Breast Conserving Surgery

Breast conserving surgery may be an option for the treatment of early stage breast cancer, where the cancer is not too large in comparison to the breast and has not invaded the surrounding tissues.

As the term implies, this type of surgery is an alternative to removal of the whole breast (mastectomy) and involves the removal of the cancerous cells and a limited amount of healthy tissue around the tumour, in such a way that the shape and appearance of the breast is maintained as much as possible. Both ‘lumpectomy’ and ‘local excision’ are surgical techniques used in breast conserving surgery. The procedure is also sometimes referred to as ‘partial mastectomy’ or ‘wide local excision’.

Oncoplastic surgery may be required if the tumour is large or in a difficult position. This allows breast conservation while retaining or improving the breast shape.

As part of this surgical approach some lymph nodes in the armpit on the same side as the affected breast may also be removed (this is called ‘sentinel lymph node biopsy’). This is to examine the first lymph node from the tumour to see if the cancer has spread to lymph nodes.

A sentinel lymph node biopsy is a way of testing the lymph nodes without removing all the lymph nodes, and therefore reducing the risk of lymphoedema.

Breast conserving surgery is generally accompanied by radiotherapy after the operation to the breast and sometimes the armpit area as well and the whole procedure normally requires day surgery or a hospital stay one day.

Statistics tend to indicate that there is no difference in long-term outcomes (over a 10 year period) between mastectomy and breast conserving surgery, in fact a recent study (2021) demonstrates that women who have had breast conserving surgery had lower rates of local, regional and distant disease recurrences.– both are as effective as each other. The main difference between the two approaches is the need for radiotherapy after the surgery in the case of a breast conserving approach, which is not generally required after a mastectomy.

It can sometimes be very difficult to decide which procedure should be carried out. Dr John Gault will be able to give you all the information you need based on your individual case to help you make the right decision.

Reference: Role of oncoplastic in breast reconstruction