Lumpectomy (Breast Conserving Surgery)

Who Is Lumpectomy Recommended For?

• People who have early-stage tumours that are in one area of the breast

• People who can have radiation therapy

• People who want to preserve breast appearance

It may not be recommended if:

• The tumour is large or in multiple areas of the breast
• Radiation is not an option (such as during pregnancy or prior radiation to the breast)
• The cancer is inflammatory breast cancer or a high-risk tumour that requires more extensive surgery

For those with hereditary breast cancer (e.g., BRCA1 or BRCA2 mutations), mastectomy may be more commonly recommended, but breast-conserving options can still be considered in some cases.

Immediate Reconstruction (Oncoplastic Lumpectomy)

Oncoplastic lumpectomy combines a lumpectomy with plastic surgery techniques to improve breast shape. This approach helps prevent noticeable dents or unevenness by reshaping the breast at the time of tumour removal.

Benefits of Oncoplastic Lumpectomy

• Helps keep breast shape and symmetry after surgery

• Reduces the need for future corrective surgery

• Helps maintain a natural breast shape, even when a larger portion of tissue is removed

Oncoplastic lumpectomy in Canada is grouped into three levels based on the complexity of reconstruction, the volume of tissue removed, and the surgical expertise required:

Level 1 (Up to 15% Tissue Removal)

• Performed by most breast surgeons without specialized training
• Uses remaining breast tissue to reshape the breast
• Scars are often placed in less visible areas
• Breast size may be slightly reduced (about one cup size)

Level 2 (15%–25% Tissue Removal)

• Requires specialized surgical training

• Involves moving the nipple and extensive reshaping
• Combines Level 1 reshaping techniques with:
  • Fat grafting (completed later on, after radiation) or tissue flaps
  • Plastic surgery techniques like a breast lift or reduction

Level 3 (25%–60% Tissue Removal)

• Uses breast reduction techniques to reshape the breast

• Often includes surgery on the opposite breast for symmetry
• Suitable for larger tumour removal while preserving breast shape
• Often an alternative to mastectomy for patients with large breasts who require extensive tissue removal

Additional Considerations

• Oncoplastic lumpectomy is widely used in Europe and the U.S. but still emerging in Canada

• Level 1 is widely available, while Levels 2 and 3 require specialized training

• Surgical clips are placed during all oncoplastic procedures to mark the tumour site for future imaging and radiation
• Recovery varies, but many patients resume normal activities within weeks
• Availability differs by region. Discuss with your surgeon to see if it's an option for you.

Medical Reviews by Siba Haykal, MD, PhD, FRCSC, FACS, October 2025 and Mark Basik, MD, FRCSC, December 2025

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