Lumpectomy (Breast-Conserving Surgery): Indications, Procedure & Advantages

Lumpectomy: Removing the Tumor, Preserving the Breast

Lumpectomy (partial mastectomy) excises the tumor with a margin of healthy tissue while maintaining breast shape.

When Is It Chosen Over Mastectomy?

• Small, unifocal tumor (typically ≤4–5 cm, breast-size relative)
• Clear margins achievable
• Patient desires breast preservation
• Candidate for adjuvant radiotherapy (standard after lumpectomy)
• No contraindications to radiation (prior chest RT, active scleroderma, pregnancy)

Procedure Overview

1. Localization (wire, radar reflector, or MRI/US-guided).
2. Incision over tumor; excision with 1–2 mm+ margins.
3. Specimen radiograph / margin assessment (frozen section or cavity shaves).
4. Cavity closure; sometimes oncoplastic rearrangement for cosmesis.
5. Sentinel node biopsy ± axillary dissection (separate incision).

Advantages vs. Mastectomy

• Less invasive, shorter recovery
• Preserves breast sensation & body image
• Equivalent survival for early-stage disease (per NSABP B-06, EORTC 10801)
• Lower complication rate

Follow-Up

Whole-breast radiation (3–6 weeks) + endocrine therapy if ER+. Surveillance imaging annually.