What is a lumpectomy?
A lumpectomy, also called breast-conserving surgery, wide local excision, or partial mastectomy, removes the tumour and a rim of healthy tissue (the margin) around it, while leaving the rest of the breast intact. It is performed under general anaesthesia and is followed by radiation therapy to reduce the risk of local recurrence.
For many patients with early-stage breast cancer, lumpectomy plus radiation gives survival outcomes equal to mastectomy. This is a well-established finding from large clinical trials spanning more than two decades.
When lumpectomy is recommended
- Early-stage breast cancer (Stage I and II in most cases)
- Single tumour that is small relative to the breast size
- Tumour located where clear margins can be achieved without major cosmetic impact
- Patients who want to preserve their breast and are willing to have radiation
- DCIS (ductal carcinoma in situ) where the area involved is limited
When mastectomy may be preferred instead
- Large tumour relative to breast size where conservation would leave a poor appearance
- Multiple tumours in different quadrants of the breast
- Inflammatory breast cancer
- Unable to have radiation therapy (e.g., previous chest radiation)
- BRCA mutation with high risk of second primary cancer in the same breast
- Patient preference after full discussion
What happens during surgery
You will be under general anaesthesia. Dr. Shruthi makes an incision to remove the tumour with a surrounding margin of healthy tissue. The excised tissue is sent for histopathology to confirm the margins are clear. If a margin comes back involved, a re-excision may be needed.
If a sentinel lymph node biopsy is performed at the same time, which is common, a small additional incision is made in the armpit. The operation typically takes 45 to 90 minutes.
Recovery after lumpectomy
- Most patients go home the same day or the next morning
- Pain is usually mild and managed with oral medications
- Normal daily activities can resume within 1 to 2 weeks
- Radiation therapy typically begins 3 to 6 weeks after surgery
- Follow-up appointments are scheduled to monitor healing and discuss pathology results
Oncoplastic techniques can be combined with lumpectomy to improve the cosmetic result. If removing the tumour would affect the shape of the breast, Dr. Shruthi uses tissue rearrangement techniques to restore the breast contour at the same time. This is oncoplastic surgery.
Dr. Shruthi's preference for conservation
Dr. Shruthi believes that preserving the breast, when oncologically safe, preserves something important for the patient. She always evaluates lumpectomy viability before recommending mastectomy, and she uses oncoplastic techniques to widen the eligibility for conservation in patients who might otherwise have needed removal.