Are you a candidate for breast conservation surgery?

Many women with early breast cancer can choose breast conservation surgery, also called lumpectomy, instead of removing the whole breast. For women who are suitable, a lumpectomy followed by radiotherapy gives long-term survival similar to mastectomy, so the choice is often about what suits you rather than which is safer. Whether you are a good candidate depends on a few key things. The first is the size of the tumour compared with the size of your breast, because the surgeon needs to remove the cancer with a clear rim of healthy tissue and still leave a breast that looks acceptable to you. The second is whether the cancer is in one area or spread across different parts of the breast. The third is whether you can have radiotherapy afterwards, since it is normally part of breast conservation. Other factors include widespread suspicious calcium spots on the mammogram, inflammatory breast cancer, an inherited gene change such as BRCA, pregnancy, and your own preferences about appearance, recovery and follow-up. Chemotherapy or hormone therapy before surgery can shrink some tumours enough to make a lumpectomy possible. Reshaping techniques, known as oncoplastic surgery, can also allow larger areas to be removed while keeping a good breast shape. Your surgeon will look at your examination, scans and biopsy together, then talk through the options with you.

Many women are suitable

Breast conservation is offered to a large share of women with early breast cancer.

Radiotherapy is part of the deal

Being able to have radiotherapy afterwards is usually essential.

Your preference counts

When both options are safe, the choice between them is yours to make.

A lumpectomy is a good option for many women, but it comes with commitments of its own.

Radiotherapy means extra visits

Treatment usually runs over a few weeks of daily sessions, which needs planning if you live far away.

More surgery is sometimes needed

If the edges are not clear, a second operation or a mastectomy may be recommended.

The local return risk is slightly different

The chance of cancer returning in the breast is a little higher than after mastectomy, though overall survival is similar.

What this page cannot tell you

It cannot decide whether you are suitable. Only your surgeon, with your full test results, can.

When both operations are medically safe, personal priorities often guide the decision.

How you feel about your breast

Some women value keeping their breast; others feel calmer having it removed.

Travel and time for radiotherapy

Consider whether you can manage several weeks of treatment visits.

Family history and gene tests

Women with a BRCA gene change may discuss more extensive surgery to lower the risk of a new cancer.