Lumpectomy
A lumpectomy is surgery that removes a breast cancer tumor and the rim of healthy tissue surrounding it (called the margin). A lumpectomy is also sometimes called breast-conserving surgery or partial mastectomy.
If you’ve been diagnosed with breast cancer that is small relative to the size of your breast, your doctor may recommend a lumpectomy. Unlike mastectomy, which removes the entire breast, lumpectomy removes only the cancer and preserves as much of your breast as possible.
What to expect with lumpectomy surgery
A lumpectomy is typically an outpatient procedure, which means you go home the same day, although in some cases you may need to stay in the hospital for a night or two. Pre-surgery preparation may involve a procedure called localization, which will help the surgeon find the tumor in the breast. It may also include a lymph node mapping procedure, which will help the surgeon find the sentinel lymph nodes during the surgery. For the surgery itself, you’ll receive general anesthesia or local anesthesia plus a sedative (relaxing) medicine, and the procedure generally takes about 60 to 90 minutes. You’ll be in the recovery room for one to three hours and usually you can go home after that.
Before lumpectomy surgery
Before the surgery begins, your surgical team usually does a procedure called localization to mark where the tumor is in the breast. This procedure may be done a few days before the lumpectomy or on the same day as the lumpectomy.
If you’re having a wire localization procedure, a radiologist locates the tumor using a mammogram or ultrasound. Then the radiologist injects a numbing agent into the breast (local anesthesia) and inserts a thin wire into the area to help guide the surgeon to the tissue that needs to be removed. The wire sticks out from the breast and has to be protected and kept in position until the surgery begins.
Some surgeons now use wire-free localization instead, which can be done a few days before surgery. The radiologist locates the tumor using a mammogram or ultrasound and then injects local anesthesia into the breast. Then, using a needle, the radiologist inserts a tiny metal device called a seed through the skin into the area where the cancer is. On the day of the procedure, the surgeon uses a detection device to locate the seed and find the cancer.
If the surgeon can feel the tumor through the skin with their hands (this is called having a “palpable” tumor), they may decide that they don’t need to do a localization procedure before the surgery.
Whether or not you have the localization procedure, the surgeon may mark the planned incision site on your breast — usually with a felt-tip marker.
If you're having a sentinel lymph node biopsy, your surgical team will usually do a lymph node mapping procedure before the lumpectomy. This will help your surgeon find the sentinel lymph node(s) during the surgery. While you lie on an exam table or in a reclining chair, a healthcare provider will inject a radioactive liquid (called a tracer), a blue dye, or both under the skin near the cancer site or underneath the nipple. The liquid and/or blue dye travels to the sentinel lymph nodes and helps the surgeon decide which lymph nodes need to be removed.
Sometimes the mapping procedure is done at the time of the surgery instead, after you’re given general anesthesia.
Most people who have lumpectomy have general anesthesia (and are asleep during the surgery).
Some may instead receive local anesthetic to numb the area involved in the surgery plus a sedative medicine (and are relaxed and sleepy but may still be awake during the surgery).
To deliver the general anesthesia or the sedative medicine, the nurse inserts an intravenous (IV) infusion line into your hand or arm and tapes it into place.
The lumpectomy procedure
A lumpectomy can take about 60 to 90 minutes. The procedure takes longer if you have oncoplastic lumpectomy or if the surgeon is removing multiple lymph nodes.
Surgeons usually operate with a scalpel and an electrocautery knife, called a Bovie. This is a kind of electric scalpel that uses heat to minimize and stop bleeding.
Most surgeons use hidden incisions or incisions that follow the natural curve of your breast. Many surgeons place the scar along the areola (the dark skin surrounding the nipple), along the edge of the breast, in the underarm crease, or under the breast fold so it’s not obvious (called aesthetic scar placement). It’s a good idea to talk to your surgeon about the placement of your lumpectomy scar before the surgery so you know what to expect.
The surgeon removes the breast cancer tumor and a rim of healthy tissue around it. The amount of tissue the surgeon removes can vary greatly depending on the size of the tumor.
Then the surgeon removes the localization devices that were used to help guide them to the tumor or that were left during an earlier biopsy (such as a clip, wire, or seed).
The surgeon may also place small clips or another type of marker to identify the original cancer site, which helps the radiation oncologist target radiation treatments.
If you need to have a sentinel lymph node biopsy or dissection, the surgeon removes up to three lymph nodes through a separate small incision under the armpit.
The tumor, margin, and lymph nodes (if they were removed) are then sent to a doctor called a pathologist. The pathologist examines the tissue under a microscope.
In some cases, a rubber tube called a drain is surgically inserted into your breast area or armpit to collect excess fluid that can accumulate in the space where the tumor was. The drain is connected to a plastic bulb that creates suction to help remove this fluid.
Finally, the surgeon closes the incisions with stitches (sutures) and puts a dressing over them.
After lumpectomy surgery
When the surgery is finished, you are taken to the recovery room, where staff monitor your heart rate, body temperature, blood pressure, and pain level. Usually you’ll be in the recovery room for one to three hours and can go home afterward. You’ll need to have a caregiver take you home.
Staying overnight in the hospital is not usually necessary but may be recommended in some cases — particularly if you had an oncoplastic lumpectomy, which is a more extensive surgery.
Recovering from a lumpectomy at home can take days or weeks, depending on your individual situation.
You and your doctor should receive the results of most of the pathology tests (the tests that are done on the tissue that was removed during the surgery) within about a week after the lumpectomy. This information will appear in your pathology report and will help you and your doctor decide on a treatment plan that's appropriate for you.
Lumpectomy risks and complications
Like all surgeries, lumpectomy carries certain risks:
A seroma is a buildup of fluid in the space where the surgeon removed tissue that typically happens after surgery. In many cases, it will resolve on its own over time. But in some cases, there can be a large buildup of fluid that has to be drained.
There is some risk of infection at the incision site. Infection happens when harmful bacteria, viruses, or other microbes enter a site in the body and reproduce. Signs of an infection after surgery can include fever, increasing pain, and redness or swelling.
There is usually some numbness and loss of sensation in part of the breast after lumpectomy, depending on the size of the removed lump. Some or most of the feeling may return over time.
Lumpectomy can lead to cosmetic changes to the breast that become visible over time as the skin heals. Radiation therapy can also cause changes to the breast skin.
Your breasts may not be the same size and shape as each other after surgery. The affected breast can look smaller after lumpectomy. You may not notice this right away because swelling after surgery might make your breast temporarily appear larger. Radiation therapy also can change the affected breast’s size.
Some people experience burning or shooting pain in the arm, armpit, or chest wall that usually goes away in the weeks or months after a lumpectomy. Sometimes nerve pain may last longer.
If the surgeon removed lymph nodes from your armpit, you may develop lymphedema. This buildup of lymph fluid can cause swelling in the arm, hand, or upper body.
Additional procedures
When you get your pathology results from your doctor, you’ll find out if cancer cells were found in the tissue surrounding the tumor. The rim of normal tissue surrounding the tumor is called the margin. If no cancer cells were found in the margins, then the margins are considered to be negative, clear, or clean. If cancer cells were found in the margins, then they are considered to be positive.
To get clean margins, your surgeon may recommend a second surgery, called re-excision lumpectomy. Some surgeons refer to re-excision as “clearing the margins.” About 20% of people who have lumpectomy require a re-excision lumpectomy because of positive margins.
If there are still positive margins after re-excision, your surgeon may need to do another re-excision or perform a mastectomy.
Your doctor may recommend that you get radiation therapy after a lumpectomy, depending on your individual diagnosis and other factors. Radiation therapy typically begins between 4 and 12 weeks after the lumpectomy. It is given to help reduce the risk of the cancer coming back (recurrence).
If you’re considering a lumpectomy, it’s a good idea to talk to your surgeon about how much tissue needs to be removed and how it might affect your breast’s appearance. In some cases, surgeons can use plastic surgery techniques during the lumpectomy (called oncoplastic lumpectomy) to give your breasts the appearance you want.
Lumpectomy can cause changes to the appearance of the breast, such as visible indentation, a tight scar, or distortions in the nipple’s appearance. These types of changes can depend on the cancer’s size and location, as well as the size of your breast compared to the tumor’s size. Radiation therapy after lumpectomy can also affect the breast’s appearance. Uneven breasts might not become obvious until months after surgery and radiation and can also be affected by weight gain or loss.
Usually oncoplastic surgery is done during the same surgery in which the breast cancer is removed. But in some cases it takes place a couple of weeks or a few months afterwards, or involves a series of procedures.
There are several other options for reconstruction after lumpectomy, including fat grafting and flap (autologous) reconstruction.
Partial breast forms
Some people who have uneven breasts after a traditional lumpectomy may not want to have reconstructive surgery but still want their breasts to look symmetrical in some situations. In these cases, they may opt for a partial breast form (or prosthesis).
Many of the manufacturers who make full breast forms for use after mastectomy also make partial forms, sometimes called partial breast shapers. These are silicone breast forms available in different shapes and sizes that you can attach directly to the skin with adhesive or place inside a post-mastectomy bra with pockets.
A certified mastectomy fitter can give you a better idea about the full range of prosthetic options and ensure you get the best-fitting forms for you. Many cancer centers have in-house boutiques with certified fitters. Some specialized lingerie shops and department stores have certified fitters on staff as well.
Most health insurance plans offer coverage for breast forms and bras after mastectomy and after lumpectomy. Still, it’s a good idea to find out exactly what your plan covers. To be eligible for health insurance coverage, you need a prescription from your doctor for the breast form and bra. Also, there are some nonprofit organizations that offer free breast forms to people who are uninsured or underinsured.
Some women prefer to use lightweight breast forms to add more volume and shape to a smaller breast. These breast forms are typically made of foam, polyurethane, or polyester and can be slipped inside a post-mastectomy bra with pockets. You can find these types of bras at various places, including Athleta, AnaOno, and The Busted Tank. In addition to being lightweight, breast forms are fairly inexpensive, washable, and easy to wear and replace. People who prefer breast forms also say they are especially comfortable to wear when they work out.
Questions to ask your surgeon about lumpectomy
Here are some questions you may want to ask your surgeon as you prepare for lumpectomy surgery:
How many times do you perform lumpectomies in an average month? What percentage of your patients require re-excision?
How should I prepare for lumpectomy surgery?
How big is the tumor relative to my breast size? How much tissue do you need to remove?
What kind of anesthesia can I expect to have?
How long does a lumpectomy take? Will I need to stay overnight in the hospital after surgery?
How do you know whether you have achieved clean margins? Do you use any technology during surgery to help ensure clean margins?
Do you use the shave margins technique (which means shaving another thin layer of tissue from the area around the tumor)?
What are the risks of lumpectomy?
Do you expect to remove any underarm lymph nodes (sentinel or axillary node dissection) along with the tumor?
Are you able to hide the scar and rearrange the tissue to minimize any dents or other cosmetic issues (oncoplastic lumpectomy) after surgery? If not, can you call in a plastic surgeon that you work with? Or would I need to find a plastic surgeon who has experience with oncoplastic surgery and can collaborate with you on my surgery?
What are the risks of lumpectomy?
How do you know whether you have achieved clean margins? Do you use any technology during surgery to help ensure clean margins?
Will I need to have a localization procedure (to mark the location of the tumor) before the surgery? If so, which localization technique will the surgical team use?
How long does it take to recover from lumpectomy? Are there any precautions I should take as I recover?
How should I care for the surgical site and dressings? Will I need a surgical drain afterward? If so, how should I care for it?
How can I expect my breast to look after a lumpectomy? Will my breast’s appearance change over time?
How might radiation therapy affect my breast after a lumpectomy?
Are there exercises I should do after surgery?
When can I return to my normal routine and activities?
What is my risk of developing lymphedema after surgery?
If I am not happy with the appearance of my breasts after a few months have passed, what options do I have?
— Last updated on August 7, 2025 at 4:38 PM
This information made possible in part through the generous support of www.BreastCenter.com.