Breast Conserving Surgery
Breast conserving surgery (BCS) is the most common way in which women presenting with early stage breast cancer will be treated. Approximately 2/3 of patients are suitable for this approach.
Generally speaking, the whole breast will need to be treated; the cancer is removed at operation with a margin of what is expected to be normal breast tissue and the remainder of the breast is then treated with radiotherapy to reduce the risk of recurrence. The aim of BCS is trying to retain the current shape and size of your breast(s) that have the cancer. It is inevitable however that your breast will be made slightly smaller by virtue of the fact that some of it has been removed. Your breast surgeon however will try to do this in a manor that minimises the chance of there being an obvious defect in your breast. The tissue removed is sent for histopathology, ie analysis under a microscope by a pathologist. For most patients (80-85%) having undergone BCS the margins around the cancer, when examined under a microscope, will be sufficiently clear. Now days margins under 1mm are considered adequate. For approximately one in five women however the margins around the cancer will be considered to be either involved or unacceptably close. In this setting following a discussion in the MDT meeting your surgeon will discuss your options with you. Most commonly there will be a choice between undergoing a wide re excision of the close or involved margin(s) or converting to a mastectomy with or without a reconstruction. Sometimes these can be complex decisions and your surgeon will help guide you through your options.