LUMPECTOMY

Breast-conserving surgery  is a less radical cancer surgery than mastectomy. Breast-conserving surgery, as in a lumpectomy removes part of the breast tissue during surgery, as opposed to the entire breast.

Patients with early stage breast cancer who are treated with lumpectomy plus radiation have a better chance of survival compared with those who undergo mastectomy. However, a recent trend has emerged with some early stage breast cancer patients, often younger women, opting for mastectomy. These women may perceive mastectomy to be more effective at eliminating early stage cancer and therefore reducing the anxiety accompanying long-term surveillance.

Indications for a diagnostic lumpectomy include the following:

• Equivocal pathology obtained on core biopsy or fine needle aspiration cytology of a radiologically suspicious breast lump
• A lump classified as category 3 or 4 by the Breast Imaging-Reporting and Data System that is close to the pectoral muscle, which makes biopsy under radiological guidance difficult

Indications for a therapeutic lumpectomy include the following:

• Benign breast lumps, such as fibroadenoma or phyllodes
• Ductal carcinoma in situ or invasive breast cancer that is amenable for breast conservation based on the size of the lesion