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Breast Conserving Surgery

Surgical removal of a breast cancer can be performed in one of two ways:

  1. Breast conserving surgery (BCS)
  2. Mastectomy

The term breast conserving surgery is often used interchangeably with ‘Wide Local Excision’ (WLE) or ‘lumpectomy’.

Breast conserving surgery involves removing a breast cancer with a small rim of healthy tissue around it. The aim is to maintain the shape and appearance of the breast as much as possible by removing the smallest amount of tissue that safely removes all of the cancerous cells.

Most breast cancers are suitable for this kind of surgery. However, breast cancers that are relatively large in comparison to the size of the breast, or that have invaded into the tissues surrounding the breast, may not be able to be removed with breast conserving surgery.

Surgeons cannot always feel small tumours that have been found on a mammogram or ultrasound. If this is the case, Dr Lancashire may recommend that the breast cancer be localised (marked) with a ‘hookwire’ so that it can be found at the time of surgery. A hookwire is a fine wire that is placed just before your surgery by a specialist radiologist.

Dr Lancashire will send the operative specimen (cancer) from the operating theatres to the x-ray department to make sure that the area of concern has been removed.

Figure 1

Figure 2

Figure 1. A breast with a hookwire placed near the non-palpable breast cancer just before the surgery. Figure 2. The operative specimen- the area of interest (breast cancer) can be seen along the middle of the wire.

 

People who have breast conserving surgery will be recommended radiotherapy in addition to their surgery.

Long-term studies have shown that there is no significant difference in survival or recurrence of breast cancer in women who have breast conserving surgery with radiotherapy, compared to women who opt to have a mastectomy.

It is important to remember that breast cancer surgery is tailored to the individual. Dr Lancashire will help guide you through your decision as to which operation will be the most suitable and appropriate for you.

Follow the links below for more on breast cancer management:

Mastectomy

Axillary surgery

Oncoplastic breast surgery

Prophylactic mastectomy

Breast Reconstruction

Endocrine Therapy

Radiotherapy

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