Why it matters
Preserving the natural breast may support body image, confidence and quality of life for suitable patients, while keeping cancer treatment priorities central.
01Breast conservation
Treat the cancer. Preserve the breast where appropriate.
Breast conservation is an approach to breast cancer surgery that aims to remove cancer safely while preserving the natural breast wherever appropriate. For many women, this can reduce the physical and emotional impact of treatment, support body image and improve confidence during survivorship.
More than lumpectomy
A coordinated approach to cancer control and quality of life.
Modern breast conservation includes careful imaging, surgical planning, margin assessment, oncoplastic reshaping, partial breast reconstruction, radiotherapy coordination and shared decision-making. The goal is to combine cancer control with quality of life.
Breast Conservation Pathway
A coordinated journey from diagnosis to quality of life.
The sequence and treatments vary between patients. This pathway shows how different decisions and disciplines may connect.
- 01
Diagnosis
Confirm the type and features of the cancer through clinical assessment and tissue testing.
- 02
Imaging
Use mammography, ultrasound and selected additional imaging to understand the extent of disease.
- 03
Surgical planning
Bring cancer findings, breast anatomy, treatment needs and personal priorities together.
- 04
Breast-conserving surgery
Remove the cancer with a surrounding margin while preserving the breast where appropriate.
- 05
Oncoplastic reshaping
Reshape remaining tissue or consider partial reconstruction when these techniques may help.
- 06
Adjuvant treatment
Coordinate radiotherapy and other treatments recommended for the individual cancer.
- 07
Recovery & quality of life
Follow recovery, function, body image, wellbeing and patient-reported outcomes over time.
Evidence-based medicine
Is breast conservation as safe as mastectomy?
For many women with early breast cancer, breast-conserving surgery followed by radiotherapy is an established treatment option with long-term survival outcomes comparable to mastectomy. The goal is not simply to perform a smaller operation, but to remove the cancer safely while preserving the breast where appropriate.
Landmark randomised studies have shown that appropriately selected patients treated with breast-conserving surgery can achieve survival outcomes similar to those treated with mastectomy. Radiotherapy after breast-conserving surgery is an important part of this treatment pathway because it reduces the risk of cancer returning in the breast and can reduce breast cancer mortality.
More recent population-based studies and meta-analyses have reported similar, and in some settings better, survival after breast-conserving therapy compared with mastectomy. These findings are encouraging, but they should be interpreted carefully because treatment choice is influenced by tumour biology, disease extent, patient health, radiotherapy, systemic treatment, patient preference and selection bias.
Breast conservation is therefore best understood as a personalised treatment approach. It may help suitable patients preserve body image, confidence and quality of life, but mastectomy remains appropriate or necessary for some patients.
Evidence Snapshot
What the evidence supports
- Comparable long-term survival for many suitable early breast cancer patients
- Reduced local recurrence and breast cancer mortality when indicated radiotherapy follows surgery
- Potential benefits for body image, psychosocial well-being and quality of life
What the evidence does not mean
- Breast conservation is not suitable for every cancer or every patient
- It does not guarantee better survival or a particular cosmetic outcome
- Population studies cannot replace individual clinical assessment or remove selection bias
Who may be suitable
Suitability depends on the cancer’s size and location, breast anatomy, the ability to obtain clear margins, other treatments required, health and personal preferences.
A shared decision
Patients should understand breast conservation, mastectomy and reconstruction options, including their possible benefits, limitations, risks and recovery considerations.
Clinical focus
Clinical work centred on safe and considered breast conservation.
Dr Chia’s clinical work is centred on helping suitable women achieve safe, precise and aesthetically considered breast-conserving treatment. This includes breast-conserving surgery, oncoplastic techniques, partial breast reconstruction, minimally invasive approaches, localisation strategies for non-palpable lesions, and multidisciplinary decision-making.
The emphasis is on tailoring treatment to the patient’s cancer, breast anatomy, personal priorities and overall health — while preserving oncological safety, surgical precision, quality of life and confidence after treatment.
Breast-conserving cancer surgery
Surgical care focused on safe tumour removal, margin strategy, localisation of non-palpable lesions, and appropriate tissue preservation.
Oncoplastic and reconstructive planning
Use of oncoplastic principles, partial breast reconstruction and symmetrisation strategies to support breast preservation and aesthetic outcomes in suitable patients.
Personalised multidisciplinary care
Treatment decisions made in the context of imaging, pathology, oncology, patient priorities, age, fitness, recovery goals and survivorship needs.
General education
What influences whether breast conservation may be suitable?
These factors are considered together. This information is educational and cannot determine what is appropriate for an individual patient.
The size of the cancer is considered in relation to the amount and shape of breast tissue. A larger area may require more complex planning or make another operation more appropriate.
The position of the cancer can influence how much tissue must be removed and how the remaining breast can be reshaped.
Mammography, ultrasound and sometimes MRI help the clinical team understand the extent of disease and whether there are additional areas requiring assessment.
Breast volume, shape and natural differences between the breasts affect surgical planning and the oncoplastic techniques that may be considered.
The aim is to remove the cancer with a rim of healthy tissue. If cancer cells are found at or close to an edge, further surgery may sometimes be advised.
Breast-conserving treatment usually includes radiotherapy. Suitability depends partly on whether radiotherapy is medically appropriate and acceptable to the patient.
An inherited cancer predisposition or a high future risk may affect the discussion about breast conservation, mastectomy and risk-reducing options.
General health, other medical conditions, recovery considerations and the wider cancer treatment plan all contribute to a recommendation.
Values regarding breast preservation, reconstruction, recovery, radiotherapy, uncertainty and future risk matter. Shared decision-making brings these priorities into the clinical discussion.
The role of oncoplastic surgery
Oncoplastic breast surgery combines cancer surgery with reconstructive principles.
Remove the tumour. Reshape the breast. Reduce avoidable deformity.
This approach allows the surgeon to remove the tumour with appropriate margins while reshaping the remaining breast tissue. In selected patients, oncoplastic techniques may allow breast conservation even when a larger volume of tissue needs to be removed. Partial breast reconstruction is tailored to the location and extent of surgery and does not guarantee a particular cosmetic result.
Concepts at a glance
A visual guide to the ideas behind breast conservation.
These simplified diagrams explain concepts only. They do not represent an individual operation, anatomy or expected cosmetic result.
Breast conservation
Remove the area of cancer while preserving the remaining breast where oncologically appropriate.
Margin assessment
Examine the edges around removed tissue to help guide whether further treatment is needed.
Oncoplastic reshaping
Bring remaining breast tissue together using reconstructive principles after tumour removal.
Partial breast reconstruction
Restore a local surgical defect with an approach selected for the individual anatomy and operation.
Shared decision-making
Bring clinical evidence, medically appropriate options and patient priorities into one conversation.
Innovation platform
Improving the breast conservation pathway.
01
REBORN digital education for clearer treatment decisions
02
Intra-operative margin assessment to address avoidable re-operation
03
Low-thermal electrosurgical devices for tissue-conscious surgery
04
Patient-reported outcome measures for recovery and quality of life
05
Responsible clinical evaluation and medtech translation
Dr Chia’s innovation work is focused on improving the breast conservation pathway — from clearer treatment decisions before surgery, to more precise surgery in the operating theatre, and better recovery after treatment. These projects are developed through careful clinical evaluation, with the aim of supporting safer, more personalised and patient-centred breast cancer care.
Academic & industry collaboration
A translational platform spanning clinical care, engineering, evidence and implementation.
Better margins. Better measurement. Better-informed care.
Technologies that improve margin assessment, surgical precision, tissue preservation, wound healing, cosmesis, patient education and outcome measurement can influence the quality of breast cancer surgery. Clement works with clinical, academic, engineering and industry partners to identify unmet needs, validate solutions in real-world pathways and translate promising technologies into patient-centred care.
Patient FAQ
Questions worth asking.
Answers provide a starting point for discussion with a breast cancer care team and are not personal medical advice.
It removes the cancer with a surrounding margin while preserving the rest of the breast. It is generally combined with radiotherapy and is suitable for some, but not all, patients.
It combines cancer surgery with reconstructive principles so that the remaining breast tissue can be reshaped after the cancer is removed.
Margins are the edges of the tissue removed during surgery. A pathologist examines them to assess whether cancer cells extend to or near an edge.
If the final pathology shows cancer at or close to a margin, another operation may sometimes be recommended to remove additional tissue. The decision depends on the findings and clinical context.
Radiotherapy is usually part of breast-conserving treatment, but the exact recommendation depends on the cancer, prior treatment and individual health considerations.
Mastectomy may be considered when breast conservation cannot safely remove the disease, radiotherapy is unsuitable, cancer risk is high, or after a patient weighs the available options and preferences.
Reconstruction may involve reshaping remaining breast tissue, partial breast reconstruction or reconstruction after mastectomy. The suitable approaches vary between patients.
REBORN is a digital patient-education innovation developed to help explain oncoplastic reconstruction and support clearer conversations about surgical choices. It does not replace consultation with the clinical team.
It means combining clinical evidence and professional recommendations with the patient’s goals, concerns and preferences, after discussing reasonable options and trade-offs.
Selected references
A short reading list spanning randomized evidence, radiotherapy, modern population studies and quality of life.
- 1Veronesi U, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. New England Journal of Medicine. 2002.
- 2Early Breast Cancer Trialists’ Collaborative Group. Effect of radiotherapy after breast-conserving surgery on recurrence and breast cancer mortality. Lancet. 2011.
- 3de Boniface J, et al. Survival after breast conservation vs mastectomy adjusted for comorbidity and socioeconomic status. JAMA Surgery. 2021.
- 4Rajan KK, et al. Overall survival after mastectomy versus breast-conserving surgery with radiotherapy in early-stage breast cancer. British Journal of Surgery. 2024.
- 5Hanson SE, et al. Long-term quality of life after breast conservation vs mastectomy and reconstruction. JAMA Surgery. 2022.
Second opinion
Second opinion for breast conservation.
For some women, the choice between mastectomy and breast-conserving surgery may not be straightforward. Tumour size, tumour location, breast size, imaging findings, margins, genetic risk, previous treatment, overall health and personal priorities can all influence what is safely possible.
Patients who have been advised to consider mastectomy, or who are uncertain whether breast conservation is feasible, may seek a focused second opinion to better understand their options. The aim is not to recommend breast conservation for everyone, but to carefully assess whether breast-preserving treatment may be oncologically safe, technically achievable and aligned with the patient’s goals.
Where appropriate, this discussion may include oncoplastic techniques, localisation strategies for non-palpable lesions, approaches to margin planning, reconstruction options, and the role of multidisciplinary treatment.
Breast conservation opinion
Considering a second opinion on breast conservation?
If you have been advised to undergo mastectomy or are uncertain whether breast-conserving surgery is possible, you may enquire about a consultation to review your options. Please bring your imaging reports, biopsy results, pathology reports and treatment recommendations where available.
“Breast conservation through surgery, education and innovation.”