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Lumpectomy is the removal of a breast tumor (the “lump”) and some of the normal tissue that surrounds it. Lumpectomy is a form of “breast-conserving” or “breast preservation” surgery. Unlike a mastectomy, which removes the entire breast, a lumpectomy removes only the tumor and a small amount of tissue around it.
Treatment with Lumpectomy
When diagnosed with breast cancer, surgery is most often the first step in treatment. It can be difficult to determine which treatment options are best. Lumpectomy is often preferred for smaller breast tumors. Before choosing lumpectomy as a treatment option, you and your medical team should consider:
● The size, location, and amount of tumor(s)
● The size of your breasts and affected tissue
● Your age and general health
● Your family history
Risks for any surgery are bleeding, infection, and allergic reactions to medicines. The appearance of your breast may change after surgery. You may notice a scar or a difference in size, shape, or texture between your breasts. You also may feel numbness around your incision site. It is possible that another procedure will need to be performed to remove more breast tissue if tests reveal the cancer is still present.
What to Expect
Breast lump removal is usually done as an outpatient surgery. If the breast cancer can be seen on imaging tests but the doctor cannot feel it in a physical examination, a wire localization procedure may be necessary. Your radiologist will inject a local anesthetic to numb your breast before the wire placement . The radiologist will use a mammogram or ultrasound to guide a needle threaded with a small wire. The tip of the needle will be placed near the affected tissue.
Some women feel pressure or a pulling sensation during the procedure. Your radiologist should be notified if you feel any further pain. Following the wire localization, the surgeon will be able to more easily find and remove the cancer.
During surgery, the surgeon makes a small incision in your breast and removes the tumor and some of the normal breast tissue around it. Your surgeon may also remove lymph nodes in your armpit for testing. Sometimes, small metal clips will be placed inside the breast to mark the area of tissue removal. This makes the area visible on mammograms and helps to guide radiation therapy.
The surgeon will close your skin with stitches, which may dissolve or will be removed later.
A pathologist examines a sample of the removed tissue and/or lymph nodes to make sure all the cancer has been taken out. When no cancer cells are found near the edges of the removed tissue, it is called a clear margin. Depending upon these test results, another procedure may need to be scheduled to completely rid the breast of cancer.
Lumpectomy and Radiation
Radiation therapy is usually given after lumpectomy to get rid of any cancer cells that may remain. Chemotherapy, hormone therapy, or targeted therapies are also treatment possibilities. According to the Susan G. Komen Foundation, women who get radiation therapy after lumpectomy have a 50 percent lower risk of breast cancer recurrence and a 20 percent lower risk of breast cancer death compared to women who get lumpectomy alone.
The recovery period can be very short for a simple lumpectomy. Many women have little pain and can take over-the-counter medication for pain relief. You will most likely be able to resume normal activities within 1-2 weeks and the incision area should heal in about a month. Make sure to follow your doctor’s instructions. In general:
- Take care of your incision site. Keep it clean and change your dressings.
- Watch for signs of infection such as redness, swelling, drainage from the incision, or fever.
- Avoid heavy lifting, jogging, or activities that cause pain in the surgical area.
Lumpectomy will change the look and feel of the breast. The location and size of the tumor make a difference in how much the appearance of the breast changes. Because some tissue is removed, the breast may be smaller or firmer. You may have a scar, dent, bulge, or other change of the breast shape near the surgical site. Radiation therapy can also further shrink the breast and change its texture.
Reconstructive surgery is an option for some women who would like to achieve a more natural look or feel. Because each situation is unique, there is no standard approach to reconstruction after lumpectomy, but there are many options. For instance, your affected breast can be filled in with fat tissue from another area of your body (usually belly or buttocks), called lipofilling.
Another option could be inserting a saline or silicone implant. In order to allow your tissues to heal, most plastic surgeons recommend that you wait at least 6 months to 1 year after lumpectomy before having any surgical reconstruction.
Tips for Recovery
Rest. Sleep will help your body heal. You may find it more comfortable to sleep on your back, or on the side that has not been operated on, with your healing breast supported by a pillow in front of you.
Take pain medication as needed. You may want to consider taking pain medication immediately following your surgery, and then on an as needed basis. You will most likely feel a mixture of numbness and pain around the surgery area in the breast.
Wear a good sports or support bra. You’ll want a supportive bra to wear both day and night to minimize any movement that could cause pain.