A lumpectomy — also called wide local excision or breast-conserving surgery — is a breast cancer operation that removes the cancer together with a rim of healthy tissue around it, while preserving the rest of the breast.
Lumpectomy is one of the two main breast cancer operations, alongside mastectomy. For cancers where it is suitable, lumpectomy plus radiotherapy gives equivalent long-term survival to mastectomy, with most of the breast preserved2. The aim is to remove the cancer with a clear margin of healthy tissue around it1.
Orientation Why you might be reading about this
You have probably been told that lumpectomy is one of the options in your treatment plan, or you are reading to understand what the operation involves. Lumpectomy is the more breast-preserving of the two main cancer operations and is appropriate for many — but not all — breast cancers. This page explains what a lumpectomy is, when it is offered, and how it relates to the rest of the treatment pathway.
Related terms: Mastectomy · Sentinel lymph node biopsy · Oncoplastic surgery · DCIS · Core biopsy
Same thing, three names Lumpectomy, wide local excision, breast-conserving surgery — same operation
Three terms commonly used in the UK refer to the same operation:
- Lumpectomy — the everyday word, used in patient information and consultations.
- Wide local excision (WLE) — the surgical term, often used in operative notes and histology reports.
- Breast-conserving surgery (BCS) — the umbrella term that distinguishes this approach from mastectomy.
In modern practice they are interchangeable. The patient-facing word is lumpectomy; the clinical record is more likely to use wide local excision.
Suitability When lumpectomy is suitable
Lumpectomy is suitable when the cancer can be removed with a clear margin of healthy tissue while leaving an acceptable cosmetic result4. The decision depends on:
- The size of the cancer relative to the breast — a smaller cancer in a larger breast is straightforward; a larger cancer in a smaller breast may not leave enough tissue for a good cosmetic outcome.
- The position of the cancer in the breast — cancers close to the nipple or at certain depths are sometimes harder to remove with a clear margin while preserving shape.
- Whether the cancer is in one place or spread across the breast (multifocal) — multifocal cancers sometimes need mastectomy.
- Whether the patient can have radiotherapy afterwards — lumpectomy is followed by radiotherapy in almost all cases. Patients who cannot have radiotherapy (for medical reasons) usually have mastectomy instead.
- Patient preference — some patients prefer mastectomy even when lumpectomy is suitable. The choice is yours.
For cancers where lumpectomy alone would not give a good cosmetic result but mastectomy is not wanted, oncoplastic surgery — particularly therapeutic mammoplasty — is the third option, combining cancer removal with reshaping of the breast.
The procedure What the operation involves
- General anaesthetic.
- Length of operation: typically 60–90 minutes.
- Hospital stay: usually day-case or one night.
- Sentinel lymph node biopsy is performed at the same operation for invasive cancers.
- Drains are sometimes used; many lumpectomies are done without.
- Stitches are absorbable, under the skin — no stitches to remove.
For impalpable cancers (visible only on imaging), the lesion is localised before surgery using a wire, magnetic seed (Magseed), or radiofrequency tag — see impalpable lesion localisation.
Margins Margins and the histology report
The removed tissue is examined by a pathologist. The key question is whether the cancer has been removed with a clear margin — that is, with a rim of healthy tissue around it, so that no cancer cells are left behind in the breast.
In UK practice, a clear margin for invasive cancer means “no ink on tumour” (no cancer cells touching the inked edge of the specimen)1. If invasive tumour cells are within 1 mm of the inked margin (a “close margin”), further surgery is considered at MDT per NICE NG101. For DCIS the convention is a 2 mm margin4.
A small percentage of lumpectomies — typically 10–25% — come back with involved margins1, meaning cancer cells were at or close to the edge. This is not a sign that the original surgery was poorly done; it reflects how cancers are sometimes distributed in tissue. The standard next step is a re-excision — a smaller second operation through the same incision to take a further rim of tissue from the involved side.
Radiotherapy Radiotherapy
Lumpectomy is almost always followed by radiotherapy to the remaining breast tissue, given several weeks after the operation4. Radiotherapy reduces the risk of cancer recurring in the same breast and is what makes lumpectomy plus radiotherapy equivalent in survival to mastectomy2.
The radiotherapy course is usually 1 week of daily treatments (5 fractions)4, sometimes 3 weeks depending on the clinical situation. The radiotherapy team is contacted via the multidisciplinary team once the histology is back; you do not need to find a separate referral.
At consultation What to discuss with your surgeon
If lumpectomy has been suggested, the conversation usually covers:
- Whether lumpectomy or mastectomy is the right operation for your specific cancer.
- Whether oncoplastic techniques (such as therapeutic mammoplasty, with a contralateral symmetrising procedure) would give a better cosmetic result.
- What “clear margins” means and what happens if the margin comes back involved.
- The radiotherapy that follows — duration, how it fits with chemotherapy or hormone therapy, side effects.
- Sentinel lymph node biopsy — almost always part of the operation for invasive cancers.
For the practice’s full lumpectomy service page, see wide local excision (lumpectomy).
Resources Further reading
- NHS — Treatment for breast cancer in women — patient overview of treatment options.
- Breast Cancer Now — Surgery for primary breast cancer — patient-focused guide.
- Breastory: Lumpectomy service page · Therapeutic mammoplasty · Re-excision for involved margins · Glossary: mastectomy