Whether you have breast conserving surgery or a mastectomy will depend on your type of breast cancer

There are two main types of breast surgery:

• breast conserving surgery (also called a wide local excision or lumpectomy) – where just the cancer is removed

mastectomy – where the whole breast is removed

The surgery you are offered will depend on your specific breast cancer. Research has shown that breast conserving surgery followed by radiotherapy is as effective as mastectomy in stopping the cancer spreading to other areas of your body. If breast conserving surgery is possible, you will be offered this option.

If either technique is suitable for you, you may be offered a choice of the surgery you have. Your breast care team will give you information and advice to help you make your choice. Your surgery will be carried out by a surgeon who is part of your breast care team and specialises in breast disease.

Breast conserving surgery

Breast conserving surgery involves the removal of the breast tumour but not the surrounding healthy tissue of your breast.

A very small amount of breast tissue around the tumour (usually 1mm or so), called the ‘margin’, is removed with the tumour. This helps to ensure all the cancer is removed. The tumour and surrounding tissue are sent to a pathologist who will check that the area around the tumour is free of cancer. If no cancer cells are found in this margin you will not need to have any more breast tissue removed.

If the pathologist does find any remaining cancer cells (or cells that might develop into cancer) in this margin you may need further surgery. This usually involves more breast tissue being removed but sometimes may mean you will need a mastectomy. This is to ensure that all the cancer has been removed from your breast.

If you have breast conserving surgery it will almost always be followed by a course of radiotherapy. The combination of these treatments reduces the chance that your cancer will come back.

Mastectomy

If you have a mastectomy your whole breast will be removed. Mastectomy is generally the best option if you have a large tumour (relative to the size of your breast) or the cancer is in more than one area of your breast. You may also be advised to have a mastectomy if radiotherapy is not suitable for you, meaning breast conserving surgery would be less effective.

If you have a mastectomy you will be offered the option of having your breast reconstructed either immediately or at a later time. If you have a large breast tumour which would normally need a mastectomy, you may be given other treatments before surgery with the aim of shrinking the tumour so that breast conserving surgery can be performed instead. These additional treatments are called neoadjuvant therapies and can include chemotherapy, hormone therapy or targeted therapy.

Information Standard

Information last reviewed: November 2017

Next review due: November 2020

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