Unlike mastectomy, in which the entire breast is removed, breast-conservation surgery saves as much of the breast as possible by removing only cancerous tissue and a small margin of healthy tissue. The advantage of this type of surgery, which is also referred to as partial, or segmental, surgery, is that most of the breast remains intact, reducing the need for reconstruction. Whether breast-conservation surgery is possible depends on the size of the tumor, and whether the cancer has spread to nearby tissue or lymph nodes, or other parts of the body. If post-surgery radiation therapy will be part of the treatment, small metallic clips that show up on X-rays may be placed inside the breast during surgery to mark the area that will receive the radiation.
Types of Breast-Conservation Surgery
There are two basic types of breast-conservation surgery:
A lumpectomy removes the breast lump and a surrounding margin of healthy tissue. Radiation therapy is usually given after a lumpectomy. If chemotherapy is also part of the treatment, it is usually done before the radiation therapy.
A quandrantectomy removes more breast tissue than a lumpectomy does, with one-quarter of the breast being removed. Post-surgery radiation therapy is usually given, but may be delayed if chemotherapy is part of the treatment.
Lymph nodes from the underarm area are often removed during surgery to check for the presence of cancer. In general, breast-conservation surgery is only recommended for women with small and/or localized cancers.