A lumpectomy is the key component of breast conserving surgery. A lumpectomy is the surgical removal of a cancerous tumor along with a surrounding margin of healthy adjacent breast tissue. A clear margin is important to ensure that all cancer cells were removed.
This procedure is often performed on patients with early stage breast cancer, whose tumor is small or localized. Once cancer is confirmed, a lumpectomy is usually followed by radiation therapy to reduce chances of the cancer returning.
Lumpectomy vs. Mastectomy?
This is often the most difficult decision you will have to make. It is important to know that during the 1970s, a number of prospective randomized trials were performed comparing lumpectomy plus radiation therapy with mastectomy. Long-term results have shown that survival was equivalent, regardless of the procedure. If your doctor offers you a lumpectomy, your survival will be the same no matter which approach you chose. You will not be jeopardizing your survival by saving your breast.
In the case of early stage breast cancer, no studies have shown that a mastectomy (removal of the entire breast) is more effective that a lumpectomy with radiation. Many times, one procedure is chosen over the other based on the woman’s preference, comfort level, stage and size of the cancer.
Overall, most women would prefer to stay whole and choose a lumpectomy plus radiation therapy, if offered.
Some factors may prevent you from having a lumpectomy as a treatment option, including:
- The tumor may be too large or located in an area that would be difficult to remove with good cosmetic results.
- If there are several areas of cancer in one breast (multicentricity), preventing the tumor to be removed as a single lump.
- The cancer has attached to nearby structures, like the chest wall or skin, and requires more extensive surgery.
- The need for radiation therapy after the lumpectomy. Women who do not want to have radiation therapy may choose a more extensive surgery that does not require it.