Everything You Need to Know About Lumpectomy

If faced with a breast cancer diagnosis, it is important to know that lumpectomy is a viable treatment option. In this procedure, the surgeon removes the part of your breast that contains the tumor. It may be referred to as breast-conserving surgery, wide local excision, partial mastectomy, quadrantectomy, or segmental mastectomy.

During a lumpectomy, a surgeon will carefully remove the tumor as well as some healthy tissue surrounding it (known as a margin) through surgery. The amount of breast tissue removed will depend on several factors, such as the size and location of the tumor, as well as breast size. This can be a hard and emotional time, but healthcare professionals will be there to support and guide you.

A lumpectomy may not be appropriate for all breast cancer patients. It may be more applicable for cases where:

• The tumor is small compared to the breast
• The tumor is in a suitable position of the breast
• Tumor(s) is only in one area of the breast or are in multiple areas in one quadrant that are close enough
• The patient is able to have radiation therapy after lumpectomy

Healthcare providers will guide patients through the various treatment options.

A lumpectomy is commonly done under general anesthesia. The surgeon will make an incision over or near the breast tumor and the tumor as well as the area around it. In some cases, the surgeon might want to hide the scar and place it either in the bra line below or on the side of the breast or around the areola.

If the surgeon needs to remove any lymph nodes, they will make a separate cut in or near the armpit. Once the surgeon removes the tissue, they will send it to a laboratory for a pathologist to examine.

The pathologist will check the margin of the tissue sample for any cancer cells. A negative or clear margin means there are no invasive or non-invasive cancer cells found at the margin. A positive margin means there are cancer cells remaining.

A positive margin means the surgeon needs to remove more tissue in another operation. Sometimes, if cancer cells are still left after a second surgery, the surgeon may need to remove the whole breast with a mastectomy.

Patients undergoing the lumpectomy procedure can expect a safe and efficient experience that typically takes about 1 to 1.5 hours. Most lumpectomy patients are able to return home on the same day. If there are complications after the surgery, you may need to stay in the hospital for one or two more days. Rest assured that you will receive the best possible treatment and support throughout their recovery.

• Bleeding at the surgery site
• Wound infection
• Pain, tenderness, numbness, and/or “tugging” sensation in the breast that may last for a few weeks
• Temporary swelling of the breast
• Change in size and shape of the breast
• Hard scar tissue at the incision site
• Swelling of the breast due to an accumulation of fluid (seroma) that may need to be drained by a health professional

If lymph nodes were removed, other possible complications can happen, depending on the type of surgery, which include:

• Swelling of the arm (lymphedema) may develop a few months or years after surgery
• Bruising or swelling under the arm
• Tingling or mild pain in the arm, armpit, or shoulder
• Restriction of shoulder and arm movement

Most breast cancer patients receive radiation therapy after a lumpectomy to lower the risk of the cancer coming back in the breast. Your healthcare professional may recommend hormone therapy, chemotherapy and other treatments, depending on each case. If chemotherapy is necessary, radiation therapy or hormone therapy will only be administered after the chemotherapy is complete.

Undergoing a lumpectomy can be a difficult experience, as it may lead to changes in the size and shape of your breasts. It is important to keep in mind that reconstructive surgery may be an option to minimize any changes and improve symmetry for the affected and unaffected breasts, respectively. This may involve making adjustments to the affected breast or reducing the size of the unaffected one.

It's a good idea to talk with your doctor about all your options before your lumpectomy, so you can choose what’s best for your needs. You'll have support and expert guidance from healthcare professionals throughout the process. Their reassuring presence will give you the confidence and peace of mind to navigate their journey with ease.