Lumpectomy

What is a lumpectomy?

A lumpectomy is the surgical removal of a cancerous or noncancerous breast tumor. A lumpectomy also includes removing a small amount of normal breast tissue around a cancerous tumor. Other names for lumpectomy include partial mastectomy, breast-conserving surgery, breast-sparing surgery, and wide excision. Doctors most commonly use a lumpectomy to treat small, early-stage breast cancer tumors in women.  

A lumpectomy conserves most of the breast tissue and generally keeps the shape and appearance of the breast. In contrast, a mastectomy is the removal of the entire breast. In a lumpectomy, your surgeon might also remove lymph nodes to test whether cancer has spread. A lumpectomy for breast cancer is accompanied by radiation treatment after surgery. Hormone treatment and/or chemotherapy may also be recommended.  

A lumpectomy is a common but major surgery with significant risks and potential complications. You may have more effective treatment options for your type and stage of breast cancer. You may also have less invasive treatment options for noncancerous tumors. You should consider getting a second opinion about your treatment choices before having a lumpectomy.

Why is a lumpectomy performed?

A lumpectomy is a major surgery that your doctor may recommend to help treat breast cancer or to remove a benign (noncancerous) tumor of the breast (fibroadenoma). Your doctor may only consider a lumpectomy if other treatment options that involve less risk of complications are ineffective. Talk with your doctor about all of your treatment options and consider getting a second opinion.

How is a lumpectomy performed?              

A general surgeon or breast surgeon will lead a surgical team to perform your lumpectomy in a hospital or outpatient surgery clinic. A breast surgeon is a general surgeon who specializes in the treatment of patients with breast disease.

Your surgeon will perform the procedure by making an incision in the breast and removing the lump. If the tumor is cancerous, he or she will also remove some normal breast tissue around the tumor and sample (biopsy) the nearby lymph nodes in your armpit for signs of cancer.

Your doctor will determine which type and method of surgery is best for you and how long you need to stay in the hospital based on certain factors. These include your diagnosis, age, medical history, general health, and possibly your personal preference.

Types of anesthesia that may be used

Your doctor will perform a lumpectomy using a nerve block or general anesthesia:

• General anesthesia is a combination of intravenous (IV) medications and gases that put you in a special type of sleep. During general anesthesia, you are unaware of the procedure and will not feel any pain. In some cases, you may also receive a peripheral nerve block infusion in addition to general anesthesia. This type of anesthesia involves an injection or a continuous drip of a liquid anesthetic, which flows through a tiny tube inserted near your surgical site to control pain during and/or after surgery.
• Nerve block anesthesia is also known as local anesthesia. Surgeons commonly use local anesthesia for a lumpectomy. This involves injecting anesthetic into the skin and tissues around the lump. You also receive sedation to help you relax and stay comfortable.

What to expect the day of your lumpectomy

The day of your surgery, you can expect to:

• Talk with a pre-operative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure that you understand and sign the surgical consent.
• Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member if possible. The surgical team will respect your privacy and give you blankets for modesty and warmth in the surgical suite.
• Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive if you are having general anesthesia.
• A surgical team member will start an IV.
• For general anesthesia, the anesthesiologist or nurse anesthetist will start your anesthesia. Your surgeon may perform local anesthesia.
• During general anesthesia, your anesthesiologist or nurse anesthetist will place a tube in your lungs to protect and control your breathing. You will not feel or remember this or the surgical procedure as they happen.
• The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.