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Surgery for breast cancer isn’t the same for everyone. While some people require a full mastectomy to remove their breasts, others can get breast-conserving surgeries such as a partial mastectomy. A partial mastectomy removes a tumor or lump from the breast, plus some healthy tissue around it.
You might hear your breast cancer specialist call a partial mastectomy by one of its other names, which include lumpectomy, segmental mastectomy, or quadrantectomy. However, some doctors consider a partial mastectomy to be a little more extensive than a lumpectomy (even though they’re very similar).
Breast-conserving surgeries like partial mastectomy and lumpectomy let you keep as much of your natural breast tissue as possible while still removing the cancer.
In this article, we’ll cover how a partial mastectomy works, how it compares to other breast cancer surgeries, and what to expect.
A typical lumpectomy removes the breast lump in one piece, plus a small amount of healthy tissue from around it.
A partial mastectomy goes a little further, removing the breast lump, some healthy tissue around it, and the lining covering the chest muscles under the breast tumor.
In some cases, these surgeries also remove lymph nodes from the armpit for a biopsy. This is called a sentinel lymph node biopsy. Lymph nodes are small, bean-shaped organs that are part of the immune system and found throughout the body. Doctors may remove nearby lymph nodes to check whether cancer has spread.
Unlike a mastectomy, which removes the entire breast, a partial mastectomy leaves some natural breast tissue behind. This can sometimes allow the breast’s natural appearance to be mostly preserved.
If a partial mastectomy leaves your breasts looking asymmetrical or uneven, you can ask your doctor about breast reconstruction options.
A partial mastectomy isn’t always the best breast cancer surgery option. Your breast cancer specialist will give you recommendations depending on the stage of your cancer, the size of the tumor, your breast cancer risk level, and other personal details.
Partial mastectomies are often used for early-stage breast cancer, which usually means the cancer is still in the breast or has only spread a little to nearby lymph nodes. Whether this surgery is an option depends mostly on the size of your breast and the tumor, where the tumor is located, and your overall treatment plan.
Doctors look at the tumors’ size and location, your breast size, and whether they can remove the cancer with a clear border of healthy tissue (called a “clear margin”).
A partial mastectomy may still be possible if a tumor is larger or there is more than one area of cancer, as long as the surgeon can safely remove all the cancer and the breast can heal well.
Sometimes treatment like chemotherapy is used first to shrink a tumor and make breast-conserving surgery possible.
Features of your natural breast tissue can also affect whether or not your breast cancer specialist recommends a partial mastectomy. They want to see that you’ll have enough remaining breast tissue to maintain your breast’s shape.
Your healthcare provider may not recommend a partial mastectomy if you’re currently pregnant.
It’s also uncommon for people to get a partial mastectomy if they’ve already had radiation treatment to the affected breast, since a partial mastectomy is usually followed by radiation therapy.
A full mastectomy is usually recommended when the tumor is large, you have multiple breast tumors, or the cancer is spreading. In some cases, you can get chemotherapy to shrink a larger tumor, and if the response is adequate, you can have a partial mastectomy instead.
You might wonder how a partial mastectomy compares to a total mastectomy while weighing your breast cancer surgery options. Following are key differences between the two surgeries.
Partial mastectomy and mastectomy can both be highly effective treatments for early-stage breast cancer. A total mastectomy and a lumpectomy or quadrantectomy with radiation therapy have the same survival rates.
Studies have also shown that, in most cases, the overall survival rate and breast cancer recurrence rate (chances that the cancer returns) is the same for both types of surgery.
A partial mastectomy is less extensive than a total mastectomy, which makes the surgical recovery period a little shorter. You can usually go home the same day as your partial mastectomy. With a total mastectomy, you may need to stay overnight.
For both breast cancer surgeries, you may feel some temporary chest soreness while you heal. If you’ve had lymph nodes removed, you may also feel soreness or numbness in your armpits.
Both surgeries can bring up some emotions, so make sure you have a support system in place for your recovery. If you feel you need professional help, talk to your doctor.
One key goal of a partial mastectomy is to preserve the breast’s natural appearance. A total mastectomy cannot do this, so many people opt for reconstructive surgery to recreate the breast’s shape. If you’d like, you can still get a breast reconstruction after a partial mastectomy to make your breasts look even.
Breast cancer specialists often recommend radiation after a partial mastectomy, to kill any cancer cells that might be left behind. Radiation is usually given on weekdays, and the total number of weeks can vary. Many people now have shorter radiation schedules than in the past (five to 15 days, instead of 32), depending on their situation.
Depending on your breast tumor’s characteristics, your doctor may recommend other breast cancer treatment after either a partial or total mastectomy. Options can include chemotherapy, targeted therapy, hormone therapy, or other drug therapies.
Like almost any treatment, a partial mastectomy can cause some side effects. Two of the most common side effects are breast numbness and soreness, which are usually only temporary.
Your doctor might prescribe pain medications to help you manage any pain in the breast or armpits during healing.
It’s possible to feel some lumps or hard areas of tissue in your breasts for the first four weeks or so after surgery. Your care team can teach you how to massage these lumps to help with scarring.
If your surgery involves removing all the lymph nodes in the armpit, it’s also possible for a partial mastectomy to cause lymphedema. Lymphedema is swelling that can affect your arms or neck. It can show up months or years after surgery.
Your doctor can tell you more about your risk of breast cancer recurrence after a partial mastectomy. After surgery, continue following all treatment instructions, including radiation therapy and other recommended cancer treatments.
Follow-up care after a partial mastectomy can help determine if you need more surgery. It can also help detect cancer, if it comes back.
Usually, your doctor will remove a sentinel lymph node from the armpit for a biopsy during your partial mastectomy surgery, to evaluate if the cancer has spread.
As the surgery continues, the pathologist will examine the sentinel lymph node. If they detect any cancer cells, they will immediately tell your surgeon. Your surgeon will then perform an axillary lymph node dissection. This procedure removes all the lymph nodes in the armpit.
Your breast cancer specialist will tell you when to get your first follow-up mammogram. It’s often scheduled within about six months after radiation ends (or on a similar timeline after surgery, if you don’t have radiation). These imaging tests allow your care team to set a new baseline for how your breast tissue looks after treatment.
After that, you can expect to continue getting yearly mammograms to look for new lumps. Your recommendations might vary based on your individual risk or on findings from these imaging tests.
Always tell your doctor if you notice any new lumps or breast changes. A partial mastectomy can change the way your breasts feel, so you should get familiar with what feels “normal.”
Your breast cancer specialist will support you with ongoing treatment planning, including your course of radiation therapy after a partial mastectomy. They may also recommend other cancer treatments based on the type of breast tumor that was removed.
On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.
What was your experience getting a partial mastectomy like? Let others know in the comments below.
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