{"entity":{"id":"lumpectomy","kind":"term","name":"Lumpectomy (breast-conserving surgery)","aka":["breast-conserving","breast-conserving surgery","breast conservation","wide excision"],"tldr":"Removing only the tumour with a rim of normal breast, keeping the breast; almost always followed by radiotherapy.","summary":"Pioneered by Veronesi and Fisher, breast conservation plus whole-breast radiotherapy matches mastectomy for survival with better body image. Margins are checked by the pathologist ('no ink on tumour' suffices for invasive cancer); re-excision is needed in 10-20%. Hypofractionated (FAST-Forward, 5 fractions) and partial-breast radiotherapy have shortened the course. Neoadjuvant therapy can shrink tumours enough to convert mastectomy candidates to lumpectomy.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Lumpectomy","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Lumpectomy"},{"label":"Macmillan: breast-conserving surgery","url":"https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/breast-conserving-surgery-for-breast-cancer"},{"label":"NICE NG101: early and locally advanced breast cancer, recommendations (updated 2025)","url":"https://www.nice.org.uk/guidance/ng101/chapter/Recommendations"},{"label":"Breast Cancer Now: surgery for primary breast cancer","url":"https://breastcancernow.org/about-breast-cancer/treatment/surgery-for-primary-breast-cancer"},{"label":"Veronesi et al., twenty-year follow-up of breast-conserving surgery versus radical mastectomy, Milan trial (NEJM 2002)","url":"https://doi.org/10.1056/NEJMoa020989"},{"label":"Fisher et al., twenty-year follow-up of total mastectomy, lumpectomy, and lumpectomy plus irradiation, NSABP B-06 (NEJM 2002)","url":"https://doi.org/10.1056/NEJMoa022152"},{"label":"EBCTCG, radiotherapy after breast-conserving surgery: meta-analysis of 10,801 women in 17 randomised trials (Lancet 2011)","url":"https://doi.org/10.1016/S0140-6736(11)61629-2"}],"tags":[],"related":["mastectomy","resection-margins","hypofractionation","breast-conserving-surgery-versus-mastectomy","oncoplastic-breast-surgery","tumour-bed-boost","partial-breast-irradiation"],"cancers":["breast-hr-positive","breast-her2-positive","tnbc","breast-cancer"],"sections":["surgery","radiation"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["nsabp-b06","milan-i","eortc-10801","eortc-22881-boost"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["In triple-negative breast cancer chemotherapy is usually given first, and Cancer Research UK says shrinking the cancer may allow breast-conserving surgery instead of a mastectomy. Macmillan says breast-conserving surgery with radiotherapy is usually as effective as a mastectomy and that a second operation is needed if cancer is at the margin; NICE NG101 (2024) asks for further surgery when invasive cancer is at the radial margin and to consider it within 1 mm.","Breast cancer, the long-term comparison with mastectomy. In the Milan trial, 701 women with breast cancers no larger than 2 cm were randomly assigned between 1973 and 1980 to radical (Halsted) mastectomy (349) or quadrantectomy followed by radiotherapy (352). After a median 20 years of follow-up, death from any cause had occurred in 41.2 percent of the radical mastectomy group and 41.7 percent of the conserving surgery group (P equals 1.0), and death from breast cancer in 24.3 and 26.1 percent (P equals 0.8). What differed was the breast: 30 women in the conserving group had a recurrence in the same breast against 8 local recurrences after radical mastectomy, a crude cumulative incidence of 8.8 against 2.3 percent, with no significant difference in contralateral cancers, distant metastases or second primary cancers.","In NSABP B-06, 1,851 women were randomly assigned to total mastectomy, lumpectomy alone, or lumpectomy with breast irradiation, and followed for 20 years. Recurrence in the same breast occurred in 14.3 percent of those given radiotherapy against 39.2 percent of those not (P less than 0.001), and no significant difference was found between the three groups in disease-free survival, distant-disease-free survival or overall survival: the hazard ratio for death was 1.05 (0.90 to 1.23) for lumpectomy alone against total mastectomy and 0.97 (0.83 to 1.14) for lumpectomy with irradiation.","NICE NG101 (1.13.3) says to offer whole-breast radiotherapy to women with invasive breast cancer who have had breast-conserving surgery with clear margins, and (1.13.4, 1.13.5) to consider partial-breast radiotherapy for women aged 50 and over with tumours 3 cm or less that are N0, ER-positive, HER2-negative and grade 1 to 2 who will take endocrine therapy for at least 5 years, telling them that local recurrence at 5 years is equivalent, that the risk beyond 5 years is not yet known, and that late adverse effects may be reduced."],"category":"Procedures"},"route":"/terms/lumpectomy/","neighbours":{"term":[{"id":"body-image-after-breast-surgery","kind":"term","name":"Body image after breast surgery and reconstruction","route":"/terms/body-image-after-breast-surgery/"},{"id":"breast-conserving-surgery-versus-mastectomy","kind":"term","name":"Breast conservation or mastectomy","route":"/terms/breast-conserving-surgery-versus-mastectomy/"},{"id":"breast-reconstruction","kind":"term","name":"Breast reconstruction","route":"/terms/breast-reconstruction/"},{"id":"dcis","kind":"term","name":"Ductal carcinoma in situ (DCIS)","route":"/terms/dcis/"},{"id":"hypofractionation","kind":"term","name":"Hypofractionation (fewer, larger radiotherapy doses)","route":"/terms/hypofractionation/"},{"id":"radiotherapy-omission-early-breast-cancer","kind":"term","name":"Leaving radiotherapy out","route":"/terms/radiotherapy-omission-early-breast-cancer/"},{"id":"breast-margins-and-re-excision","kind":"term","name":"Margins after breast-conserving surgery, and second operations","route":"/terms/breast-margins-and-re-excision/"},{"id":"mastectomy","kind":"term","name":"Mastectomy","route":"/terms/mastectomy/"},{"id":"numbness-after-breast-surgery","kind":"term","name":"Numbness and nerve pain after breast surgery","route":"/terms/numbness-after-breast-surgery/"},{"id":"oncoplastic-breast-surgery","kind":"term","name":"Oncoplastic breast surgery","route":"/terms/oncoplastic-breast-surgery/"},{"id":"partial-breast-irradiation","kind":"term","name":"Partial-breast irradiation","route":"/terms/partial-breast-irradiation/"},{"id":"resection-margins","kind":"term","name":"Resection margins (R0 / R1 / R2)","route":"/terms/resection-margins/"},{"id":"seroma-after-breast-surgery","kind":"term","name":"Seroma after breast surgery","route":"/terms/seroma-after-breast-surgery/"},{"id":"tumour-bed-boost","kind":"term","name":"Tumour bed boost","route":"/terms/tumour-bed-boost/"}],"cancer":[{"id":"adenoid-cystic-carcinoma-breast","kind":"cancer","name":"Adenoid cystic carcinoma of the breast","route":"/cancers/adenoid-cystic-carcinoma-breast/"},{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"ductal-carcinoma-in-situ","kind":"cancer","name":"Ductal carcinoma in situ (DCIS)","route":"/cancers/ductal-carcinoma-in-situ/"},{"id":"her2-positive-early-breast-cancer","kind":"cancer","name":"Early HER2-positive breast cancer","route":"/cancers/her2-positive-early-breast-cancer/"},{"id":"tnbc-early","kind":"cancer","name":"Early triple-negative breast cancer","route":"/cancers/tnbc-early/"},{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"hr-positive-early-high-risk","kind":"cancer","name":"High-risk early HR-positive breast cancer","route":"/cancers/hr-positive-early-high-risk/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"metaplastic-breast-carcinoma","kind":"cancer","name":"Metaplastic breast carcinoma","route":"/cancers/metaplastic-breast-carcinoma/"},{"id":"paget-disease-of-the-nipple","kind":"cancer","name":"Paget disease of the nipple","route":"/cancers/paget-disease-of-the-nipple/"},{"id":"phyllodes-tumour","kind":"cancer","name":"Phyllodes tumour of the breast","route":"/cancers/phyllodes-tumour/"},{"id":"secretory-carcinoma-breast","kind":"cancer","name":"Secretory carcinoma of the breast","route":"/cancers/secretory-carcinoma-breast/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"section":[{"id":"radiation","kind":"section","name":"Radiation Therapy","route":"/fronts/radiation/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"trial":[{"id":"eortc-10801","kind":"trial","name":"EORTC 10801","route":"/trials/eortc-10801/"},{"id":"eortc-22881-boost","kind":"trial","name":"EORTC 22881-10882 (boost against no boost)","route":"/trials/eortc-22881-boost/"},{"id":"insite","kind":"trial","name":"INSITE","route":"/trials/insite/"},{"id":"milan-i","kind":"trial","name":"Milan I (quadrantectomy against radical mastectomy)","route":"/trials/milan-i/"},{"id":"nsabp-b06","kind":"trial","name":"NSABP B-06","route":"/trials/nsabp-b06/"},{"id":"targit-a","kind":"trial","name":"TARGIT-A (targeted intraoperative radiotherapy)","route":"/trials/targit-a/"}]}}