Breast Lumpectomy

About Breast Lumpectomy

Lumpectomy, also called partial mastectomy, wide local excision or breast conserving surgery, removes a breast tumor with a margin of surrounding normal tissue while preserving the rest of the breast. Combined with radiation therapy, it is a standard treatment for early stage breast cancer and for ductal carcinoma in situ. Landmark randomized trials, including NSABP B 06 led by Bernard Fisher in the United States and the Milan trial led by Umberto Veronesi, showed that breast conserving surgery with radiation gives long term survival equivalent to mastectomy for suitable tumors. Radiation after lumpectomy substantially reduces the risk of cancer returning in the breast. The excised tissue is oriented so that the pathologist can examine each margin, and consensus guidelines define what counts as an adequate margin for invasive cancer and for DCIS; further surgery, called re excision, is needed when cancer cells reach the edge. Tumors that cannot be felt are located before surgery with a guide wire placed under imaging or with wire free markers such as radioactive or magnetic seeds and radar reflectors. Sentinel lymph node biopsy is usually performed at the same time for invasive cancer. Oncoplastic techniques rearrange the remaining breast tissue to preserve shape when larger volumes are removed. Partial breast irradiation is an option for some patients with lower risk disease. Complications include infection, seroma, changes in breast shape and the need for further surgery.