A lumpectomy is a type of breast cancer treatment. The National Cancer Institute defines a lumpectomy as a surgery "to remove abnormal tissue or cancer from the breast and a small amount of normal tissue around it." A lumpectomy is considered a form of breast-conserving surgery. This means that the patient does not lose the breast---only a small portion of it is surgically removed. A lumpectomy is generally followed by radiation therapy.
Eligibility
Many breast cancer patients are eligible for a lumpectomy. In general, the tumor needs to be smaller than five centimeters across. In order to avoid a disfigured breast, the tumor also has to be considered small in comparison to the woman's breast size, and it cannot be located too deep inside the breast. If the patient is not eligible to receive radiation to the chest area, then a lumpectomy will likely not be recommended. If there is more than one tumor in the breast, a mastectomy may be the only way to remove all of the cancer from the breast. A mastectomy is a type of surgery that removes the entire breast.
Success
A successful lumpectomy removes the cancerous tissue and achieves clear margins. The U.S. Department of Health and Human Services Office on Women's Health defines the margin as the "distance between the outer edge of the tumor and outer edge of the normal tissue surrounding it." If the pathology report indicates that the lumpectomy did not achieve cancer-free margins, then another surgery will be required. This second surgery is called a re-excision.
Considerations
Some women choose to have a mastectomy even if a lumpectomy is an option. A woman may choose a mastectomy if she has a high risk of developing a second breast cancer. By choosing a mastectomy, she might be able to forgo radiation therapy. The choice between a lumpectomy and a mastectomy often includes a psychological component.
Misconceptions
In women with small breast tumors, a mastectomy does not improve the long-term chances of survival when compared with a lumpectomy followed by radiation. Two separate studies that followed women for twenty years both reached this conclusion. Both studies---one conducted in the United States and one conducted in Italy---were published in the New England Journal of Medicine in 2002.
Cosmetic Results
Some women are unhappy with the appearance of their breast after a lumpectomy. If the breast has been treated with a lumpectomy and radiation, the Abramson Cancer Center of the University of Pennsylvania does not recommend reconstructive surgery. A partial prosthesis is an alternative to reconstruction. If the patient is concerned with breast symmetry, she may consider surgery on the other breast.
