• A lumpectomy is a breast-conserving surgery that removes only the tumor and some surrounding healthy tissue.
• This surgery is typically used to treat early-stage breast cancer and is often followed with radiation therapy.
• The decision between a lumpectomy and a mastectomy is up to you and your oncologist, keeping your best interests in mind.

When weighing surgery options for breast cancer treatment, you may consider a lumpectomy. Also known as a partial mastectomy, this breast-conserving procedure removes only the breast cancer and a small amount of healthy tissue surrounding it. Lumpectomy is most commonly done in cases of early-stage breast cancer.

According to the National Cancer Institute, one study of 560 women — most of whom had early-stage breast cancer — found that 72 percent chose a mastectomy (removal of the entire breast) and 28 percent opted for lumpectomy. On MyBCTeam, more than 10,000 members reported having a lumpectomy.

Researchers have found that choosing one or the other type of surgery doesn’t affect overall long-term survival of breast cancer. The choice of a lumpectomy or mastectomy as a treatment option is up to you and your oncologist.

Why Lumpectomy?

A lumpectomy is a breast-conserving procedure — part of the breast tissue will be left after surgery. Some people prefer this to having their entire breast removed. Oncologists and surgeons typically recommend undergoing radiation therapy after a lumpectomy to help prevent cancer from returning. However, not everyone is a candidate for this surgery.

A lumpectomy followed by radiation may be the right treatment choice for those who:

• Want to keep as much breast tissue as they can
• Have one small tumor revealed by breast imaging, such as a mammogram or breast sonogram
• Do not want to undergo extensive surgeries for a mastectomy and breast reconstruction
• Are eligible to receive radiation treatment

Those who do not make ideal candidates for a lumpectomy include people who previously had radiation therapy on the same breast or to the breast or chest for another diagnosis, as well as those who are pregnant and should avoid radiation therapy. In addition, lumpectomy might not be option for those who have:

• Inflammatory breast cancer, which requires a mastectomy
• A large tumor within a small breast
• Cancer that has spread throughout the breast
• Connective tissue disease, such as lupus or scleroderma

Lumpectomies are typically recommended for people with early-stage cancer that has not spread throughout the breast. Of those who qualify for the surgery, around half opt instead for a mastectomy for more peace of mind. However, according to Breastcancer.org, some studies show that for younger women, lumpectomies improve quality of life and sexual well-being compared with mastectomies.

Timing of Lumpectomy

Treatments vary depending on the stage of breast cancer you have. Surgery is recommended as the main treatment for stage 1 breast cancer. Lumpectomies are often performed along with a sentinel lymph node biopsy (SLNB) to check if the cancer has spread. For people who are 65 years or older, a lumpectomy without radiation therapy can be done if:

• The tumor is no more than 3 centimeters (just over an inch) long and is completely removed
• The cancer is positive for estrogen receptor or progesterone receptor, so hormone therapy can be given
• The lymph nodes are free of cancer

Stage 2 breast cancer is also treated with surgery. Sometimes, people with this stage of cancer are first given systemic (whole-body) treatments such as hormone therapy or chemotherapy. These treatments, known as neoadjuvant therapies, help shrink tumors before surgery for a better chance of success. After a lumpectomy, you will likely have radiation therapy. If you need more chemotherapy, radiation will be done after treatment is complete.

If you have stage 3 breast cancer, your oncologist will likely recommend neoadjuvant therapy first with chemotherapy to shrink the tumor. If the tumor gets small enough, a lumpectomy can be performed. If not, a mastectomy is preferred.

For some individuals, surgery may be a first-line treatment option. A lumpectomy may be performed if you have fairly large breasts and the tumor has not spread into the nearby lymph nodes. After surgery, you will likely have an adjuvant treatment such as hormone therapy or chemotherapy to reduce the chances of the cancer returning.

Lumpectomy Procedure

Depending on your specific case of breast cancer, a lumpectomy may be either an outpatient or inpatient procedure. Outpatient procedures allow you to leave the hospital that same day, whereas inpatient procedures require a hospital stay of a few days. Most lumpectomies are outpatient and take roughly 60 to 90 minutes to complete.

Before Surgery

Before surgery, a radiologist will use an ultrasound or a mammogram to locate the tumor if it cannot be easily felt during a physical exam. The tumor area is then numbed with a local anesthetic so you will not feel the procedure. Next, the radiologist inserts a wire into the area to show the surgeon where the tumor is. If you are also having an SLNB, blue dye will be injected under the skin or deeper, near the tumor, to mark the lymph nodes. This helps the surgeon determine which lymph nodes to remove.

During Surgery

Once you are ready for surgery, you may be put under general anesthesia so you go to sleep. Many people have only local anesthesia with sedation. Once you’re sedated, the surgeon makes an incision along the curve of the breast, along the areola, or under the fold of the breast to help hide a scar. The tumor is removed, along with some healthy surrounding tissue, known as margins. This helps the surgeon get rid of as many cancer cells as possible.

During the procedure, the surgeon may also place clips where the tumor was located, which act as a target for radiation therapy later on. If you’re having an SLNB, the surgeon will also remove one to three lymph nodes from under your armpit. If necessary, a drain — a plastic tube connected to a suction bulb — will be placed to help remove the extra fluid that collects where the tumor was. Once everything is complete, the surgeon will sew the incisions closed.

Lumpectomy Recovery

After a lumpectomy, it may take a few days for you to feel better. Most people are back to their normal activities within a few weeks, depending on how intensive their surgery was. To make recovery easier, follow all your doctor’s instructions about taking your medications, consuming alcohol, and smoking before your surgery.

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.”

Pain and Swelling Management

The main goals of recovering after surgery are to keep your pain levels under control and care for your drain if one was placed. Pain can be managed with medications you get from the hospital or over-the-counter medications like ibuprofen (Advil) or acetaminophen (Tylenol). Ice packs can also help keep pain and swelling down.

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 from Amazon. You put your arm through it, your surgery side. It will help.”

You will likely experience swelling around the surgical site, which may make wearing a bra difficult. Members have found ways to make themselves 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 from Amazon.”

Drain Care

Drain care is also important for healing. If you go home with a drain still in, the fluid should be drained two or three times a day, with the output measured. A drain is typically removed at the first postoperative appointment. 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 the stitches becoming abnormally swollen or red or if the wound begins oozing.

Risks of Lumpectomy

As with any surgery, a lumpectomy comes with some risks. These include:

• Dimpling, scars, and other changes in the breast skin and tissue
• Cellulitis (skin infection)
• Seroma (buildup of fluid in the breast) where the tumor was removed
• Lymphedema (buildup of lymph fluid) if lymph nodes were removed
• Nerve pain for a few weeks or months after surgery
• Numbness or loss of sensation where the tumor was removed
• Bleeding at the surgical site

If you are concerned about any of these risks, talk with your surgeon beforehand. They will go over the risks of your exact procedure with you.

What’s Next After Lumpectomy?

After a lumpectomy, you will likely undergo radiation therapy to destroy any remaining cancer cells and reduce the chances that the cancer will come 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 found in your tumor, you may also start targeted therapy or hormone therapy to decrease the likelihood that the cancer will return.

Some women also consider breast reconstruction surgery after their lumpectomy. This surgery is done to improve the overall look of the breast and offer more shape and support. The decision to have reconstruction surgery is completely up to you. If you are interested, talk to a plastic surgeon about this procedure.

Find Your Team

On MyBCTeam, the social network for people with breast cancer and their loved ones, more than 58,000 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 your experience, 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.