Lump removal (wide local excision / lumpectomy)
An operation to remove a breast cancer or abnormal area along with a margin of healthy tissue, keeping as much of the breast as possible.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It removes the cancer or abnormal area plus a margin of healthy tissue, keeping most of the breast.
- It is usually followed by radiotherapy, and about one in five people need a further operation if the margins are not clear.
- It is often done with a check of the armpit lymph nodes, and recovery is usually a couple of weeks.
- It is part of a wider cancer plan decided by a multidisciplinary team, not a treatment that can promise a cure on its own.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Removes the cancer or abnormal area while keeping most of the breast
The cancer is large relative to the breast, or there is disease in more than one area, where a mastectomy may be more appropriate.
Expect soreness, bruising and swelling. Simple pain relief helps. Wear a soft, supportive bra and start any gentle arm exercises you are given, especially...
A named breast care nurse and clear contact route.
Expect soreness, bruising and swelling. Simple pain relief helps. Wear a soft, supportive bra and start any gentle...
Bruising settles and you gradually return to light activities. Many people are back to non-physical work within a...
You usually get the laboratory results, including the margins and any lymph node findings, and discuss the next...
Scars soften and fade, and arm movement improves with exercises. Any radiotherapy or other treatment is planned...
What is a wide local excision (lumpectomy)?
A wide local excision, often called a lumpectomy, removes a breast cancer or abnormal area along with a border (margin) of normal-looking tissue around it. It is a form of breast-conserving surgery, meaning it keeps as much of your breast as possible.
It is usually offered when the abnormal area is small compared with the size of the breast and is in one place. For most people it is followed by radiotherapy to the rest of the breast, and together this is generally as effective as removing the whole breast (mastectomy) for suitable cancers.
At the same time, the surgeon often checks the lymph nodes in the armpit (a sentinel lymph node biopsy) to see whether any cancer cells have spread there. This helps plan further treatment.
The removed tissue is examined in the laboratory, including the margins. If cancer cells reach the edge, a further operation may be needed to remove more tissue. This guide explains what is involved so you can ask better questions; your treatment is planned by a breast multidisciplinary team.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Lumpectomy compared with mastectomy
| Feature | Lumpectomy (wide local excision) | Mastectomy |
|---|---|---|
| Breast tissue | Keeps most of the breast | Removes the whole breast |
| Radiotherapy | Usually needed afterwards | Sometimes needed |
| Suitability | Smaller cancers in one area | Larger or multiple areas, or by choice |
| Further surgery | Sometimes needed for clear margins | Less likely for margins |
| Effectiveness | Similar survival for suitable cancers | Similar survival for suitable cancers |
For suitable cancers, lumpectomy with radiotherapy and mastectomy give similar survival. The right choice depends on the cancer, breast size, your preferences and your team's advice.
Preparing for your surgery
- You will usually meet the breast team, including a specialist nurse, and have scans and a biopsy to confirm the diagnosis and plan surgery.
- Ask whether a check of the armpit lymph nodes (sentinel node biopsy) is planned and what it involves.
- Tell the team about all your medicines, especially blood thinners, and any other health conditions.
- If the area cannot be felt, a wire or marker may be placed under imaging on the day of surgery.
- Arrange time off and support at home, especially if you are having lymph node surgery as well.
- Get a soft, supportive (non-wired) bra ready to wear afterwards.
- Ask what the plan is if the laboratory finds the margins are not clear.
What happens
Under a general anaesthetic, the surgeon removes the cancer or abnormal area along with a margin of normal tissue around it. If the area cannot be felt, a wire or marker placed beforehand helps guide the surgeon to the right spot.
At the same time, the armpit may be checked. For a sentinel lymph node biopsy, a tracer and sometimes blue dye are used to find the first few nodes that drain the breast, and these are removed and tested.
The surgeon closes the wound, often with dissolvable stitches, and aims to keep a good breast shape. The operation often takes around one to two hours. Many people go home the same day or after one night. The removed tissue and any lymph nodes are sent to the laboratory.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The cancer is large relative to the breast, or there is disease in more than one area, where a mastectomy may be more appropriate.
- You are unable to have the radiotherapy that usually follows breast-conserving surgery.
- Previous radiotherapy to the same breast or certain medical conditions make conservation unsuitable.
- A clear margin is unlikely to be achievable while keeping an acceptable breast shape.
Delay surgery if…
- You have an active infection or are acutely unwell.
- The diagnosis or staging is not complete, or key scans or biopsy results are missing.
- Blood thinners or other medicines have not been safely managed.
- You need more time and information to make an informed choice between conservation and mastectomy.
- Other treatment, such as chemotherapy before surgery, is planned first.
Alternatives to discuss
- Mastectomy, with or without reconstruction.
- Chemotherapy, hormone treatment or targeted therapy before surgery to shrink the cancer.
- Oncoplastic surgery to remove more tissue while keeping a good breast shape.
- In selected situations, treatment other than surgery first, decided by the team.
- A second opinion if you are unsure about your options.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Removes the cancer or abnormal area while keeping most of the breast
- For suitable cancers, gives similar survival to mastectomy when followed by radiotherapy
- Often a shorter operation and recovery than mastectomy
- Allows the lymph nodes to be checked at the same time
- Provides tissue and lymph node information that guides further treatment
Risks & complications
- Bruising, swelling and soreness of the breast
- A collection of fluid (seroma) or blood (haematoma) at the operation site
- A scar, and some change in the shape or size of the breast
- Numbness or altered sensation around the scar
- Wound infection needing antibiotics
- Needing a further operation because the margins are not clear
- A noticeable difference between the two breasts
- Shoulder stiffness or arm symptoms if the armpit was operated on
- A larger collection of blood (haematoma) needing another operation
- Long-term swelling of the arm or breast (lymphoedema), more likely with more lymph node surgery or radiotherapy
- Persistent pain or nerve symptoms
- Cording (a tight band of tissue) in the armpit affecting arm movement
About one in five people need a further operation because cancer cells are found at or near the margin. Lymphoedema is an important long-term risk, especially if many lymph nodes are removed or you also have radiotherapy. Ask your team about your personal risk of needing more surgery, what the plan is for the lymph nodes, and how to reduce and watch for lymphoedema.
Published figures to discuss
How likely you are to need further surgery, and your risk of complications such as lymphoedema, depends on the size and type of cancer, how much tissue is removed, how many lymph nodes are involved and whether you have radiotherapy. Figures vary between units, so they should be discussed in your own context. The need for a further operation to achieve clear margins is a well-recognised possibility rather than a sign that something has gone wrong.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Needing a further operation for clear margins | Around one in five (about 20%) in English data and NHS patient information; lower in some modern units | Disease at the margin can be found that was not visible on scans beforehand; sometimes a mastectomy is then advised. | Margins in breast-conserving therapy (review) — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Lymphoedema of the arm or breast | Often quoted as under about 5% after limited node surgery, higher with more extensive surgery or radiotherapy | Risk rises with the number of nodes removed and with radiotherapy; arm care and early reporting matter. | Margins in breast-conserving therapy (review) — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Change in breast shape, nipple position or symmetry | Common to some degree, higher with larger excisions and radiotherapy | Oncoplastic planning can reduce deformity but cannot guarantee unchanged appearance. | Guide sourcesClinical context |
| Local recurrence after breast-conserving surgery plus radiotherapy | Low in modern treatment, but varies by tumour biology, margins, age and adjuvant therapy | Breast conservation is oncologically safe for many patients, but follow-up and radiotherapy are part of the package. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery from a lumpectomy is usually quicker than from a mastectomy, often a couple of weeks, though it can take longer if you also have lymph node surgery. Waiting for the laboratory results, which guide the next steps, is often the hardest part.
- Soreness, bruising and swelling of the breast that settles over a couple of weeks
- A firm area or fluid collection (seroma) that gradually reabsorbs
- Numbness or tingling around the scar
- Tiredness, both physical and emotional, while waiting for results
- Gradually improving arm movement if the armpit was operated on
Aftercare
- Wear a soft, supportive bra day and night at first if advised, to ease discomfort.
- Take simple pain relief regularly in the first days as needed.
- Do the arm and shoulder exercises you are given, especially before any radiotherapy.
- Keep the wound clean and dry, and watch for redness, swelling or discharge.
- Take care of the arm on the operated side to reduce lymphoedema risk, following your team's advice.
- Attend all follow-up appointments and any onward treatment such as radiotherapy.
- Know who to contact if you have problems or notice warning signs.
- A soft, supportive (non-wired) bra
- Simple pain relief at home
- The arm and shoulder exercise sheet from your team
- Time off work arranged, more if you had lymph node surgery
- Your breast care nurse's contact number
- A note of when you will get results and the date of any follow-up
Scars and how they heal
A wide local excision leaves a scar on the breast, and there may be a separate small scar in the armpit if the lymph nodes were checked. Scars are firm and pink at first and usually fade over months. The breast may be a slightly different shape or size afterwards; oncoplastic techniques aim to keep a good shape.
⚠ Get urgent help if…
- Spreading redness, heat, swelling or discharge from the wound (signs of infection)
- A fever or feeling generally unwell
- A rapidly enlarging, painful, firm swelling at the operation site
- Increasing pain not helped by simple pain relief
- A swollen, painful or stiff arm on the operated side
- A hot, red or swollen calf, or breathlessness
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the cancer or abnormal area is removed with a clear margin, a reasonable breast shape is kept, and the lymph node findings help plan further treatment. The laboratory results usually take about a week or two, and your team will explain what they mean.
Surgery is one part of treatment, usually followed by radiotherapy and sometimes other treatments. It cannot on its own promise that cancer will never come back. Whether cancer is controlled long term depends on the type and stage of the cancer, the margins, the lymph nodes and the further treatment you have, all of which your team will discuss.
For suitable cancers, breast-conserving surgery with radiotherapy gives similar long-term survival to mastectomy. The breast continues to age and change naturally, and you will usually have ongoing surveillance, such as mammograms, to watch for any return of cancer or new problems over time.
Combining with other procedures
A lumpectomy is usually combined with radiotherapy to the rest of the breast, and is often done with a check of the armpit lymph nodes. Depending on the cancer, it may also be combined with chemotherapy, hormone treatment or targeted therapy, before or after surgery. Your multidisciplinary team should explain how these fit together for you.
Follow-up & long-term care
You will be seen to discuss the laboratory results, including the margins and lymph nodes, and to plan further treatment such as radiotherapy. Longer-term follow-up usually includes surveillance mammograms and a clear point of contact. You should be told how to get help if you have problems or notice changes.
- Surveillance mammograms as advised by your team
- Ongoing treatment such as hormone therapy where part of the plan
- Arm care and watching for lymphoedema if lymph nodes were removed
- Breast awareness and reporting any new changes promptly
Revision and secondary surgery reality
- About one in five people need a further operation to achieve a clear margin.
- Occasionally a mastectomy is recommended after a lumpectomy if clear margins cannot be achieved.
- A seroma may need draining one or more times.
- The cancer can return in the breast or elsewhere, so surveillance continues.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- A named breast care nurse and clear contact route.
- A clear process and timeline for results, margins and node findings.
- Arm and shoulder exercises and lymphoedema advice where the armpit is operated on.
- A coordinated plan for radiotherapy and any other treatment.
- Long-term surveillance such as mammograms and clear advice on what changes to report.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether lymph node surgery (sentinel node biopsy) is done at the same time
- Whether oncoplastic reshaping or surgery to the other breast is involved
- Surgeon and anaesthetic team fees and the facility fee
- Imaging, wire or marker localisation and laboratory examination of the tissue and nodes
- Length of stay (day case or overnight)
- Follow-up appointments and onward treatment such as radiotherapy
- Management of complications or a further operation if margins are not clear
- The surgeon's and anaesthetist's fees and the facility fee
- Imaging, localisation and pathology fees
- Whether lymph node surgery is included
- Follow-up appointments and how results are given
- What happens, and any extra cost, if a further operation is needed for clear margins
- How onward treatment such as radiotherapy is arranged and funded
On the NHS? Breast-conserving surgery is standard NHS treatment for suitable breast cancers when clinically indicated; private care is also available, with the same multidisciplinary planning.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that a further operation may be needed if the margins are not clear.
- Not making clear that radiotherapy usually follows breast-conserving surgery.
- Not discussing the risk of lymphoedema when the armpit is operated on.
- Implying surgery alone removes all risk of the cancer returning.
- Not offering mastectomy as an alternative or supporting an informed choice between options.
Marketing red flags
- Any promise of a cure or that the cancer will definitely not come back.
- Downplaying the likelihood of needing further surgery for clear margins.
- Glossing over radiotherapy and the wider treatment plan.
- Surgery offered without a multidisciplinary team assessment.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Is breast-conserving surgery suitable for my cancer, or would a mastectomy be better for me?
- How likely am I to need a further operation to get clear margins?
- What will happen to the shape and size of my breast, and could oncoplastic surgery help?
- Are my lymph nodes being checked, and what does that mean for my treatment and arm?
- What further treatment, such as radiotherapy, am I likely to need afterwards?
- How will I be followed up, and how do I reduce and watch for lymphoedema?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will I need radiotherapy after a lumpectomy?
What happens if the margins are not clear?
Is a lumpectomy as good as removing the whole breast?
Will my breast look different?
Why are my lymph nodes checked?
Can I have this done privately?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Cancer Research UK — Breast-conserving surgery (lumpectomy) Association of Breast Surgery — patient information Margins in breast-conserving therapy (review) — PMC Reoperation rates after breast-conserving surgery for breast cancer in England — BMJ/PMC NICE NG101 — early and locally advanced breast cancer: diagnosis and management (2018)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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