Lumpectomy

Lumpectomy is a surgical procedure which is intended to remove the cancerous tissue from the breast, without removing the breast itself.  The amount of tissue that must be removed depends on the size of the tumor and must include a rim of surrounding normal tissue.  This may be an area no larger than large marble, but can sometimes require removal of an area that is much larger. 

The goal, of course, is to remove only as much tissue as needed to maintain the best cosmetic result.  Because cancers can have small "feelers" extending into surrounding tissue, it is sometimes necessary to have a second minor surgery to removal additional margins of tissue to ensure complete removal of the abnormal tissue.

Lumpectomy almost always requires radiation treatments to the breast later, to help prevent recurrence of the cancer in the breast.  In addition, some cancers are positioned in a location, or are so large, that lumpectomy is not the ideal treatment and that removal of the entire breast is required (mastectomy).

Patients often ask which operation is "better" - lumpectomy or mastectomy.  The answer depends on the endpoint of treatment that you are considering.  There is no difference in survival between lumpectomy plus radiation and mastectomy, so that they are equivalent in that regard.  There is a difference between the two procedures in many ways, but several that are important:

• Mastectomy rarely requires radiation; lumpectomy almost always does.

• Mastectomy requires breast reconstruction to achieve a cosmetic results comparable to lumpectomy

• The risk of local recurrence (i.e., cancer coming back in the same breast) is slightly less with mastectomy than with lumpectomy and radiation.