📍 Whitefield, Bengaluru
HOD & Senior Consultant · Surgical Oncology
Consultation by Appointment
Looking for more detail? Read our complete guide with 15 patient FAQs: Breast Conservation Surgery and Oncoplasty. See also: Breast Cancer Treatment FAQs (59 questions).
Read the complete guide: Organ Preservation Surgery for Cancer: Treatment Options, Candidacy and Outcomes
Breast-conserving surgery, also called lumpectomy or partial mastectomy, removes the breast tumor with a rim of healthy tissue and keeps the rest of the breast, usually followed by radiation therapy.
The table below compares the two operations on the points patients ask about most often.
| Feature | Lumpectomy | Mastectomy |
|---|---|---|
| Tissue removed | Tumor plus a margin of normal tissue | Whole breast |
| Radiation therapy | Usually required | Sometimes required |
| Breast appearance and sensation | Largely preserved | Reconstruction or prosthesis may be used |
| Typical recovery | About 1 to 2 weeks | About 3 to 6 weeks |
| Generally suited to | Early-stage, single or limited tumors | Large, multifocal, or widespread disease |
For women with early-stage breast cancer, lumpectomy followed by radiation therapy has shown long-term survival comparable to mastectomy in randomized trials.
Randomized trials with decades of follow-up, including NSABP B-06 and the Milan studies, found similar overall survival between the two approaches in appropriately selected patients. Radiation is an important part of the plan, since lumpectomy without it carries a higher risk of local recurrence. Tumor biology, such as hormone receptor and HER2 status, also guides how much additional therapy is recommended.
A good candidate has a tumor that can be removed with clear margins while leaving an acceptable cosmetic result, and is able to receive whole-breast or partial-breast radiation.
Features that generally support breast conservation include:
In contrast, mastectomy may be advised in situations such as the following:
Oncoplastic breast surgery combines cancer removal with plastic surgery techniques to reshape the breast, and neoadjuvant chemotherapy may shrink larger tumors so that more women can be considered for breast conservation.
Oncoplastic surgeons generally use one of three strategies, chosen by tumor location and breast size:
Neoadjuvant chemotherapy or targeted therapy given before surgery tends to be especially effective in HER2-positive and triple-negative breast cancer, and may allow some patients who would have needed a mastectomy to be considered for lumpectomy.
Lumpectomy is normally followed by radiation therapy and, when indicated, hormone therapy or other systemic treatment, while sentinel lymph node biopsy allows many patients to avoid removal of all underarm lymph nodes.
The table below outlines the usual treatments after lumpectomy and their purpose.
| Treatment | Typical schedule | Purpose |
|---|---|---|
| Whole-breast radiation | Often a hypofractionated course of about 3 to 5 weeks | Lowers the risk of local recurrence; some low-risk patients qualify for partial-breast radiation |
| Hormone therapy (aromatase inhibitor or tamoxifen) | Typically 5 to 10 years for hormone receptor-positive cancer | Reduces the risk of recurrence |
| Sentinel lymph node biopsy | Performed during surgery | Removes only the first draining nodes; may lower the risk of arm swelling (lymphedema) compared with full axillary dissection |
