Lumpectomy (breast-conserving surgery)

This page was reviewed under our medical and editorial policy by

Daniel Liu, MD, Plastic and Reconstructive Surgeon

This page was reviewed on February 8, 2022.

If you’re diagnosed with breast cancer, you may be working with your cancer care team—a team of providers and specialists—on a treatment plan. One of these treatments may be a lumpectomy. Learn about what a lumpectomy is, why one may be recommended, and what to expect during surgery and aftercare.

What is a lumpectomy?

A lumpectomy is a surgical procedure that’s performed when you have cancer and need to have some of the cancerous tissue and nearby areas removed. The goal of this procedure is to extract cancer tissue while still maintaining breast tissue.

You may also hear this procedure called by a few other names, such as:

  • Breast-conserving surgery (BCS)
  • Quadrantectomy
  • Partial mastectomy
  • Segmental mastectomy

These terms mean slightly different things depending on how much breast tissue is removed. This surgery is different from a mastectomy, which involves surgically removing the entire breast.

You may have a part of your chest wall removed as well during a lumpectomy if the cancer is detected near this area. Your care team may also choose to remove some of the lymph nodes underneath your arm if these are concerning areas for cancer.

Why are lumpectomies performed?

A lumpectomy is performed for patients who are diagnosed with breast cancer. It's a form of treatment that may be a good option in the early stages of cancer. The goal of this surgery is to prevent cancer from spreading to the rest of the body.

Many patients decide to have a lumpectomy because they want to keep as much of their breast as possible. It’s less invasive than a mastectomy, but patients who have a lumpectomy also need to have radiation therapy or another treatment.

When compared with a mastectomy, your chances of long-term survival can be the same with a lumpectomy followed by radiation if:

  • You have a small cancer (less than 4 cm) in only one breast, or cancers that are close together and can be treated at the same time
  • Your margins (surrounding tissue) are clear 

Three factors to consider before deciding

There are several issues to take into consideration when deciding whether or not to have a lumpectomy.

  1. Are you a candidate? Not everyone who has breast cancer is a good candidate for a lumpectomy. This depends on your overall health status, the type of cancer, or other factors that you may discuss with your care team.
  2. What is your individual treatment plan? It's also important to realize that you’re unique, just like your specific cancer treatment plan. How much of your breast tissue is removed during a lumpectomy depends on several things, including the tumor's size and location, and the size of your breast.
  3. How important is maximizing your breast tissue? The benefit of having this surgery means you’re able to keep most of your breast, but it also means that your care team may recommend radiation therapy as well. In most cases, radiation follows a lumpectomy, but you may also need to undergo chemotherapy or hormone therapy. If you elect to have a lumpectomy along with radiation instead of having a mastectomy, it doesn't affect your overall recovery or survival rate of breast cancer.

What are the risks?

All surgeries come with a level of risk, and a lumpectomy is no different. Breast swelling is common after surgery but should be temporary. You may have pain, and you may have a scar or dimple where your tumor was taken out. You may even feel a "tugging" feeling in the breast. Breast asymmetry is expected following lumpectomy and radiation therapy, but the degree of cosmetic deformity varies widely among patients. Partial breast reconstruction may be offered at the time of lumpectomy or thereafter to fix contour deformities.

After this type of surgery, you may feel a type of nerve pain called post-mastectomy pain syndrome (PMPS). This affects 20 percent to 30 percent of patients, according to the American Cancer Society. You may feel a shooting or burning pain in your chest wall, armpit or in an arm. Unfortunately, this doesn't go away, but many patients say the pain isn’t severe.

Some patients may also experience swelling in the arm, known as lymphedema. Alert your care team as soon as possible if you experience swelling, tight skin or a feeling of heaviness in your affected arm, so that treatment may start as soon as possible. Caught early, lymphedema may be reversed with treatment, but infection may develop if it progresses.

How to prepare for a lumpectomy

A lumpectomy is usually performed as an outpatient procedure in a surgery center. Usually, an overnight stay in a hospital isn't necessary, and most patients resume regular daily activities within two weeks. Consider finding someone to help you out while you’re recovering.

You’ll likely have appointments with your doctor to review what to expect before, during and after surgery. It may help to take notes or bring along someone who is able to do this for you or ask questions. It’s also important to review all the medications you're currently taking. Some of these, such as blood thinners, need to be stopped before surgery. You may or may not need to stop eating or drinking for a few hours before surgery.

What to expect during the procedure

During a lumpectomy, the surgeon's goal is to remove as much cancer as possible, and some healthy tissue may need to be removed as well. This tissue is sent for testing. Some lymph nodes under the arm may also be extracted.

When the surgery is finished, a pathologist studies the tissue samples under a microscope. If the pathologist doesn't see any cancer at the edge of the tissue, it means the tissue has clear, or negative, margins. If there are cancer cells present at the edges, it means there are close, or positive, margins. Your doctor will then inform you of these results and what treatment looks like going forward.

Follow-up care/results

Expect written instructions from your care team about how to manage your surgical site after discharge, along with contact information in case you have questions or concerns.

Most lumpectomy patients should be able to return to their daily routines about two weeks after surgery.

Make sure you understand how to care for your site and know how to change the dressing. If you have a drain, you’ll need to know how to empty it and keep it clean.

You'll receive instructions on when and how to bathe after surgery, and when you may wear a bra again.

It’s also important to discuss infection prevention and pain management, along with any numbness in your breast or arm. Your care team may provide instructions on appropriate activity levels and prescribed exercises to prevent stiffness in your arm.

Signs of a possible infection at the surgical site after a lumpectomy include:

  • Pain
  • Skin that’s warm to the touch
  • Fluid discharge
  • Redness
  • Swelling
  • Fever

Other signs of a problem include:

  • Fluid collecting near the wound and around the armpit that doesn’t go away on its own after a few weeks
  • Blood collecting around the wound site that causes pain and swelling (called a hematoma), which may go away on its own after a few months
  • Swelling in your arm or hand that persists

Consult your doctor if you experience any of these issues. You may need oral or intravenous antibiotics.

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