Lumpectomy: How the Procedure Works, Risks, and More

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  • What Is Lumpectomy?

    What Is Lumpectomy?

    If you’ve been diagnosed with breast cancer recently, you may be offered a choice between a lumpectomy or mastectomy in order to surgically remove the tumor.

    Mastectomy typically removes the breast tissue. It may also remove portions of the skin and maybe the nipple surrounding it. Lumpectomy is a surgery in which only the tumor and some surrounding, healthy tissue is removed. A lumpectomy may provide more aesthetically pleasing results than a mastectomy.

    Learn more about what to expect from these procedures.

  • Breast-Conserving Surgery

    Breast-Conserving Surgery

    You may hear lumpectomy referred to as breast-conserving surgery. The goal of the surgery is to remove all the cancer and leave a clear margin of healthy tissue behind, while preserving as much of the breast as possible.

    The amount of tissue removed in breast-conserving surgery will vary based on the size of the tumor. You could end up with a small scar, or may lose as much as a quarter of the breast. This will require reconstructive plastic surgery.

    Other common terms used to describe this surgery include:

    • wedge resection
    • quadrantectomy
    • partial mastectomy
  • Lumpectomy Candidates

    Lumpectomy Candidates

    Lumpectomy works best on women with large breasts who have small tumors, and in those who are able to receive radiation therapy. Lumpectomy may be offered to women who don’t have complicating factors such as lupus and multicentric disease. Multicentric disease means that cancer is spread across several quadrants (quarters) of the breast. In that case, a mastectomy will be required as the amount of breast tissue removed to get a pleasing result would be too great.

  • Radiation Pairing

    Radiation Pairing

    Lumpectomy is paired with radiation in order to ensure that any stray cancer cells are removed. Radiation is given daily for five to six weeks once the recovery from surgery is complete.

    While a woman’s first impulse may be to remove the breast entirely, studies show that lumpectomy and radiation together are considered as effective as mastectomy. In one study, women with small cancers that were treated with the combination of radiation and lumpectomy were just as likely to be alive in 20 years as women who had mastectomies.

  • Day of Surgery

    Day of Surgery

    On the day of surgery, you’ll change into a hospital gown and an IV will be inserted. If the tumor is too small to be felt, your doctor may first visualize the area with a mammogram or ultrasound. Then they’ll use a surgical marker to write the location of the tumor on your skin. You will be taken into the surgical room and given some medication to relax. Most women don’t need general anesthesia for this surgery.

  • During Surgery

    During Surgery

    During a procedure that takes 15 to 45 minutes, your doctor will use a scalpel to remove the tumor and the margin of tissue around. Sometimes, although not always, a drain is inserted in either the armpit or the breast.

    A drain is a rubber tube ending in a collection bulb. It’s used to prevent fluid build-up in the damaged area where the tumor was. Drains are used until the fluid slows, and will be removed later in a painless procedure.

    Depending on your cancer, a sentinel node biopsy may be necessary, and you may need to have lymph nodes removed. Lumpectomy is typically an outpatient procedure, but if many nodes are taken, an overnight hospital stay might be required.

  • Post-Procedure

    Post-Procedure

    After the procedure, you’ll be transferred to a recovery area and your vitals will be monitored as your medication wears off. At this time, you will be given instructions for post-surgical care, along with any prescriptions you may need. You’ll be shown how to change your bandages, manage the drain (if you have one), and recognize signs of infection. Before you leave, you’ll schedule a follow-up appointment with your doctor and sign paperwork. Then you can go home.

  • Recovery

    Recovery

    Make sure you’ve made arrangements that will allow you to rest after the procedure. Take any pain medications your doctor prescribed. Drink plenty of fluids and get lots of rest. If you have drains, you may need to take sponge baths until they are removed, and follow any instructions you were given about getting the surgical area wet.

    A good, supportive sports bra should be worn day and night until the wound has healed. It’s normal to feel numbness and pain in the surgical area, but this should go away quickly. Sometimes nerves are cut during the procedure, and you may experience itching as they heal.

  • Re-Excision

    Re-Excision

    After your surgery, your tumor and the healthy margin of tissue that has been removed will be sent to pathology for review. It can take about a week to get results back.

    Sometimes cancer cells are found in the margins. In that case, your doctor will need to go back in to remove more tissue and create a larger area to be certain that the cancer cells are removed. This is called re-excision.

  • Risks

    Risks

    The procedure may leave you with a dent in your breasts, or breasts that don’t match in size or shape. Often, this can be fixed with plastic surgery. Most plastic surgeons recommend waiting a year after surgery to have reconstruction, as many initial problems may heal on their own.

    Another risk is loss of sensation. That sensation may come back, or it may become permanent. There is also a risk that the margin may not be clear, and your surgeon will have to do re-excision surgery. In some cases, clear margins can’t be obtained and mastectomy may be necessary.

  • Is It Right for You?

    Is It Right for You?

    Despite these risks, lumpectomy provides an excellent chance at full recovery and survival in early-stage breast cancer while preserving much of the breast. You and your doctor can discuss your unique circumstances and together decide whether breast conserving surgery is the right decision for you.

Thank you!

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