Reconstruction during or after lumpectomy

Lumpectomy surgery removes breast cancer and an area of healthy breast tissue around it, leaving the remaining breast tissue alone. It is sometimes called breast-conserving surgery.

Many people do not need breast reconstruction during or after lumpectomy. But in some cases, lumpectomy can affect the way your breast looks, including:

• Changes in breast size
• Changes in breast shape
• Hard scar tissue or dimples

Surgeons may be able to restore shape and symmetry (evenness of breasts) during or after a lumpectomy.

Types of lumpectomy reconstruction

Surgeons can use different reconstructive techniques at the same time as lumpectomy surgery or months to years later.

Reconstruction during lumpectomy

Surgeons can perform reconstruction procedures during lumpectomy to reduce the risk of issues such as dents or noticeable scarring. This is called oncoplastic lumpectomy.

Oncoplastic lumpectomy combines a cancer-removing lumpectomy with plastic or reconstructive surgery. Techniques may include:

• Making the lumpectomy incision in a location that is not as visible, such as the crease under the breast (inframammary fold)
• Repositioning the breast tissue to fill the gap where cancer was removed
• Performing a breast lift or reduction on one or both breasts to preserve balance

Breast surgeons may use basic oncoplastic techniques during lumpectomy surgery. More complex techniques require a plastic surgeon to work with the breast surgeon during surgery. Talk with your care team about options that may be available to you.

You can learn more about oncoplastic lumpectomy on the Lumpectomy page.

Reconstruction after lumpectomy

Surgeons can also use breast reconstruction techniques after lumpectomy surgery. This is called delayed lumpectomy reconstruction.

Delayed lumpectomy reconstruction procedures include:

• Techniques to address major changes in breast shape or size:
  • Implant placement
  • Reconstruction using tissue from another part of the body, such as the belly or thigh
  • A combination of implant and tissue reconstruction
• Fat grafting (transferring fat from another part of the body to the breast) to add volume or fix indentations resulting from lumpectomy
• Breast lift or reduction on one or both breasts to achieve balance

Timing lumpectomy reconstruction with radiation

Radiation therapy to the breast is usually recommended after lumpectomy.

Radiation side effects can include changes to the breast skin, shape, or size. Plastic surgeons can perform secondary breast reconstruction techniques such as fat grafting to address some changes.

• If your treatment plan includes lumpectomy and radiation therapy, talk with your doctor about whether oncoplastic lumpectomy and/or reconstruction after radiation therapy might be good options for you—and if so, what the best timing might be.
• If you have already had a lumpectomy and radiation therapy and want breast reconstruction, ask your plastic surgeon how long you may need to wait before reconstruction. Radiation therapy requires some time for the breast to heal before having more surgery.

There are no set guidelines about how long you should wait after radiation treatment for all types of breast reconstruction, but for tissue reconstruction techniques, the National Comprehensive Cancer Network (NCCN) recommends at least 6 months to heal first.

To learn more about timing reconstruction with radiation, visit Immediate versus delayed reconstruction.