Surgery to remove the breast cancer and some surrounding healthy tissue is called breast-conserving surgery. It is also called a lumpectomy or wide local excision. Breast-conserving surgery is recommended if the cancer is relatively small compared to the size of your breast. The surgeon removes the tumour and a rim of breast tissue, while leaving as much breast tissue as possible. This will leave a scar and may change the size and shape of the breast and the position of the nipple.
The removed tissue is sent to a laboratory. A specialist called a pathologist checks it under a microscope to see if there is an area of healthy cells around the cancer – this is known as a clear margin. The pathologist will create a report, which will include information about:
- the size and grade of the cancer
- whether there are cancer cells near the edge (margin) of the removed breast tissue
- whether the cells are hormone receptor positive and/or HER2 positive or triple negative
- whether the cancer has spread to any lymph nodes.
The report will help guide further treatment. If cancer cells are found at the edge of the removed tissue (an involved or positive margin), there is a greater chance of the cancer returning. You may need more tissue removed (re-excision or wider excision), or your doctor may recommend a mastectomy.
After breast-conserving surgery, most women have radiation therapy to the whole breast to destroy any undetected cancer cells that may be left in the breast or armpit, and to keep the cancer from coming back.
Occasionally, radiation therapy may not be required. Some women also need chemotherapy, targeted therapy or hormone therapy.
|Oncoplastic breast-conserving surgery combines oncological surgery (to remove the cancer) with plastic surgery (to reshape the breast and try to preserve its appearance). It is performed by oncoplastic breast surgeons.|
Prof Christobel Saunders, Professor of Surgical Oncology and Head, Division of Surgery, The University of Western Australia, and Consultant Surgeon, Royal Perth, Fiona Stanley and St John of God Subiaco Hospitals, WA; Dr Marie-Frances Burke, Radiation Oncologist, Medical Director, Genesis CancerCare Queensland, QLD; Kylie Campbell, Breast Care Nurse and Clinical Lead, Murraylands, McGrath Foundation, SA; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland, QLD; Annmaree Mitchell, Consumer; Sarah Pratt, Nurse Coordinator, Breast Service, Peter MacCallum Cancer Centre, VIC; Dr Wendy Vincent, Breast Physician, Chris O’Brien Lifehouse and Royal Hospital for Women, Randwick, NSW, and Clinical Director BreastScreen NSW, Royal Prince Alfred Hospital, NSW; A/Prof Nicholas Wilcken, Director of Medical Oncology, Westmead Hospital, and Co-ordinating Editor, Cochrane Breast Cancer Group, NSW. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. This booklet is funded through the generosity of the people of Australia.
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