What is a Lumpectomy?
A lumpectomy is a surgery to remove cancer from the breast. Unlike a mastectomy, a lumpectomy removes only the tumor and a margin (a small rim of normal tissue around the tumor). It leaves most of the breast skin and tissue in place.
With a 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.
A lumpectomy is also called a breast-conserving surgery, a partial mastectomy or a wide excision.
Lumpectomy – the procedure
With a lumpectomy, the surgeon makes an incision (cut) in the breast and removes the tumor, along with a small rim of normal tissue around it. In some cases, a person may get 2 lumpectomies in the same breast.
Learn more about the surgical procedure and what to expect before and after a lumpectomy.
Radiation therapy after a lumpectomy
Radiation therapy is usually given after a lumpectomy to kill 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 [3]:
- Breast cancer recurrence (a return of breast cancer)
- Death from breast cancer
If both surgeries are options, overall survival is the same for a lumpectomy plus radiation therapy and a mastectomy [1-2]. This means both treatments lower the risk of dying (from breast cancer or other cause) by the same amount.
After a lumpectomy, chemotherapy, hormone therapy, HER2-targeted therapy and/or other drug therapies may be given.
When is a lumpectomy plus radiation therapy an option?
Radiation therapy is usually given after a lumpectomy to kill any cancer cells that might be left in the breast.
A lumpectomy is an option for most people who have early breast cancer or ductal carcinoma in situ (a non-invasive breast cancer).
A lumpectomy may also be an option for some people with locally advanced breast cancer after treatment with neoadjuvant therapy (drug therapy given before surgery). Neoadjuvant therapy is also called preoperative therapy.
In some cases, neoadjuvant therapy can shrink a tumor enough so a lumpectomy becomes an option instead of a mastectomy.
When may mastectomy be the best surgical option?
A mastectomy may be the best surgical option when:
- There are 2 or more multi-centric tumors (tumors in different areas of the breast), and when multiple lumpectomies cannot be done with a good enough cosmetic result.
- The tumor is large (relative to breast size) and neoadjuvant therapy won’t be given.
- The tumor is diffuse (has spread throughout the breast).
- The mammogram showed large areas of suspicious calcifications in the breast.
- A breast MRI before surgery showed extensive abnormal tissue in the breast which cannot be removed with a lumpectomy.
- The tumor is located just below the nipple and the cosmetic look after a lumpectomy will not be good. (In some cases, a lumpectomy may remove the nipple, areola and tumor but leave the rest of the breast intact.)
- The surgeon can’t get negative margins (remove all the tumor) after multiple attempts by a lumpectomy.
- Radiation therapy can’t be given.
Some women who have the option of a lumpectomy, choose to have a mastectomy for other reasons.
Learn about deciding between a lumpectomy and a 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 a lumpectomy and safely wait until after delivery to have radiation therapy.
- Scleroderma. Radiation therapy can cause harm to normal tissue during and after breast cancer treatment in people who have scleroderma. 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 rare, inherited gene mutations. In some women at higher risk of breast cancer recurrence, radiation therapy may still be used. In addition, some women with certain gene mutations may be at a higher risk of a new breast cancer in the future. Sometimes these women choose to have a mastectomy to avoid radiation therapy and lower this risk.
- Past radiation therapy to the same breast. In general, radiation therapy to the breast can only be given once. However, repeat radiation to the chest is sometimes recommended in the treatment of breast cancer recurrence. And, some data suggest repeat radiation therapy to a portion of the breast may be a reasonable option for certain women who had a lumpectomy for breast cancer in the past [4].
What to expect after a lumpectomy
After a lumpectomy, you’ll likely have some pain and numbness. The look of the breast will also likely change.
Learn more about what to expect after a lumpectomy, including:
- Pain and numbness after a lumpectomy
- Limited range of motion in the shoulder area (if axillary lymph nodes are removed)
- Risk of lymphedema (if axillary lymph nodes are removed)
- Cosmetic issues after a lumpectomy
- Emotional health after a lumpectomy
Treatment guidelines
Although the exact treatment for breast cancer varies from person to person, evidence-based guidelines help make sure high-quality care is given. 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 follow.
After you get a recommended treatment plan from your health care team, study your treatment options. Together with your health care team, make thoughtful, informed decisions that are best for you. Each treatment has risks and benefits to consider along with your own values and lifestyle.
Transportation, lodging, childcare and eldercare assistance
You may not live near the hospital where you’ll have your surgery. It’s OK to ask for help.
There may be resources available if you need a ride to and from surgery or help with childcare or eldercare. Family and friends often want to help but don’t know how. These are great ways for them to get involved.
There may be some programs that help with local or long-distance transportation and lodging (if you need a place to stay overnight).
There may also be programs to help you with childcare or eldercare costs.
Learn more about transportation, lodging, childcare and eldercare assistance programs.
You’re not alone
If you’re facing breast cancer surgery, it’s normal to feel worried or afraid. Many people have been where you are today. They had the same fears and faced the same tough choices. They’ve gone through breast cancer treatment and are living their lives.
It may help to talk with others who’ve finished treatment to help ease your fears. You can do this in a support group or by connecting one-on-one with another breast cancer survivor.
You can also talk with your health care providers about how you’re coping. They care about your overall well-being and can help you find ways to improve it. In addition to suggesting a support group, they may connect you to another member of your health care team, such as a social worker or patient navigator, for support. They may also refer you to a counselor.
Our Support section has a list of resources to help you find local and online support groups and other resources.
Learn more about social support and support groups.
Learn about ways to cope with stress.
Susan G. Komen® Support Resources |
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Updated 04/08/24
