Lumpectomy is the removal of the breast tumor and some of the normal tissue that surrounds it. Lumpectomy is a form of “breast-conserving” or “breast preservation” surgery, partial mastectomy or wide excision) is a surgery to remove cancer from the breast. Unlike amastectomy, a lumpectomy removes only the tumor and a small rim of normal tissue around it. Most often, the general shape of the breast and the nipple area are kept.
Radiation therapy after Lumpectomy
Radiation therapy is given after lumpectomy to get rid of any cancer cells that may remain. Women who get radiation therapy after lumpectomy have a 50 percent lower risk of breast cancer recurrence and a 20 percent lower risk of breast cancer death compared to women who get lumpectomy alone.
It is instructive to note that following a successful lumpectomy, you may have chemotherapy, hormone therapy and/or targeted therapy as measures to eliminate potentials risks.
When is lumpectomy plus radiation therapy an option?
Lumpectomy with radiation therapy is an option for most women who have early breast cancer. In some cases, it is also an option for women with locally advanced breast cancer. Most women prefer this option to a mastectomy. Women who are pregnant or who have certain health conditions cannot have radiation therapy and may need to have a mastectomy.
In pregnancy, radiation is harmful to a fetus, so it should not be given during pregnancy. However, depending on the timing of the pregnancy and the breast cancer diagnosis, a woman may be able to have a lumpectomy and put off radiation therapy until after delivery.
Active scleroderma or systemic lupus: these disorders can keep tissue from healing correctly after radiation therapy.
When a large part of the breast is affected by cancer and must be removed to get rid of the tumor(s), a mastectomy may be a better option. This may be the case when:
there are two or more tumors in different areas of the breast (multi-centric tumors).
The tumor is large (relative to breast size).
The tumor has spread throughout the breast (diffuse tumor).
The mammogram showed large areas of calcifications in the breast.
The tumor is located just beneath the nipple (such that the cosmetic look after lumpectomy will not be good).
Treatment guidelines
The exact treatment for breast cancer varies from person to person, treatment guidelines help ensure quality care. These guidelines are based on the latest research and the consensus of experts.
Cosmetic issues
Women may choose lumpectomy over mastectomy to keep their breast and have it look (as much as possible) like it did before surgery. Lumpectomy does change the look of the breast though. As a result of the removal of some tissues, the breast may become smaller and firmer with some scar.
Radiation therapy (usually given after lumpectomy) can also affect the look of the breast. It can further shrink the breast and change its texture or feel. Sometimes, factors like the location and size of the tumor make it unlikely that a woman will be happy with the look of her breast after lumpectomy. In these cases, mastectomy (with or without breast reconstruction) may be the better option.
In rare cases, a woman may have reconstructive surgery (either at the time of the lumpectomy or later) to maintain a more natural appearance of the breast, or to match the size and shape of the opposite breast. These surgeries are complex. You may wish to meet with a plastic surgeon to discuss your options.
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