Lumpectomy

Lumpectomy is a surgery to remove cancer from the breast. Unlike mastectomy, 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 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.

Lumpectomy is also called breast-conserving surgery, partial mastectomy and wide excision.

Radiation therapy after lumpectomy

Radiation therapy is usually given after 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 lumpectomy and mastectomy are both options for surgery, survival with lumpectomy plus radiation therapy is the same as with mastectomy [2-3].

After lumpectomy, chemotherapy, hormone therapy, HER2-targeted therapy and/or other drug therapies may also be given.

When is lumpectomy plus radiation therapy an option?

Radiation therapy is usually given after lumpectomy to get rid of any cancer cells that might be left in the breast.

Lumpectomy is an option for most women who have early breast cancer or ductal carcinoma in situ (a non-invasive breast cancer).

Lumpectomy may also be an option for some women 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 lumpectomy becomes an option, instead of mastectomy.

When may mastectomy be the best surgical option?

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 lumpectomy will not be good. (In some cases, lumpectomy may remove the nipple, areola and tumor but leave the rest of the breast intact.)
• The surgeon cannot get negative margins (remove all the tumor) after multiple attempts by lumpectomy.
• Radiation therapy can’t be given.

Learn about deciding between lumpectomy and 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 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 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, recent 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.

Treatment guidelines

Although the exact treatment for breast cancer varies from person to person, 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.

Cosmetic issues

What to expect after lumpectomy

Women may choose lumpectomy over mastectomy to keep their breast and have it look (as much as possible) like it did before surgery.

However, lumpectomy will change the look and feel of the breast. Because some tissue is removed, the breast may be smaller. There will also be a scar and some numbness. Ask your health care provider about products that might help reduce the appearance of the scar.

Radiation therapy (usually given after lumpectomy) can also affect the look of the breast. It may:

• Make the breast smaller
• 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 lumpectomy. In these cases, 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.

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. 

SUSAN G. KOMEN® SUPPORT RESOURCES

If you or a loved one needs more information about breast health or breast cancer, contact the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org. All calls are answered by a trained specialist or oncology social worker, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET. Se habla español. Komen Patient Navigators can help guide you through the health care system as you go through a breast cancer diagnosis. They can help to remove barriers to high-quality breast care. For example, they can help you with insurance, local resources, communication with health care providers and more. Call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org to learn more about our Patient Navigator program, including eligibility. Komen Facebook groups provide a place where those with a connection to breast cancer can share their experiences and build strong relationships with each other. Visit Facebook and search for “Komen Breast Cancer group” or “Komen Metastatic Breast Cancer group” to request to join one of our closed groups. Our fact sheets, booklets and other education materials offer additional information.