Lumpectomy vs Mastectomy: Differences Explained

Lumpectomy vs mastectomy: at a glance

How a lumpectomy and a mastectomy compare, using NHS, NICE and WHO information.
Feature	Lumpectomy (breast-conserving surgery)	Mastectomy
What is removed NHS inform (Scotland): Breast cancer in women	The cancer plus some surrounding normal breast tissue	The whole breast
What decides the choice NHS: Treatment for breast cancer in women	How big the cancer is and whether it has spread	How big the cancer is and whether it has spread
Treatment before surgery NHS inform (Scotland): Breast cancer in women	Chemotherapy or hormone therapy first can shrink a larger cancer so this is possible	Treatment first may allow breast-conserving surgery instead
Radiotherapy afterwards NICE NG101: Radiotherapy	Whole-breast radiotherapy offered for invasive cancer with clear margins	Offered if cancer is in the lymph nodes or margins; not when the risk of return is low
If cancer cells reach the edge (margin) NICE NG101: Early and locally advanced breast cancer	Further surgery offered: a wider excision or a mastectomy	Radiotherapy after the mastectomy is offered
How radiotherapy helps World Health Organization: Breast cancer fact sheet	With early-stage cancer, radiotherapy can mean a mastectomy is not needed	With later-stage cancer, radiotherapy can lower the risk of it coming back
Finding cancer early NHS: Why breast screening is done	Makes a mastectomy less likely to be needed	Less likely to be needed when cancer is found early

Each row links to the NHS, NICE or WHO page it comes from. On a small screen, scroll the table sideways.

Key takeaways

Breast-conserving surgery removes the cancer and some normal tissue around it; a mastectomy removes the whole breast. (NHS inform (Scotland): Breast cancer in women)
The NHS says the type of surgery depends on how big the cancer is and whether it has spread. (NHS: Treatment for breast cancer in women)
Radiotherapy is given after breast-conserving surgery and sometimes after a mastectomy, to lower the chance of the cancer coming back. (NHS inform (Scotland): Breast cancer in women)
NICE says breast reconstruction should be offered after a mastectomy, at the same time or later, and that some people prefer not to have it. (NICE NG101: Breast reconstruction)
Finding breast cancer early makes it less likely that a mastectomy will be needed. (NHS: Why breast screening is done)

What happens in breast-conserving surgery?

The WHO calls surgery that removes just the cancerous tissue a lumpectomy. UK hospitals often call it breast-conserving surgery or a wide local excision: an operation to remove the area containing cancer or DCIS with a small amount of surrounding normal tissue, called a margin. One NHS hospital says most people go home the same day.

The tissue is checked in a laboratory. If the margin has no cancer cells, no more surgery is needed. If cancer cells are found at the edge, another operation is needed to remove them. Sometimes the breast looks much the same afterwards; some people notice it is a little smaller or dimpled.

Sources: World Health Organization: Breast cancer fact sheet; University Hospitals Birmingham NHS Foundation Trust: Wide local excision of a breast lump leaflet

What happens in a mastectomy?

A mastectomy removes the breast. It is done under general anaesthetic and usually takes about an hour and a half. Sometimes the lymph glands in the armpit are removed too, and often the skin around the breast and the nipple.

Depending on the operation, people may go home the same day or after 1 or 2 days, or stay a few days if they have reconstruction at the same time. Most usual activities are possible after around 3 weeks, though it can take longer, and wounds take around 6 weeks to heal fully.

Source: NHS: Mastectomy

Is radiotherapy needed after each operation?

NHS inform says radiotherapy is given after breast-conserving surgery and sometimes after a mastectomy. NICE recommends whole-breast radiotherapy for invasive breast cancer after breast-conserving surgery with clear margins. Partial-breast radiotherapy may be considered instead for some women at low risk of the cancer coming back.

After a mastectomy, NICE recommends radiotherapy if the cancer has spread to the lymph nodes or the margins are involved. It is not offered to people at low risk of the cancer coming back, such as most people whose lymph nodes are clear.

Sources: NHS inform (Scotland): Breast cancer in women; NICE NG101: Radiotherapy

Can treatment before surgery change which operation is possible?

Sometimes. NHS inform says chemotherapy or hormone therapy may be given before surgery to shrink a larger cancer, so that breast-conserving surgery can be done instead of a mastectomy. This is called neoadjuvant treatment.

NICE notes good evidence that chemotherapy before surgery lets some women have breast-conserving surgery who would otherwise have had the whole breast removed.

Sources: NHS inform (Scotland): Breast cancer in women; NICE NG101: Hormone receptor positive, HER2-negative breast cancer

What about breast reconstruction?

NICE says breast reconstruction should be offered to people who have had a mastectomy for breast cancer. Both immediate reconstruction (in the same operation) and delayed reconstruction (later) should be offered, and NICE notes that some people prefer not to have reconstruction.

The NHS explains that a new breast can be made using a breast implant, or sometimes skin, fat or muscle from another part of the body.

Sources: NICE NG101: Breast reconstruction; NHS: Mastectomy

Frequently asked questions

Is a lumpectomy the same as breast-conserving surgery?

Yes, they describe the same kind of operation. The NHS describes surgery that removes only the area of the breast with cancer in it, sometimes called breast-conserving surgery; in many countries it is called a lumpectomy. Some UK hospitals also call it a wide local excision.

Source: NHS: Treatment for breast cancer in women

Will I need radiotherapy after a lumpectomy?

Usually. NHS inform says radiotherapy is given after breast-conserving surgery and sometimes after a mastectomy, as one of the treatments used after surgery to reduce the risk of breast cancer coming back. The cancer doctor explains which treatments are recommended after surgery for each person.

Source: NHS inform (Scotland): Breast cancer in women

How long does it take to recover from a mastectomy?

The NHS says it can take several weeks. Many people get back to most of their usual activities in around 3 weeks, though it can take longer, and wounds can take around 6 weeks to heal fully. Heavy lifting and strenuous activities are avoided for 2 to 3 weeks after surgery.

Source: NHS: Mastectomy

Can breast reconstruction be done at the same time as a mastectomy?

Often, yes. NICE says immediate breast reconstruction should be offered to women advised to have a mastectomy, including those who may need radiotherapy, unless other health conditions rule it out. Delayed reconstruction is also an option, and some people choose not to have reconstruction.

Source: NICE NG101: Breast reconstruction

What if cancer cells are found at the edge after a lumpectomy?

NICE says further surgery should be offered after breast-conserving surgery if cancer cells are found right at the edge of the removed tissue (the margin). This can be a second, wider operation, called a re-excision, or a mastectomy, depending on what is appropriate.

Source: NICE NG101: Further surgery after breast-conserving surgery

Are lymph nodes removed during breast cancer surgery?

Often. The WHO says lymph nodes are removed at the time of surgery for invasive breast cancers. A smaller procedure called sentinel node biopsy is now preferred to removing all the lymph nodes under the arm, because it has fewer complications.

Source: World Health Organization: Breast cancer fact sheet

Sources and references

This page is general information, not medical advice. A GP or doctor can advise on your own situation. Source links do not imply endorsement by the NHS or another organisation. See our editorial policy.

Lumpectomy vs mastectomy