Breast conserving surgery, also known as lumpectomy or partial mastectomy, is a surgical procedure that aims to remove cancerous tissue while preserving as much healthy breast tissue as possible.
Breast conserving surgery is often considered a preferable alternative to mastectomy, where the entire breast is removed. It enables women to maintain their breast’s appearance and sensation while effectively treating breast cancer. Studies have shown that breast conserving surgery combined with radiation therapy can have similar survival rates to mastectomy, making it an attractive option for those who qualify.
Suitable candidates for this procedure typically have early-stage breast cancer, with a tumour size that allows for effective removal while retaining a cosmetically acceptable breast shape. Other factors, such as the location of the tumour and the patient’s overall health, also play a crucial role in determining eligibility.
There are two primary types of breast conserving surgery: lumpectomy and segmental mastectomy.
Also known as breast-sparing surgery or wide local excision, is the least invasive form of breast conserving surgery. During this procedure, the surgeon removes the cancerous tumour along with a small margin (about 1-2 millimetres) of surrounding healthy tissue. This margin serves as a safety buffer to ensure that all cancer cells are removed. The goal of a lumpectomy is to excise the tumour while maintaining the breast’s natural shape and size as much as possible. A lumpectomy is often followed by radiation therapy to eradicate any remaining cancer cells and reduce the risk of recurrence.
Or quadrantectomy, is a more extensive form of breast conserving surgery. In this procedure, the surgeon removes the cancerous tumour along with a larger portion of the breast tissue, typically about one-quarter to one-third of the entire breast. This approach may be necessary if the tumour is relatively large in comparison to the breast size or if it is located in an area where a lumpectomy would be difficult to perform without compromising the breast’s appearance. As with lumpectomy, segmental mastectomy is usually followed by radiation therapy to minimize the risk of cancer recurrence.
Preparation for breast conserving surgery includes preoperative consultations, imaging studies, and lab tests. Patients may be advised to stop taking certain medications and supplements before surgery. It’s essential to discuss any concerns and expectations with your surgeon to ensure a smooth surgical experience.
As with any surgery, breast conserving surgery carries some risks, including infection, bleeding, and anesthesia complications. Additionally, there’s a possibility of positive margins, meaning that cancerous cells are found at the edge of the removed tissue, necessitating further treatment. It’s vital to discuss these risks with your surgeon before proceeding.
Breast conserving surgery is typically performed under general anaesthesia and takes about 1-2 hours. Patients can expect some postoperative discomfort, swelling, and temporary changes in sensation. Most women can return to their regular activities within a few weeks.
The cost of breast conserving surgery in Singapore varies depending on the hospital, surgeon’s fees, and other associated costs. On average, the price ranges from SGD 10,000 to SGD 25,000. It’s important to consult with your healthcare provider for an accurate estimate.
Dr Jesse specialises in managing both benign and malignant breast and thyroid conditions, which also includes breast pain, breast lumps, breastfeeding problems, neck lumps, amongst others.
Her dual expertise in cancer removal and plastic surgery techniques expands the design of individualized treatments, leading to holistic patient outcomes.
Dr Jesse was part of the teaching faculties of both NUS Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine, where she teaches and mentors the next generation of medical students and trainee doctors.
Dr Jesse is recognized as an authority in breast cancer and thyroid surgery and a sought-after conference speaker.
Dr Felicia is actively involved in promoting breast cancer awareness. She has also been invited to give lectures and public talks on breast cancer related issues both locally and internationally.
Her clinical interest lies in treatment of breast cancer and the use of various surgical techniques to achieve the best oncologic and cosmetic outcome for her patients.
She is the pioneer of the procedure radioisotope occult lesion localisation (ROLL) in Singapore – which is used for locating non-palpable breast lesions and micro-calcifications for surgical excision.
She is also adept with the whole range of breast surgical procedures including vacuum assisted biopsies and endoscopic (key-hole) breast surgery for breast lesions.
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Breastfeeding after breast conserving surgery may be possible, depending on the extent of the surgery and the involvement of the milk ducts. It is important to discuss this with your surgeon before the procedure.
The risk of local recurrence after breast conserving surgery varies, but studies have shown that it is generally low, with a 10-year recurrence rate of approximately 10-15%.
Neoadjuvant chemotherapy may be used to shrink larger tumours, making breast conserving surgery a viable option.
Research has shown that breast conserving surgery combined with radiation therapy can yield similar survival rates as mastectomy for early-stage breast cancer patients.
Most women undergoing breast conserving surgery require radiation therapy to reduce the risk of cancer recurrence.
Radiation therapy typically begins 4-6 weeks after breast conserving surgery, allowing time for the surgical site to heal properly.
