas of suspicious calcifications in the breast.
- The tumor is located just below the nipple and the cosmetic look after a lumpectomy will not be good. (In some cases, a lumpectomy may remove the nipple, areola and tumor but leave the rest of the breast intact.)
- The surgeon can’t get negative margins (remove all the tumor) after multiple attempts by a lumpectomy.
- Radiation therapy can’t be given.
Some women who have the option of a lumpectomy, choose to have a mastectomy for other reasons.
Learn about deciding between a lumpectomy and a mastectomy.
Who cannot have radiation therapy?
Not everyone can have radiation therapy. Being pregnant, having certain health conditions or having certain inherited gene mutations can make radiation therapy harmful.
- Pregnancy. Radiation can harm a fetus. Depending on the timing of the pregnancy and the breast cancer diagnosis, you may be able to have a lumpectomy and safely wait until after delivery to have radiation therapy.
- Scleroderma or systemic lupus erythematosus (SLE). Radiation therapy can cause harm to normal tissue during and after breast cancer treatment in people who have scleroderma or SLE. In some women at higher risk of breast cancer recurrence, radiation therapy may still be used.
- Some inherited gene mutations. Radiation therapy can cause harm to normal tissue during and after treatment in people who have certain inherited gene mutations. In some women at higher risk of breast cancer recurrence, radiation therapy may still be used.
- Past radiation therapy to the same breast. In general, radiation therapy to the breast can only be given once. However, some data suggest repeat radiation therapy to a portion of the breast may be a reasonable option for some women [5]. Also, repeat radiation to the chest is sometimes recommended in the treatment of breast cancer recurrence.
Cosmetic issues
What to expect after lumpectomy
Women may choose a lumpectomy over a mastectomy to keep their breast and have it look (as much as possible) like it did before surgery.
However, a lumpectomy may change the look and feel (sensation) of the breast. Because some tissue is removed, the breast may become smaller. There will also be some numbness and a scar. Ask your health care provider about products that might help reduce the appearance of the scar.
Radiation therapy (usually given after a lumpectomy) can also affect the look of the breast. It may:
- Make the breast smaller or larger
- Change the texture of the breast
- Make the breast feel firmer
The look and feel of your breast will continue to change during the first 1-2 years after surgery and radiation therapy.
When mastectomy may be a better option
Sometimes, things like the location and size of the tumor make it unlikely a woman will be happy with the look of her breast after a lumpectomy. In these cases, a mastectomy (with or without breast reconstruction) may be the better option.
Breast reconstruction after lumpectomy
While not common, a woman may wish to have breast reconstruction (either at the time of the lumpectomy or later) to maintain a more natural appearance of the breast, or to match the size and shape of the other breast.
These surgeries are complex, so it’s best to meet with a plastic surgeon to discuss your options.
Treatment guidelines
Although the exact treatment for breast cancer varies from person to person, evidence-based guidelines help ensure high-quality care. These guidelines are based on the latest research and agreement among experts.
The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) are respected organizations that regularly review and update their guidelines.
In addition, the National Cancer Institute (NCI) has treatment overviews.
Talk with your health care team about which treatment guidelines they use.
After you get a recommended treatment plan from your health care team, study your treatment options. Together with your health care team, make thoughtful, informed decisions that are best for you. Each treatment option has risks and benefits to consider along with your own values and lifestyle.
Transportation, lodging, child care and elder care assistance
You may not live near the hospital where you’ll have your surgery.
Sometimes, there are programs that help with local or long-distance transportation and lodging. Some also offer transportation and lodging for a friend or family member going with you.
There are also programs to help with child and elder care costs.
Learn about transportation, lodging, child care and elder care assistance programs.
You’re not alone
If you’re facing breast cancer surgery, it’s normal to feel worried or afraid. Many people have been where you are today. They had the same fears and faced the same tough choices. They’ve gone through breast cancer treatment, recovered and are living their lives.
It may help to talk with others who’ve finished treatment to help ease your fears. You can do this in a support group or by connecting one-on-one with another breast cancer survivor.
You can also talk with your health care providers about how you’re coping. They care about your overall well-being and can help you find ways to improve it. In addition to suggesting a support group, they may connect you to another member of your health care team, such as a social worker or patient navigator, for support. They may also refer you to a counselor.
Our Support section has a list of resources to help you find local and online support groups and other resources.
Learn more about social support and support groups.
Learn about ways to cope with stress.
Susan G. Komen® Support Resources |
|
Updated 06/29/23
