Surgery to remove part of the breast is called breast-conserving surgery. It is also called a lumpectomy or wide local excision.
The surgeon removes the tumour and some of the healthy tissue around it, so you can keep as much of your breast 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 looked at under a microscope by a pathologist to see if there is an area of healthy cells around the cancer – known as a clear margin.
The pathologist’s report 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, unless this has already been reported on the core biopsy results
- whether the cancer has spread to any lymph nodes.
The pathology report will help guide further treatment. If cancer cells are close to 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, you will generally be recommended to have radiation therapy to destroy any cancer cells that may be left in the breast or armpit, and to help keep the cancer from coming back. In some cases, radiation therapy is not required.
Prof Bruce Mann, Professor of Surgery, The University of Melbourne, and Director, Breast Tumour Stream, Victorian Comprehensive Cancer Centre, VIC; Dr Marie Burke, Radiation Oncologist, and Medical Director GenesisCare Oncology, QLD; Dr Susan Fraser, Breast Physician, Cairns Hospital and Marlin Coast Surgery Cairns, QLD; Ruth Groom, Consumer; Julie McGirr, 13 11 20 Consultant, Cancer Council Victoria; A/Prof Catriona McNeil, Medical Oncologist, Chris O’Brien Lifehouse, NSW; Dr Roya Merie, Staff Specialist, Radiation Oncology, Liverpool Cancer Therapy Centre, Liverpool Hospital, NSW; Dr Eva Nagy, Oncoplastic Breast Surgeon, Sydney Oncoplastic Surgery, NSW; Gay Refeld, Clinical Nurse Consultant – Breast Care, St John of God Subiaco Hospital, WA; Genny Springham, Consumer.
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