Breast-conserving surgery (BCS) removes the cancer while leaving as much normal breast as possible. Usually, some surrounding healthy tissue and lymph nodes also are removed. Breast-conserving surgery is sometimes called lumpectomy, quadrantectomy, partial mastectomy, or segmental mastectomy depending on how much tissue is removed.
Breast-conserving surgery (BCS) is a good option for many women with early-stage cancers. The main advantage is that a woman keeps most of her breast. However, most women will also need radiation therapy, given by a radiation oncologist (a doctor who specializes in radiation). Women who have their entire breast removed (mastectomy) for early-stage cancers are less likely to need radiation, but they may be referred to a radiation oncologist for evaluation because each patient’s cancer is unique.
BCS might be a good option if you:
This type of surgery is typically done in an outpatient surgery center, and an overnight stay in the hospital usually is not needed. Most women should be able to function after going home and can often return to their regular activities within 2 weeks. Some women may need help at home depending on how extensive their surgery was.
Ask a member of your health care team to show you how to care for your surgery site and affected arm. Usually, you and your caregiver(s) will get written instructions about care after surgery. These instructions might include:
As with all operations, bleeding and infection at the surgery site are possible. Other side effects of breast-conserving surgery can include:
During BCS, the surgeon will try to remove all the cancer, plus some surrounding normal tissue. This can sometimes be difficult depending on where the cancer is located in your breast.
After surgery, a doctor, called a pathologist, will look closely at the tissue that was removed in the lab. If the pathologist finds no invasive cancer cells at any of the edges of the removed tissue, it is said to have negative or clear margins. For women with DCIS, at least 2mm (0.08 inches) of normal tissue between the cancer and the edge of the removed tissue is preferred. If DCIS cancer cells are found near the edges of the tissue (within the 2mm), it is said to have a close margin. If cancer (invasive or DCIS) cells are found at the edge of the tissue, it is said to have a positive margin.
Having a positive margin means that some cancer cells may still be in the breast after surgery, so the surgeon often needs to go back and remove more tissue. This operation is called a re-excision. If cancer cells are still found at the edges of the removed tissue after the second surgery, a mastectomy might be needed.
Before your surgery, talk to your breast surgeon about how breast-conserving surgery might change the look of your breast. The larger the portion of breast removed, the more likely it is that you will see a change in the shape of the breast afterward. If your breasts look very different after surgery, it may be possible to have some type of reconstructive surgery or to have the size of the unaffected breast reduced to make the breasts more symmetrical (even). It may even be possible to have this done during the initial surgery. It's very important to talk with your doctor (and possibly a plastic surgeon) before the cancer surgery to get an idea of how your breasts are likely to look afterward, and to learn about your options.
Most women will need radiation therapy to the breast after breast-conserving surgery. Sometimes, to make it easier to aim the radiation, small metallic-like clips (which will show up on x-rays) may be placed inside the breast during surgery to mark the area where the cancer was removed.
Many women will have hormone therapy after surgery to help lower the risk of the cancer coming back. Some women might also need chemotherapy after surgery. If so, radiation therapy and hormone therapy are usually delayed until the chemotherapy is completed.
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Last Revised: October 27, 2021