What is Breast Conserving Surgery?
Surgery to remove the breast cancer and some surrounding healthy tissue is called breast conserving surgery. It is also called lumpectomy or wide local excision. Breast conserving surgery is recommended if the cancer is small compared to the size of your breast.
How Is It Done?
The surgeon removes the smallest amount of breast tissue possible. This will leave a scar and may change the size and, potentially, the shape of the breast, and it may affect the position of the nipple.
Oncoplastic breast conserving surgery combines oncological surgery (to remove the cancer) with plastic surgery (to reshape the breast and preserve its appearance as much as possible). This specialised surgical technique is performed by oncoplastic breast surgeons and some breast surgeons.
The removed breast and lymph node tissue is sent to a laboratory. A specialist called a pathologist checks it under a microscope to see if there is an area of healthy cells around the cancer – this is known as a clear margin. The pathologist will create a report, which will include information about the size and grade of the cancer, whether it has spread to any lymph nodes (the stage), whether the margins contain cancer cells, and whether the cells are hormone and/or HER2 receptor positive or negative.
If cancer cells are found at the edge of the removed tissue (an ‘involved’ or ‘positive’ margin), there is a greater chance of the cancer returning. You may need more tissue removed (re-excision or wider excision), or your doctor may recommend you have a mastectomy.
Results and recommendation
After breast conserving surgery, radiotherapy to the whole breast is usually recommended to destroy any undetected cancer cells that may be left in the breast or armpit, and to keep the cancer from coming back (recurrence). For some women, radiotherapy may not be required.
Some women also need chemotherapy, targeted therapy or hormone therapy.