What to Expect During Your Lumpectomy

Surgery for Breast Cancer

Learn what to expect during a lumpectomy, and how to care for yourself during recovery. Be prepared to deal with health insurance, anesthesia, surgical dressings, and drains. Learn some tips for self-care during recovery from your lumpectomy.

Lumpectomy Preserves Your Breast

Nurse comforting patient in hospital bed
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A lumpectomy is one type of breast-conserving surgery and is usually done as an outpatient procedure. Your surgeon will remove just the breast lump and a margin of tissue around the lump. You will keep most of your breast, and you will have a scar at the incision site.

If you're still debating whether to have a lumpectomy, talk to your surgeon. Think about some of the differences between a lumpectomy and a mastectomy and consider what is best for you personally.

This is a very personal decision, and one you need to make based on your own needs and wishes. Keep in mind that no matter which surgery you choose, you will run across people who would choose the other option. Learn to thank people for their input, but firmly let them know that your decision is made and is yours alone.

Your Pre-Operative Appointment

Before your lumpectomy, the hospital or surgical center may ask you to come in for a pre-operative appointment. It's a good idea to take time for this appointment, so you can get most of the paperwork out of the way before surgery, and ask questions that you may have. Bring your insurance card with you and identification such as a driver's license.

Some hospitals require you to make a copayment on the day of surgery. Be prepared to make a payment or ask them what amount will be due on the day of surgery. Give the nurse a list of your current medications, and be prepared to answer questions about your health history. If you are allergic to particular medications, let them know.

You may be asked to sign consent forms for the surgery, and it's important that you read all that's written so you don't encounter any surprises.

Ask about any medications you take routinely. It's usually advised that medications such as aspirin be held beginning a good week before surgery, and drugs such as Advil (ibuprofen) should be avoided as well. It's important to let your doctor know about any dietary supplements you use as well, since some of these can increase bleeding (such as fish oil and vitamin E). You don't want to get to the hospital the day of your surgery and have it rescheduled due to supplements or over-the-counter medications you take.

Questions to Ask Before Surgery

Ask about the symptoms you may experience after surgery, and about any medications that you will be prescribed.

The last thing on your mind is probably the cost, but asking questions about billing, such as will the hospital, surgeon, and anesthesiologist bill you separately, is usually much easier to do in person and ahead of time. Check again to make sure your surgeon and the medical center is covered under your insurance, and that they are first tier providers (unless you have expressly chosen to go out of network). People are often surprised to learn that one of their providers (for example, the anesthesiologist) was not in their network.

Ask practical questions, such as what you should wear on the day of surgery. If you will be having a general anesthetic, hospitals require that you have a driver (it's generally advised not to drive for at least 24 hours after any surgery).

Find out who you should call if you have any problems after surgery. Make sure to write down numbers, so that you are prepared if you need these.

Preparing for a Lumpectomy

You will be required to avoid food and drink for 8 to 12 hours before surgery. Ask ahead of time about any medications you use routinely, and that were not stopped prior to surgery. Surgeons will often allow you to take routine medications (such as thyroid medication) with a small sip of water on the day of surgery. But it's best to ask.

When you arrive for surgery, you will check in and begin preparations. You will change into a hospital gown, and your own clothes will be stored. A nurse will take your vital signs. In some cases, your skin may be marked to indicate where the incision should be started. Your anesthesiologist will meet with you and talk about what anesthetic will be used, and you may be given pills (or a patch) to help prevent nausea. A nurse will start an ​intravenous line (IV) for fluids and anesthesia. The IV needle will be inserted in your hand or arm and taped into place.

Related Procedures Before Lumpectomy

If your surgeon wants to check your lymph nodes during your lumpectomy, you will need to have lymphoscintigraphy in preparation for a sentinel lymph node biopsy. And if your breast lump is too small to be easily felt, a wire localization procedure may be done to help your surgeon locate and remove the lump.

During Your Lumpectomy

Most lumpectomies are done while you are under general anesthesia (asleep). Once the anesthesia is started, your surgeon will make the incision using a special heated scalpel. The heated scalpel cauterizes your tissue and helps prevent bleeding during your surgery. Your incision will be curved, following the natural contour of your breast, to allow it to heal properly.

The breast lump will be removed along with a margin of tissue. The cancerous tissue is then sent to the pathology lab for examination. If needed, a surgical drain will be placed to help remove fluid that collects in your surgical site. Your incision will be closed with stitches or staples, and dressed (bandaged) to keep it clean, and apply pressure to the wound.

Recovery After Your Lumpectomy

While you are still under the effects of anesthesia, you will be moved to the recovery room, where your vital signs will be monitored. Since a lumpectomy is usually done as an outpatient procedure, you will be given instructions on self-care and allowed to return home. If you need special attention after the surgery, or if you've had other procedures done as well, you may be moved to a hospital room for the night.

Rest and Mend at Home

If you have been given pain medication, and feel the need for it, take it as directed. The pain will lessen, and soon you won't need the extra pills. Keep your bandages clean and dry. If required, wear a sports bra over the bandages, to maintain pressure over the incision. Follow your directions in caring for your surgical drain, if you have one. Rest while you are recovering, and plan on having someone do the lifting and driving for you until you feel back to normal. When your surgeon says it's okay, start doing arm exercise to prevent arm and shoulder stiffness. Keep your follow-up appointments.

Re-Excision Ensures Clear Surgical Margins

After your lumpectomy, if the pathology report states that your lump has cancer cells in the margin of tissue around it, your surgeon may need to remove a bit more tissue. This is done to ensure that all of the cancer has been removed, and your risk of recurrence is lowered. This is a separate surgical procedure for removing extra marginal tissue, and it is called re-excision. If the re-excision will make your breast significantly smaller or undesirably shaped, your surgeon may ask if you would prefer a mastectomy, and possibly reconstruction.

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