Lumpectomy

Lumpectomy, also known as breast-conserving surgery or wide local excision, is a surgical procedure to remove a malignant tumor from the breast while preserving most of the surrounding tissue. It is commonly used for early-stage breast cancer or ductal carcinoma in situ (DCIS). The goal is to remove the tumor with a margin of normal tissue to reduce the likelihood of residual cancer and may be followed by radiation therapy to lower recurrence risk.

Planning typically involves imaging and a biopsy to confirm cancer type and extent. A sentinel lymph node biopsy is often performed at the same time to assess regional spread; if nodes are cancer-positive, additional treatment or surgery may be needed.

During the operation, anesthesia is used. The surgeon makes an incision, removes the tumor with surrounding tissue, and sends the specimen to pathology for margin assessment. The breast may be reshaped to optimize appearance. After lumpectomy, radiation therapy to the remaining breast is commonly advised, usually starting several weeks later. Depending on the tumor characteristics, adjuvant treatments such as chemotherapy, hormone therapy, or targeted therapy may be recommended.

Risks include infection, bleeding, changes in breast size or contour, numbness, scarring, and fatigue. There is a risk of cancer returning in the treated breast, which is mitigated by clear margins and adjunct therapies. Recovery typically spans a few weeks, with activity gradually increasing and most patients able to resume normal tasks.

Lumpectomy is generally favored when the tumor-to-breast size ratio is favorable, disease is localized, and radiation therapy is feasible. In other cases, mastectomy or other approaches may be preferred.