Breast-Conserving Therapy for Early-Stage Breast Cancer

If you’ve recently been diagnosed with early-stage breast cancer, your physician may recommend breast-conserving therapy as part of your treatment plan. Typically, this involves breast-conserving surgery followed by radiation therapy to treat any remaining cancer cells. Used as an alternative to mastectomy for many patients with early-stage breast cancer, breast-conserving therapy allows patients to preserve most of their breast while achieving outcomes comparable to mastectomy in appropriately selected cases.

“When breast cancer is caught in an early stage or before it has spread, a breast-conserving approach may be appropriate for some patients,” said Dr. Regina Hampton at Maryland Oncology Hematology. “Our practice works with each patient to determine the best plan for their cancer and their goals”.

Who Is Breast-Conserving Therapy Appropriate For?

Breast-conserving therapy is an option for many patients with early-stage breast cancer. Studies have shown that, for appropriately selected patients, breast-conserving therapy and mastectomy offer similar long-term survival outcomes.

You may consider breast-conserving therapy if you:

Have concerns about losing a breast.
Can receive radiation therapy and have not previously received radiation therapy to the same breast.
Have cancer in one area of the breast, or in multiple areas close enough to be removed together.
Have a tumor that can be safely removed while preserving the appearance of the breast. Tumor size, breast size, tumor location, and response to treatment are all considered when determining whether breast-conserving therapy is appropriate.
Can receive radiation therapy. Because radiation is not given during pregnancy, breast-conserving therapy may not be appropriate depending on the timing of treatment and stage of pregnancy.
Have discussed any inherited genetic mutations, such as BRCA1 or BRCA2, and your family history of breast cancer with your treatment team. While some patients with hereditary cancer syndromes may choose mastectomy to reduce future cancer risk, breast-conserving therapy may still be an appropriate option for selected patients.

What Can I Expect from Surgery?

If breast-conserving therapy is recommended as part of your treatment plan, surgery is performed to remove the cancer while preserving as much of the breast as possible. Some surrounding tissue and nearby lymph nodes may also be removed.

You may hear this surgery referred to as a lumpectomy, quadrantectomy, partial mastectomy, or segmental mastectomy. The type of surgery performed depends on how much of the breast is removed.

To determine this, your surgeon will consider the size and location of the tumor, as well as the size and shape of your breast.

Surgery is usually performed in an outpatient surgery center and often does not require an overnight stay in the hospital.

Before going home, ask your healthcare team any questions you have about:

How to care for the surgery site and any bandages or drains
What signs of infection to watch for
How to shower while the surgery site is healing
When you can begin wearing a bra again
Restrictions on physical activity
Any prescribed medications, including antibiotics

Please contact your doctor if you have any concerns during the recovery process.

How Do I Know If All of the Cancer Was Removed?

When breast cancer is removed, the surgeon also removes a small amount of normal tissue surrounding the tumor. This is called the margin.

After surgery, a pathologist examines the removed tissue to determine whether cancer cells are present at the margins. If there is concern that cancer cells remain in the breast, the surgeon may recommend removing additional tissue. This procedure is called a re-excision. In some cases, if cancer cells continue to be found at the margins, a mastectomy may be recommended.

Most patients receive radiation therapy following breast-conserving surgery. Radiation helps destroy cancer cells that may remain in the breast after surgery and reduces the risk of the cancer returning.

Small clips may be placed inside the breast during surgery to mark where the cancer was removed so radiation therapy can be more precisely targeted.

Some patients with very low-risk breast cancers may not require radiation therapy. Your physician will discuss whether radiation therapy is recommended for your specific situation.

How Is Cancer Recurrence Prevented?

Your physician may recommend hormone therapy following surgery if your breast cancer is hormone receptor-positive. Hormone therapy can help reduce the risk of the cancer returning.

Some patients may also benefit from chemotherapy after surgery. If chemotherapy is recommended, radiation therapy or hormone therapy may be delayed until chemotherapy is completed.

Your treatment team will work with you to determine the timing and sequence of treatments that best fit your individual needs.

Can I Have Breast Reconstruction Surgery After Breast Cancer Treatment?

Before beginning treatment, talk to your breast surgeon about the changes you can expect in your breast after surgery.

Breast reconstruction surgery can help rebuild the shape and appearance of the breast. If you are considering reconstruction, discuss your options with your surgical team before breast-conserving surgery.

Reconstruction may sometimes be performed at the same time as breast cancer surgery, while other procedures may be performed later.

Your breast surgeon can connect you with a plastic surgeon who can explain your options.

If you are considering breast reconstruction surgery, ask your doctor:

Will reconstruction interfere with chemotherapy, radiation therapy, or any other treatment?
Is reconstruction recommended during the initial breast cancer surgery, or should it be delayed?
What reconstruction options are available to me?
How long will recovery take?
What changes can I expect in my breast over time?
Should I consider surgery on both breasts to help them look more symmetrical?

You may also ask your physician for photos of typical results or whether they can connect you with other patients who have undergone similar procedures.

The breast cancer specialists at Maryland Oncology Hematology work with you to create the treatment plan that best fits your diagnosis and goals. For more information about breast-conserving therapy or other breast cancer treatment options, visit Breast Cancer Treatment & Care | Maryland Oncology Hematology