What to Expect If You Need a Lumpectomy

This approach to treating breast cancer is less invasive than mastectomy.

doctor and patient
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A lumpectomy is a surgical procedure to remove a small area of breast tissue that is cancerous or suspected to be cancerous. It's sometimes referred to as breast conservation surgery or partial mastectomy.

Usually, lumpectomy surgery is reserved for patients who have a single, relatively small area of tissue to be removed. Those with a large mass may need to have significantly more breast tissue removed, which often requires a more aggressive approach, such as a mastectomy.

While a lumpectomy is less disfiguring than a mastectomy and typically does not require reconstructive plastic surgery afterward, a lumpectomy can cause significant changes in the appearance of the breast—especially if a large amount of tissue is taken.

In addition to scars left by surgery, there may be a visible change in the texture of the skin over the site. There also may be an obvious lack of tissue (a shallow dent, for example) in the area, even after the skin heals.

Note that excisional biopsy and lumpectomy are different. Lumpectomy is done when breast cancer has been diagnosed and the purpose of the procedure is to remove the cancerous tissue along with a margin of healthy tissue surrounding it. An excisional biopsy is not a surgical treatment, it is a diagnostic procedure.

A surgical oncologist, or cancer specialist, typically performs lumpectomy surgeries which can be done with local anesthesia on an outpatient basis. If general anesthesia is used a patient will need to stay in the hospital overnight.

What Happens During a Lumpectomy

If you'll be having a lumpectomy, the skin around the area where the lump is will be prepared and you'll be given anesthesia before your surgeon makes an incision. Before he removes the lump, he'll inspect it to make sure it's a tumor and not a cyst (a small fluid-filled sac). If it is a cyst, the fluid will be aspirated until the cyst is emptied of fluid and saved for an analysis after the surgery.

If the lump is a tumor, the surgeon will take it out along with a margin of healthy tissue that surrounds it. The tumor and tissue will be analyzed later by a pathologist. The surgeon will also inspect the area to see if any nearby structures, such as the muscle underlying the breast, have been affected by the lump.

Last, the surgeon will inspect the remaining breast tissue for signs of cancer that may have spread outside of the lump that was removed. He'll then close the incision with sutures and cover the area with a sterile bandage.

If the surgeon suspects cancer may have spread to the lymph nodes, he may make a separate incision under the arm and take a few samples of lymph node tissue or remove as many as 15 or 20 entire nodes. He also may insert a drain in the underarm area to allow excess fluid to flow out. The drain will be kept in place with a sterile dressing and can easily be removed after surgery when the drainage is minimal.

Recovering After Lumpectomy Surgery

The amount of time it takes to recover from a typical lumpectomy depends largely on the size of the mass and amount of tissue that's removed. If the tumor is smaller than 5 cm, you should be fully recovered within three to four weeks. If a larger amount of tissue was excised, recovery can take as long as six weeks.

The first two to three days of recovery from a lumpectomy tend to be the most painful. You'll be advised to not do any sort of activity that involves bouncing movements, such as running, so you don't jar your still-healing incision. Other activities that are discouraged after lumpectomy include lifting objects or raising the arms over the head. To help support the breast that was operated on, it can help to wear a supportive bra continuously (day and night) for the first week or so.

During this time, dissolvable sutures will be slowly absorbed by the body. Standard sutures will be removed by the surgeon at a follow-up visit within a couple of weeks of surgery.

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