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When weighing surgery options for treating breast cancer, you may consider a lumpectomy — also called a partial mastectomy or breast-conserving surgery. This procedure removes the tumor along with a small amount of healthy tissue surrounding it. Lumpectomy is most commonly performed for early-stage breast cancer or when the tumor has been reduced in size with chemotherapy before surgery. On MyBCTeam, more than 11,000 people living with breast cancer have reported having a lumpectomy.
One benefit of lumpectomy compared to mastectomy is a generally shorter recovery time. Many people recover from lumpectomy within about two weeks, while stiffness, soreness, and tenderness can last for months after mastectomy.
Earlier studies found that both lumpectomy (with radiation) and mastectomy provided similar overall long-term breast cancer survival rates. However, a more recent large-scale study in BJOS Open suggests that for women with early-stage breast cancer, lumpectomy followed by radiation may be linked with slightly higher survival rates compared with mastectomy. Because this research looked at data from observational studies rather than new randomized clinical trials, the authors noted the certainty of the evidence was very low. More research is needed.
The choice between lumpectomy and mastectomy is best made as a shared decision between you and your cancer care team.
A lumpectomy is also known as breast-conserving surgery because most of the breast tissue will be left intact. Some people prefer this to having their entire breast removed. In most cases, lumpectomy is followed by radiation therapy to treat any remaining breast tissue and lower the risk of the cancer returning.
Not everyone is a candidate for this surgery. A lumpectomy followed by radiation may be the right breast cancer treatment choice for those who:
You might not be an ideal candidate for a lumpectomy if you’ve previously had radiation therapy to the same breast or chest for another diagnosis, or if you’re pregnant.
In addition, lumpectomy may not be recommended for people who have:
Lumpectomies are typically recommended for people with early-stage cancer that hasn’t spread throughout the breast. Some people who qualify for a lumpectomy opt for a mastectomy instead for more peace of mind.
However, large-scale studies that compared overall survival for people with breast cancer who received either mastectomy or lumpectomy followed by radiation found that lumpectomy with radiation may offer better odds for survival.
Also, according to Breastcancer.org, some research shows that lumpectomies may be associated with improved quality of life and sexual well-being compared with mastectomies.
Treatment plans vary depending on the stage of a person’s breast cancer. For stage 1 or stage 2A breast cancer, surgery is usually the main treatment. Lumpectomies are more often performed along with a sentinel lymph node biopsy (SLNB) to check if the cancer has spread. Lymph nodes are small, bean-shaped glands that help the body fight infection, and the sentinel lymph nodes are typically the first ones that cancer cells may reach.
Some people aged 65 and older who have a lumpectomy may be able to skip radiation therapy if:
Stage 2B breast cancer is also treated with surgery. Sometimes, people with this stage of cancer first receive systemic (whole-body) treatments, such as hormone therapy or chemotherapy. These treatments, called neoadjuvant therapy, help shrink tumors before surgery, improving the chances of successful removal. After a lumpectomy, radiation therapy is typically recommended. If additional chemotherapy is needed, radiation is given after that treatment is finished.
For stage 3 breast cancer, oncologists usually recommend neoadjuvant chemotherapy first to shrink the tumor. If the tumor becomes small enough, a lumpectomy may be possible. If not, a mastectomy is preferred, and you will receive radiation therapy in both the chest wall and the armpit.
For some individuals, surgery may be a first-line treatment option. A lumpectomy may be considered if you have relatively large breasts and the tumor has not spread to nearby lymph nodes. After surgery, you will likely receive another treatment — such as hormone therapy or chemotherapy — to lower the risk of the cancer coming back.
Depending on your specific breast cancer diagnosis, a lumpectomy may be done as either an outpatient procedure — meaning you can go home the same day — or an inpatient procedure, which requires a short hospital stay. Most lumpectomies are outpatient and take about 60 to 90 minutes. If lymph node removal is performed at the same time, expect the surgery to take longer.
If the tumor can’t be easily felt during a physical exam, a radiologist will use imaging tests to locate it. The area is numbed with a local anesthetic.
The radiologist then places a thin wire, a small metal marker, or a tiny radioactive seed into the tumor area to help the surgeon locate it during the operation.
If you are also having an SLNB, blue dye or a harmless radioactive substance will be injected under the skin near the tumor to identify the sentinel lymph nodes. These lymph nodes are then checked to see if the cancer has spread.
The surgeon makes an incision along the curve of the breast, the edge of the areola, or under the fold of the breast to help make the scar less visible. The tumor is removed along with a small amount of surrounding healthy tissue, called the margin, to lower the chance of leaving cancer cells behind.
During the procedure, the surgeon will also place clips where the tumor was located. The clips act as a target for radiation therapy later on. If you’re having an SLNB, the surgeon will also remove one to five lymph nodes from under your armpit. If necessary, a drain — a plastic tube connected to a suction bulb — may be placed temporarily to remove fluid from the surgical area.
The incisions are then closed with stitches. All tissue samples are sent to the lab for a pathology report, which will confirm whether cancer cells are present at the margins or in the lymph nodes.
Lumpectomy surgery itself isn’t painful because you’ll receive either local or general anesthesia beforehand. Most people receive general anesthesia, which puts you to sleep. Local anesthesia numbs only the tumor site and surrounding tissue. If you get local anesthesia, you’ll also get moderate sedation.
Some discomfort is normal during recovery. You might feel tenderness or brief, shooting pains in the breast, chest, or arm as nerves heal. For most people, this improves within a few weeks of surgery. One MyBCTeam member shared, “After my lumpectomy, I’d get short sharp pains in my breast. My doctor said it could be scar tissue along with nerves trying to reconnect.”
After a lumpectomy, it may take a few days for you to feel better. Most people are back to their normal activities after two weeks. Some may take longer depending on the extent of surgery, whether lymph nodes were removed, and individual healing.
To help your recovery go smoothly, follow all instructions from your cancer care team — including on taking your medications, avoiding alcohol, and not smoking before surgery. Your healthcare provider may also recommend wearing a supportive sports bra or breast binder to reduce swelling and provide comfort.
One MyBCTeam member shared, “Three days after lumpectomy surgery, I finally slept last night, so I’m feeling a little better today.”
Another shared their experience with recovery, saying, “I’ve had three lumpectomies, and it wasn’t too bad. Recovery was like a day or so. I was able to do everything I normally do after three days.”
The main goals of lumpectomy recovery are to keep pain under control and care for your surgical drain if you have one. Pain can be managed with prescription medications from your care team or with over-the-counter medicines, as recommended by your doctor.
Applying ice packs in short intervals can also help reduce pain and swelling. One MyBCTeam member said, “Ice packs will help. I keep the reusable ones in the freezer. It’s a flat gel pack. I also bought a heart pillow. … You put your arm through it, your surgery side. It will help.”
It’s common to have swelling and bruising around the surgical site, which may make wearing a bra uncomfortable at first. Members have found different ways to stay comfortable while healing. One member shared, “I was told to wear a sports bra. You may have to get a bigger size because of swelling. I bought a Jockey ladies’ sports bra.”
Caring for a surgical drain is an important part of healing. If you go home with a drain in place, you will need to empty the bulb two or three times a day and record how much fluid is collected each time.
A drain is often removed at the first follow-up visit — usually within eight to 12 days — but timing depends on the amount of drainage. Most surgeons remove the drain when the output is less than 25 milliliters in a 24-hour period.
Any stitches, whether they will dissolve or need to be removed, should be monitored to make sure they are healing properly. Call your doctor if you notice signs of infection after lumpectomy, like discoloration, swelling, or oozing.
As with any surgery, a lumpectomy comes with potential side effects and risks. These may include:
Talk to your cancer care team if you have concerns about lumpectomy risks or possible complications. They can explain the risks specific to your situation and how they can be managed.
Depending on the status of your cancer and your preferences, you might need further treatment after lumpectomy surgery.
Most people have radiation therapy after lumpectomy to destroy any remaining cancer cells and lower the risk of the cancer coming back. The decision to have radiation and the type used will be made by you and your radiation oncologist.
Chemotherapy might also be recommended after lumpectomy to kill any remaining cancer cells that were left behind (even if they cannot be seen with imaging tests). Depending on any genetic mutations (changes) found in your tumor, you may also be offered targeted therapy or hormone therapy to further reduce the chance of recurrence (cancer returning).
Some people also consider breast reconstruction surgery after a lumpectomy to restore shape and symmetry. You might notice changes in appearance, such as a dent in the breast after lumpectomy or breast dimpling, which reconstruction can help fix.
The decision to have reconstruction surgery is completely up to you. If you are interested, talk with a plastic surgeon who specializes in breast reconstruction to learn about your options, timing, and expected results.
On MyBCTeam, the social network for people with breast cancer and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.
Have you had a lumpectomy? What was it like, and what advice would you give to others who need the same procedure? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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A MyBCTeam Member
On 3/11 I had a lumpectomy with two lymph nodes, biopsied and felt ready to go to work a couple of days later! My Dr told me to put a bottle of water in the freezer and to use that under my arm to… read more