Breast-Conserving Surgery: An Effective Option for Treating Breast Cancer

What Is Breast-Conserving Surgery (BCS)?

Breast-Conserving Surgery is generally suitable for patients who have a single, small tumor confined to one area of the breast, with no extensive spread within the breast tissue.

During the procedure, the surgeon removes:

• The cancerous tumor

• A margin of normal breast tissue around the tumor (approximately 1–2 centimeters)

In most cases, the nipple, areola, and the majority of the breast tissue are preserved. Only the malignant tissue is removed. However, postoperative radiation therapy is required as part of the standard treatment.

Clinical studies have shown that long-term outcomes—both recurrence rates and survival—are comparable to total mastectomy when BCS is combined with radiation therapy.

If removal of axillary lymph nodes (underarm lymph nodes) is necessary, this can be performed during the same surgical procedure.

In cases where the tumor is relatively large and removal of a significant amount of breast tissue may lead to noticeable asymmetry or deformity, breast reconstruction surgery can be considered to restore balance and appearance. When breast cancer is detected early and the tumor is small, BCS can often preserve the natural shape of the breast very well.

Advantages of Breast-Conserving Surgery

The key benefits of removing only the tumor and surrounding tissue include:

• A less extensive surgical procedure

• Better preservation of the natural breast shape and sensation

• Shorter recovery time and reduced hospital stay

• Positive impact on body image and self-confidence

Disadvantages and Limitations of Breast-Conserving Surgery

Despite its benefits, BCS has some limitations:

1. Radiation therapy is required after surgery

   • Typically lasts 5–7 weeks, five days per week

2. Possibility of additional surgery

   • If pathology results (available about one week after surgery) show cancer cells at the margins of the removed tissue, further surgery may be needed

   • This may involve removing additional breast tissue or, in some cases, proceeding with a total mastectomy

3. Not recommended for patients with genetic mutations

   • Patients with BRCA1 or BRCA2 gene mutations are generally advised against breast-conserving surgery due to higher recurrence risk

4. Ongoing breast surveillance is necessary

   • Because breast tissue remains, patients must continue regular follow-up with mammography and ultrasound, as recommended by their physician

Who Is a Good Candidate for Breast-Conserving Surgery?

Breast-Conserving Surgery is most suitable for patients with early-stage breast cancer. The decision is made on an individual basis after careful evaluation by a specialist, taking into account factors such as:

• Tumor size and location
  The tumor must be small enough and located in an area that allows removal without significantly affecting breast appearance.

• Number of tumors
  Patients with a single tumor are more likely to be suitable candidates.

• Cancer spread
  BCS may still be considered if cancer has spread only to nearby axillary lymph nodes, but not to distant organs.

Individualized Treatment for the Best Outcome

Ultimately, the choice of surgical treatment for breast cancer must be personalized. Your physician will carefully assess whether breast-conserving surgery or another surgical approach is most appropriate, whether reconstruction is advisable, and which method will provide the highest level of safety and best long-term outcome for each individual patient.