In a mastectomy, the entire breast is removed, sometimes including nearby lymph nodes or muscle tissue. In contrast, BCS removes only the tumor and a small amount of surrounding tissue, leaving the majority of the breast intact. BCS, followed by radiation therapy, has been shown to provide equivalent survival rates to mastectomy in many cases of early-stage breast cancer.

BCS is performed to remove the cancerous tumor while preserving the breast. This procedure is often preferred by patients who want to avoid the removal of the entire breast, as it offers a better cosmetic outcome and can help maintain the body image and self-esteem of the patient.

BCS may be appropriate for patients with: • Early-stage breast cancer: Typically, stage 1 or 2. • A single tumor: BCS is usually recommended for patients with one tumor or few small tumors confined to one part of the breast. • Tumor size: The tumor size should be small enough (typically less than 5 cm) relative to the size of the breast, so that removing the tumor and surrounding tissue can be done without affecting the cosmetic appearance of the breast. • Clear margins: The tumor should be accessible for removal with clear margins (healthy tissue surrounding the tumor). • No widespread disease: The cancer should not have spread to distant parts of the body.

There are several situations where BCS may not be suitable: 1. Large Tumor Relative to Breast Size: If the tumor is large compared to the size of the breast, a mastectomy may be recommended. 2. Multifocal or Multicentric Disease: When there are multiple tumors spread throughout the breast tissue, BCS may not be feasible. 3. Inability to Achieve Clear Margins: If the tumor cannot be removed with a clear margin of healthy tissue, the risk of cancer recurrence increases. 4. Pregnancy: Some surgeons may recommend delaying surgery until after delivery or suggest alternative treatments. 5. Recurrent Cancer: If the breast cancer has recurred after previous breast conservation surgery, a mastectomy may be needed. 6. Presence of Distant Metastasis: If the cancer has spread to other parts of the body, BCS will not be sufficient as part of a comprehensive treatment plan.

During BCS: • The surgeon removes the tumor along with a small margin of surrounding healthy tissue. • The procedure is typically done under general anesthesia. • Depending on the tumor’s location, the incision can be made in various positions on the breast to ensure the best cosmetic result. • After the surgery, the breast is reconstructed to the best possible shape. In most cases, a sentinel lymph node biopsy (removal of a few lymph nodes) is done to check if cancer has spread to the lymph nodes.

Yes, most patients who undergo BCS will require radiation therapy to reduce the risk of cancer recurrence in the breast. Radiation therapy helps to destroy any cancer cells that may remain after the tumor is removed. The radiation is usually delivered over several weeks.

• Cosmetic outcome: BCS allows you to keep most of your breast tissue, leading to a better cosmetic appearance compared to a mastectomy. • Faster recovery: BCS typically requires a shorter hospital stay and quicker recovery compared to mastectomy. • Similar survival rates: For many patients with early-stage breast cancer, BCS provides survival rates similar to mastectomy when followed by radiation therapy.

As with any surgery, there are risks associated with BCS, including: • Infection at the site of the incision. • Bleeding or hematoma. • Changes in breast appearance: There may be a visible change in the shape or size of the breast. • Pain or tenderness after surgery. • Lymphedema: Swelling in the arm if lymph nodes are removed during the surgery. • Radiation side effects: Skin irritation, fatigue, and possible long-term changes in the breast tissue due to radiation.

Whether you need chemotherapy after BCS depends on several factors, such as: • The type and stage of the cancer. • Whether the cancer is hormone receptor-positive, HER2-positive, or triple-negative. • The presence of cancer cells in nearby lymph nodes. Your oncologist will discuss the need for chemotherapy based on the specific characteristics of your cancer.

Recovery after BCS is generally quicker than mastectomy. Most patients can go home the same day or the following day. You may experience: • Mild pain or discomfort, which can be managed with medications. • Swelling or bruising in the breast or the area where the tumor was removed. • Limitations on activity for a few weeks, especially avoiding heavy lifting or vigorous exercise. • Follow-up appointments to ensure proper healing and to monitor for any signs of recurrence. It is important to attend follow-up appointments for regular checks, including mammograms or ultrasounds to monitor the health of your remaining breast tissue.