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Lumpectomy/breast-conserving surgery (BCS)

The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

If you’re diagnosed with breast cancer, you may be working with your care team—a team of providers and specialists—on a treatment plan. One of these treatments may be a lumpectomy. Learn about what a lumpectomy is, why one may be recommended, and what to expect during surgery and aftercare.

What is a lumpectomy?

A lumpectomy is a surgical procedure that’s performed when you have cancer and need to have some of the cancerous tissue and nearby areas removed. The goal of this procedure is to extract cancer tissue while still maintaining breast tissue.

You may also hear this procedure called by a few other names, such as:

  • Breast-conserving surgery (BCS)
  • Quadrantectomy
  • Partial mastectomy
  • Segmental mastectomy

These terms mean slightly different things depending on how much breast tissue is removed. This surgery is different from a mastectomy, which involves surgically removing the entire breast.

You may have a part of your chest wall removed as well during a lumpectomy if the cancer is detected near this area. Your care team may also choose to remove some of the lymph nodes underneath your arm if these are concerning areas for cancer.

Why are lumpectomies performed?

A lumpectomy is performed for patients who are diagnosed with breast cancer. It's a form of treatment that may be a good option in the early stages of cancer. The goal of this surgery is to prevent cancer from spreading to the rest of the body.

Many patients decide to have a lumpectomy because they want to keep as much of their breast as possible. It’s less invasive than a mastectomy, but often, patients who have a lumpectomy also need to have radiation or another treatment.

Three factors to consider before deciding

There are several issues to take into consideration when deciding whether or not to have a lumpectomy.

  1. Are you a candidate? Not everyone who has breast cancer is a good candidate for a lumpectomy. This depends on your overall health status, the type of cancer, or other factors that you may discuss with your care team.
  2. What is your individual treatment plan? It's also important to realize that you’re unique, just like your specific cancer treatment plan. How much of your breast tissue is removed during a lumpectomy depends on several things, including the tumor's size and location, and the size of your breast.
  3. How important is maximizing your breast tissue? The benefit of having this surgery means you’re able to keep most of your breast, but it also means that your care team may recommend radiation therapy as well. In most cases, radiation follows a lumpectomy, but you may also need to undergo chemotherapy or hormone therapy. If you elect to have a lumpectomy along with radiation instead of having a mastectomy, it doesn't affect your overall recovery or survival rate of breast cancer.

What are the risks?

All surgeries come with a level of risk, and a lumpectomy is no different. Breast swelling is common after surgery but should be temporary. You may have pain, and you may have a scar or dimple where your tumor was taken out. You may even feel a "tugging" feeling in the breast.

After this type of surgery, you may feel a type of nerve pain called post-mastectomy pain syndrome (PMPS). This affects 20 percent to 30 percent of patients, according to the American Cancer Society. You may feel a shooting or burning pain in your chest wall, armpit or in an arm. Unfortunately, this doesn't go away, but many patients say the pain isn’t severe.

Some patients may also experience swelling in the arm, known as lymphedema. Alert your care team as soon as possible if you experience swelling, tight skin or a feeling of heaviness in your affected arm, so that treatment may start as soon as possible. Caught early, lymphedema may be reversed with treatment, but infection may develop if it progresses.

How to prepare for a lumpectomy

A lumpectomy is usually performed as an outpatient procedure in a surgery center. Usually, an overnight stay in a hospital isn't necessary, and most patients resume regular daily activities within two weeks. Consider finding someone to help you out while you’re recovering.

You’ll likely have appointments with your doctor to review what to expect before, during and after surgery. It may help to take notes or bring along someone who is able to do this for you or ask questions. It’s also important to review all the medications you're currently taking. Some of these, such as blood thinners, need to be stopped before surgery. You may or may not need to stop eating or drinking for a set amount of hours before surgery.

What to expect during the procedure

During a lumpectomy, the surgeon's goal is to remove as much cancer as possible, and some healthy tissue may need to be removed as well. This tissue is sent for testing. Some lymph nodes under the arm may also be extracted.

When the surgery is finished, a pathologist studies the tissue samples under a microscope. If the pathologist doesn't see any cancer at the edge of the tissue, it means the tissue has clear, or negative, margins. If there are cancer cells present at the edges, it means there are close, or positive, margins. Your doctor will then inform you of these results and what treatment looks like going forward.

Follow-up care/results

Expect written instructions from your care team about how to manage your surgical site after discharge, along with contact information in case you have questions or concerns.

Make sure you understand how to care for your site and know how to change the dressing. If you have a drain, you’ll need to know how to empty it and keep it clean.

You'll receive instructions on when and how to bathe after surgery, and when you may wear a bra again.

It’s also important to discuss infection prevention and managing pain, along with any numbness in your breast or arm. Your care team may provide instructions on managing your activity levels and doing any prescribed exercises to prevent stiffness in your arm.

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