Breast-conserving surgery (BCS) removes the cancer while leaving as much normal breast as possible. Usually, some surrounding healthy tissue and lymph nodes also are removed. Breast-conserving surgery is sometimes called lumpectomy, quadrantectomy, partial mastectomy, or segmental mastectomy depending on how much tissue is removed.

What you should know before having breast-conserving surgery

• How much of the breast is removed depends on the size and location of the tumor, your breast size, and other factors.
• Breast-conserving surgery allows a woman to keep most of her breast, but makes it likely she will also need radiation.
• After BCS, most women will have radiation therapy. Some women might also get other treatments, such as hormone therapy or chemotherapy.
• Choosing BCS plus radiation over mastectomy does not affect a woman’s chances of long-term survival.
• If you think you want breast reconstruction, talk to your doctor before your breast cancer surgery.
• Not all women with breast cancer can have BCS. Talk to your doctor to find out whether BCS is an option for you.
• Side effects of BCS may include pain, a scar and/or dimple where the tumor was removed, a firm or hard surgical scar, and sometimes lymphedema, a type of swelling, in the arm.

Who can have breast-conserving surgery?

Breast-conserving surgery (BCS) is a good option for many women with early-stage cancers. The main advantage is that a woman keeps most of her breast. However, most women will also need radiation therapy, given by a radiation oncologist (a doctor who specializes in radiation). Women who have their entire breast removed (mastectomy) for early-stage cancers are less likely to need radiation, but they may be referred to a radiation oncologist for evaluation because each patient’s cancer is unique.
BCS might be a good option if you:

• Are concerned about losing a breast
• Are willing to have radiation therapy and are able to get to the appointments (if you need help getting to and from your appointments see Road to Recovery).
• Have not already had that breast treated with radiation therapy or BCS
• Have only one area of cancer in the breast, or multiple areas in one quadrant (multifocal) that are close enough to be removed together without changing the look of the breast too much
• Have a tumor smaller than 5 cm (2 inches), that is also small relative to the size of the breast
• Are not pregnant or, if pregnant, will not need radiation therapy immediately (to avoid risking harm to the fetus)
• Do not have a gene mutation (change) such as a BRCA or ATM mutation, which might increase your chance of a second breast cancer
• Do not have certain serious connective tissue diseases such as scleroderma or Sjögren's syndrome, which may make you very sensitive to the side effects of radiation therapy
• Do not have inflammatory breast cancer
• Do not have positive margins (see Was all the cancer removed? below)

Recovering from breast-conserving surgery

This type of surgery is typically done in an outpatient surgery center, and an overnight stay in the hospital usually is not needed. Most women should be able to function after going home and can often return to their regular activities within 2 weeks.

Instructions for post-surgery care may include:

• How to care for the surgery site and dressing.
• How to care for your drain, if you have one.
• How to tell if an infection is starting.
• Tips on bathing and showering after surgery.
• When to call the doctor or nurse.
• When to start using your arm again and how to do arm exercises to prevent stiffness.
• When you can start wearing a bra again.
• The use of medicines, including pain medicines and possibly antibiotics.
• Any restrictions on activity.
• What to expect regarding sensations or numbness in the breast and arm.
• What to expect regarding feelings about body image.
• When to see your doctor for a follow-up appointment.

Possible side effects of breast-conserving surgery

Side effects can include:

• Pain or tenderness or a "tugging" sensation in the breast.
• Temporary swelling of the breast.
• Hard scar tissue and/or a dimple that forms at the surgical site.
• Swelling of the breast from a collection of fluid (seroma) that might need to be drained.
• Change in the shape of the breast.
• Neuropathic (nerve) pain in the chest wall, armpit, and/or arm.
• If axillary lymph nodes are also removed, lymphedema may occur.