Breast-conserving surgery: advanced care offering hope for breast cancer patients

Breast cancer remains the most common cancer in women in the UK, with around 60,000 new cases diagnosed every year (data from 2019 and 2021–2022).¹ For many patients, surgery is a first-line treatment option, aiming to remove the tumour and treat the cancer. Approximately 80% of patients in England undergo surgery as part of their primary course of treatment, often alongside radiotherapy or systemic anti-cancer treatments (SACT), such as chemotherapy and immunotherapy.¹

Surgical treatment includes two main options: mastectomy, when an entire breast is removed, and breast-conserving surgery, when only the tumour with some surrounding healthy breast tissue is removed and the patient’s overall breast is preserved. 

Breast-conserving surgery, in combination with adjuvant radiotherapy, is associated with survival outcomes that are equivalent to, or in some cases better than, those of mastectomy, and is associated with fewer complications. By using modern surgical techniques in all appropriate patients to remove breast tumours while achieving better cosmetic outcomes, we aim to improve psychological wellbeing and body image of our patients, as well as to support quicker recovery.²

- Miss Harleen Deol, Consultant Oncoplastic Breast Surgeon 

While both approaches can be effective, breast-conserving surgery reflects an important shift in modern cancer care, where treatment considers survival as well as quality of life and long-term well-being. For many eligible patients, it may be considered the preferred surgical option. It is often the starting point for discussions between the surgeon and the patient, although its suitability depends on the size of the tumour relative to the size of the breast.

Breast-conserving surgery (also called lumpectomy or wide local excision) is the removal of the tumour and a small amount of surrounding tissue, called a margin. Besides complete tumour removal, it aims to reduce the physical and emotional impact of the treatment and maintain breast shape and appearance.

Sometimes, treatment is given before surgery to help shrink the tumour. This is known as neoadjuvant treatment and may include chemotherapy or hormone-blocking treatment. Also, if a tumour is too small for the surgeon to feel, a fine wire or magnetic seed may be inserted into the tumour area prior to the operation. This is done to accurately mark the area for removal, and the marker is removed together with the tumour during surgery.

If required, removal of a sentinel lymph node may also be done during the procedure to check whether cancer has spread further from the tumour to the lymph nodes in the armpit (axilla). The sentinel lymph node is the first lymph node to which cancer cells are most likely to spread from the breast, and its removal for testing helps guide further treatment tailored to the individual patient.

Surgery is often followed by radiotherapy or other treatment, also called adjuvant therapy, to eliminate any remaining cancer cells and minimise the risk of cancer recurrence.

In some cases, additional techniques may be used alongside lumpectomy to improve cosmetic results. These aim to reconstruct or reshape the breast after tumour removal, maintaining symmetry and a natural appearance as much as possible.

Studies show that women who have breast-conserving surgery followed by radiotherapy generally have similar long-term survival to those who have a mastectomy, depending on their individual situation.

For example, a large study from 2025 analysed survival results in more than 14,000 patients who had breast surgery. It showed that approximately 8 of 10 patients who had breast-conserving surgery followed by radiotherapy were alive 10 years after treatment compared with only around 6 of 10 patients who underwent mastectomy and radiotherapy.³

However, these results do not depend solely on the type of surgery. Survival is also influenced by how early the cancer is found, its specific features, and the other treatments used alongside surgery, such as radiotherapy or SACT. Women who need a mastectomy may sometimes have more complex or advanced cancers, which can also affect outcomes.

Breast-conserving surgery is not suitable for everyone. This may be due to the size of the tumour relative to the size of the breast. In addition, some patients who undergo breast-conserving surgery may require further surgery depending on the final pathology results.

Breast-conserving surgery is usually a shorter and less extensive operation. A study observing patients undergoing treatment showed that it is significantly shorter (about 1 hour compared with around 1.5 hours for a mastectomy) and is generally linked to less strain and physiological stress on the body during surgery and less pain immediately afterwards.⁴

While this study did not assess overall recovery time, NHS guidance suggests that recovery time after a lumpectomy is typically 3–4 weeks, compared with 3–6 weeks after a mastectomy. This means most patients can return to their daily activities more quickly after a lumpectomy.

The choice between lumpectomy and mastectomy varies between individuals and is influenced by personal preferences, cancer anxiety, reconstructive options, and the breast volume. However, lumpectomy allows women to preserve most of the breast, which may play an important role in their body image, well-being, and overall satisfaction.

A recent review article analysed the results of six studies that all compared post-operation results in women who underwent breast-conserving surgery versus mastectomy. It showed that those who underwent breast-conserving surgery felt that they had a better future perspective and better body image compared with those who had a mastectomy.⁵

Similarly, another study demonstrated that well-being and breast satisfaction were higher in women who had a lumpectomy than in patients after a mastectomy.⁶

Your surgeon will discuss the suitability of breast-conserving surgery with you. In general, it can be a viable treatment option if:

• The tumour is localised (not spread across multiple areas of your breast)
• The tumour is relatively small compared to your overall breast size
• The tumour is in a suitable position in your breast, allowing surgeons to safely remove it and leaving good cosmetic results
• The patient is able to undergo radiotherapy following surgery
• The patient is willing to undergo regular follow-ups after surgery

Doctors may not recommend a lumpectomy if:

• Breast cancer has recurred after prior breast-conserving treatment and radiotherapy
• The patient carries a genetic mutation linked to a high risk of developing breast cancer
• The patient has advanced-stage disease or inflammatory breast cancer, a rare and aggressive form of breast cancer

At GenesisCare, we work with specialist surgeons in partner hospitals who carefully consider the decision between breast-conserving surgery and mastectomy for each patient. It includes assessment of imaging, tumour size and location, tumour biology, and genetic risk factors. Patient preference, breast size, and the suitability for radiotherapy are also important factors.

If lumpectomy is recommended, a personalised treatment plan reflecting the individual situation is discussed with every patient, including the outlined duration of hospital stay, recovery pathway, and follow-up plan.

In my practice, discussions about surgical options for individual patients form the starting point of the consultation. I assess tumour size and breast volume and then discuss the available treatment options. By reviewing all options, including expected recovery, patients are supported to make informed choices about what they feel is most appropriate for them. Advances in modern radiotherapy techniques, together with close collaboration between surgeons and oncologists, ensure that each patient receives individualised care tailored to their specific needs and circumstances, including the most appropriate surgery option. This approach has been associated with significant psychological benefits, supporting patients’ quality of life, body image, and confidence following treatment.

- Miss Harleen Deol, Consultant Oncoplastic Breast Surgeon

Breast-conserving surgery is the cornerstone of modern cancer care and can present a suitable treatment option for selected patients with breast cancer. Studies have shown that it can be an effective treatment that also considers patients’ recovery, well-being, body image, and overall satisfaction.

Understanding all available surgical options can help patients feel more informed and supported when making treatment decisions. Treatment options are carefully considered for each patient based on a thorough assessment, and an individualised treatment plan is then prepared.

Through our collaboration with partner hospitals and breast surgeons, you can have your surgery close to home and then continue your treatment at one of our GenesisCare centres. We aim to make the process as easy and seamless as possible, with your consultant supporting you throughout your treatment journey.

Miss Harleen Deol, MBBS, MRCS, MSc, DiplC, FRCS (Gen Surg)

Consultant Oncoplastic Breast Surgeon

1.       Cancer Research UK: Breast cancer statistics. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer. Accessed: 11 May 2026.

2.      Fisher MD, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–1241.

3.      Mhairi M, et al. Survival after standard or oncoplastic breast-conserving surgery versus mastectomy for breast cancer. BJS Open. 2025;9(2).

4.      Jacobs LM, et al. The role of surgical tissue injury and intraoperative sympathetic activation in postoperative immunosuppression after breast-conserving surgery versus mastectomy: a prospective observational study. Breast Cancer Res. 2024;26(1):42. doi: 10.1186/s13058-024-01801-0.

5.      Ng ET, et al. Comparing Quality of Life in Breast Cancer Patients Who Underwent Mastectomy Versus Breast-Conserving Surgery: A Meta-Analysis. Int J Environ Res Public Health. 2019;16(24):4970. doi: 10.3390/ijerph16244970.

6.      Tomita S, et al. Patient-reported outcomes and quality of life after breast-conserving surgery, mastectomy, and breast reconstruction assessed using the BREAST-Q questionnaire. Breast Cancer Res Treat. 2024;207(3):641–648. doi: 10.1007/s10549-024-07396-6.