“The goal of lumpectomy surgery is to take the cancer out and do the safest operation that we can."
“Most women [who] are diagnosed with breast cancer will have surgery at some point during their treatment,” says Jaime Alberty-Oller, MD, breast cancer oncologist and surgeon at the Dubin Breast Center of the Tisch Cancer Institute at Mount Sinai Hospital.
Surgery for breast cancer can help remove the tumor, but it can also help prevent cancer from coming back in the future. Mastectomies—or a total removal of the breast or breasts—are commonly associated with breast cancer treatment, but there's also a type of breast cancer surgery called a lumpectomy.
What to Know About Lumpectomy Surgery
Lumpectomies are a type of breast surgery where, instead of removing all of the breast tissue, a portion of the breast is removed. The surgeon will remove the cancer, as well as a rim of normal tissue surrounding it, which is called the margin. A lumpectomy may also be called breast-conserving surgery, quadrantectomy, partial mastectomy, or segmental mastectomy. Learn more about types of breast cancer surgery here.
“The goal of lumpectomy surgery is to take the cancer out and do the safest operation that we can," says Dr. Alberty-Oller. The amount of breast tissue that's removed during a lumpectomy depends on the size and location of the tumor, your breast size, and other factors.
"When you decide if a patient is a candidate for a lumpectomy, the most important thing that you are looking at is what we call breast-to-tumor ratio," says Dr. Alberty-Oller. "You’re looking at the size of the breast and the size of the cancer. If you excise that cancer, is the breast going to look OK once you close it back up. If there is a small breast and a large cancer, and you excise that, sometimes the breast will not look the same."
The side effects of a lumpectomy may include pain, a scar or dimple where the tumor was removed, and sometimes lymphedema, which is swelling in the arm.
It's also important to know that after a lumpectomy, most women will have radiation therapy. Some women may also get other treatments, such as chemotherapy or hormone therapy.
After the surgery, the tissue is examined under a microscope by a pathologist to look for evidence of cancer. If cancer cells are present in the margin, the surgeon may recommend additional surgery. Learn more about what to expect after a lumpectomy here.
Not every woman with breast cancer is a good candidate for lumpectomy. For example, women with larger tumors, several tumors throughout the breast, or who are unable to receive radation therapy, may be a better fit for a mastectomy instead. It's important for women to talk to their doctor to learn if lumpectomy surgery is right for them.
Some people may be interested in a mastectomy because they just want the cancer and/or the breasts gone, but if you are a candidate for a lumpectomy, getting a mastectomy has not been shown to be more effective in preventing recurrence, according to Dr. Alberty-Oller. "There are clear differences between both surgeries, in terms of recurrence, cosmesis, how it’s going to make them look, how it’s going to make them feel," says Dr. Alberty-Oller. "It’s important for them to know that we have studied this at length…and choosing a lumpectomy in most cases, over a mastectomy will not be better or worse in terms of overall survival."
Dr. Alberty is a surgical breast oncologist at the Dubin Breast Center of the Tisch Cancer Institute at Mount Sinai Hospital.
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The goal of lumpectomy surgery
is to take the cancer out and
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do the safest operation that we can.
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While at the same time leaving the breast
looking the most like it looked before
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Most women with early stage breast
cancer would be good candidates for
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It depends on the size of the tumour, the
size of the breast, before the surgery.
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And also if there are multiple areas
in the breast that have cancer.
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There are certain patients that will
not be able to have lumpectomy surgery.
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And that would be patients that have
what we call multicentric cancer.
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Which means that the cancer is spread
throughout the breast in different areas
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of the breast, or
patients that cannot get radiation.
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Usually when we talk about
lumpectomy surgery, it comes tied to
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the idea of giving radiation, which is
a therapy that is given after a surgery.
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And so if you have any medical condition
that would preclude you getting radiation,
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then that would not make
you a candidate for it.
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When you do a lumpectomy surgery, the idea
is to take out all of the cancer, right?
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But there may always be microscopic
cancer cells left behind.
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And the goal of radiation therapy it's
to mop up those cells, eliminate them,
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anything that we have left behind,
which is microscopic in nature.
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Usually when a patient
will choose lumpectomy,
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they will have to have radiation
on the back end of the surgery.
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If they don't need chemotherapy,
they should get the radiation
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a couple weeks after surgery,
maybe four to six weeks after surgery.
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If they are getting chemotherapy, the
timeline will be surgery, chemotherapy,
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and then the radiation.
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To mop up any remaining cancer cells
that might be there microscopically.
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When you talk about a lumpectomy,
the chance of the cancer coming back,
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usually we will tell patients
it's anywhere from 5-10%.
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By getting treatment,
whether it be with chemotherapy,
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radiation, or anti-hormone therapy.
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Usually those percentage
points will be lowered.
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In the majority of cases we are finding
these cancers very early on, early stage.
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They have not spread, and so
people do very, very well.
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Survival is very high, and so they
should not feel like this is necessarily
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something that will end their life or
completely change their life.
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And I want them to understand
that breast cancer is something
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that happened that we treated
that they successfully got over.
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And not necessarily something that
will change their lives forever.
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Breast conserving surgery. Waltham, MA: UpToDate, 2019. (Accessed on October 3, 2019 at https://www.uptodate.com/contents/breast-conserving-therapy.)
Breast-conserving surgery (lumpectomy). Atlanta, GA: American Cancer Society. (Accessed on October 3, 2019 at https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer/breast-conserving-surgery-lumpectomy.html.)
NCI dictionary of cancer terms: lumpectomy. National Cancer Institute. (Accessed on October 3, 2019 at https://www.cancer.gov/publications/dictionaries/cancer-terms/def/lumpectomy.)