Many patients who are diagnosed with breast cancer choose a treatment that will save their breast. This surgery is called a lumpectomy, or partial mastectomy. The goal of the surgery is to remove the breast cancer, as well as a rim of healthy tissue.
If the breast cancer cannot be felt, it must first be located using an imaging technique. If the cancer can be seen by ultrasound, the surgeon may use ultrasound in the operating room to assist in the surgery. Other methods for localizing the breast cancer in surgery include placement of a:
Wire, using mammography or MRI
Radioactive seed into the cancer for identification using a Geiger machine in the operating room
Magnetic seed into the cancer
Lumpectomies can be performed as an outpatient procedure in an ambulatory surgery center or hospital. The surgery can be performed using a local anesthetic with intravenous sedation, a general anesthetic, or a regional anesthetic, depending on patient preference and the recommendations of the surgeon and anesthesiologist.
The goal of the lumpectomy is to remove the cancer, as well as normal tissue around the edge of the lumpectomy specimen, known as a clear margin. If there is cancer involving the edge, or margin, of the specimen on the final pathology report, repeat surgery to remove additional tissue may be required so that clear margins are obtained.
In nearly all patients who choose breast conservation therapy, radiation therapy will follow the lumpectomy. In some special cases, the radiation therapy may be delivered in the operating room, which is known as intraoperative radiation therapy. In most cases, radiation therapy will be delivered after the surgery.
The long-term survival rates for early-stage breast cancer are the same for patients who choose breast conservation therapy and those who choose mastectomy. The risk of cancer recurring in the treated breast following a lumpectomy is not significantly higher than the risk of recurrence following mastectomy. However, patients who choose lumpectomy will need follow-up of the treated breast as a recurrent breast cancer may develop.