What is breast-conserving surgery?

Breast-conserving surgery removes the cancer while keeping as much of the breast tissue and shape as possible. The surgeon removes the cancer and some normal looking tissue around it (the margin). This is called a wide local excision (WLE). You might also hear it called a lumpectomy. After breast-conserving surgery, most women are pleased with the appearance of their breast.

If the cancer is very small, you may need to have a fine wire put into the breast before surgery. This marks the area to be removed and means the surgeon can find it more easily. This is called wire localisation. The wire is then removed along with the area of cancer during the operation.

Removing a larger area of breast tissue

Depending on the size of the cancer, you may need to have a larger area of breast tissue removed.

Surgeons can use different ways to help improve the appearance of your breast if you need a larger area of tissue removed. They may reshape the breast by moving the breast tissue around and making it smaller. Sometimes, they take tissue from somewhere else in the body to help reshape the breast.

Your surgeon may suggest you have the other breast made smaller so that both breasts are the same size. This can be done at the same time as surgery or later.

We have more information on breast reconstruction for women having breast-conserving surgery.

Radiotherapy after breast-conserving surgery

Your surgeon will usually advise you to have radiotherapy after breast-conserving surgery. Radiotherapy after a WLE reduces the risk of the cancer coming back in the breast.

Having breast-conserving surgery, followed by radiotherapy, is as effective at treating breast cancer as a mastectomy.

Clear margins

After breast-conserving surgery, the tissue that has been removed is looked at under a microscope by a pathologist. They check the area (margin) around the cancer. You will need another operation to remove more tissue if:

  • there is DCIS (the earliest possible form of breast cancer) close to the edge of the area
  • there are any cancer cells close to the edge of the area.

If the margins are clear, this will reduce the risk of cancer coming back in the breast.

If your surgeon does not think another breast-conserving operation is likely to be successful, they may recommend a mastectomy. In this situation, you will usually be offered breast reconstruction.

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