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.
Your surgeon might also remove lymph nodes to test whether cancer has spread. 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.
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A lumpectomy for breast cancer is combined with radiation treatment. 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. Consider getting a second opinion about your treatment choices before having a lumpectomy.
Why is a lumpectomy performed?
Your doctor may recommend a lumpectomy to 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 have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a lumpectomy.
Who performs a lumpectomy?
A general surgeon performs a lumpectomy. A general surgeon specializes in the surgical treatment of a wide variety of diseases, disorders and conditions. Some general surgeons specialize in the treatment of patients with breast disease; they may use the term breast surgeon.
How is a lumpectomy performed?
Your lumpectomy will be performed in a hospital. Your surgeon will make an incision in the breast and remove the lump. If the tumor is cancerous, your surgeon 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 surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different lumpectomy procedures and ask why your surgeon will use a particular type for you.
Types of anesthesia that may be used
Your doctor will perform a lumpectomy using either general anesthesia or regional anesthesia. :
General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain. You may also have a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. To numb a smaller area, your doctor injects the anesthetic in the skin and tissues around the procedure area (local anesthesia). You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
What to expect the day of your lumpectomy
The day of your surgery, you can expect to:
Talk with a preoperative 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 you understand and sign the surgical consent form.
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. Your care team will give you blankets for modesty and warmth.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have.
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.
A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery 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.
What are the risks and potential complications of a lumpectomy?
As with all surgeries, a lumpectomy involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Bleeding, which can lead to shock
Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
Infection and septicemia, which is the spread of a local infection to the blood
Potential complications of a lumpectomy
Complications of a lumpectomy are uncommon but include:
Damage to nearby organs, such as the lymph nodes and lungs
Differences in breast sizes after a lump is removed
Numbness of the affected breast that may or may not go away
Opening or infection of the external incision
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This includes physical therapy, occupational therapy, and other rehabilitation treatments.
Informing your doctor if you are nursing or there is any possibility of pregnancy
Notifying your doctor right away of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my lumpectomy?
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.
You can prepare for a lumpectomy by:
Answering all questions about your medical history and medications you take. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a mammogram, breast lump biopsy, chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
Losing excess weight before the surgery through a healthy diet and exercise plan
Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments.
It is also a good idea to bring a list of questions to your appointments. Questions can include:
Why do I need a lumpectomy? Are there any other options for treating my condition?
How much of my breast will be removed? What will my breast look like after surgery?
How long will the procedure take? When can I go home?
What restrictions will I have after the surgery? When can I return to work and other activities?
What assistance will I need at home?
Will I need physical therapy or rehabilitation?
How do I take my medications?
How will you treat my pain?
When and how will I receive the results of my lymph node biopsy test?
What other treatment will I need?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my lumpectomy?
Knowing what to expect can help make your road to recovery after lumpectomy as smooth as possible.
How long will it take to recover?
Most lumpectomies are outpatient procedures in which you go home the day of surgery. In some cases, a brief hospital stay is required.
You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.
You might have a small tube in your chest at your surgery site. This will be attached to small bags into which fluid can drain. Your doctor will remove the tube within a week or so. During this time, you will need to empty the drain several times a day. Your care team will show you how to do this before you go home.
Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, age, and other factors. Full recovery takes up to a month.
Will I feel pain?
Pain control is an important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.
When should I call my doctor?
It is important to keep your follow-up appointments after. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
Change in level of alertness, such as passing out, unresponsiveness, or confusion
Chest pain, chest tightness, chest pressure, or palpitations
Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery. It is not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.
Inability to urinate, pass gas, or have a bowel movement
Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
Nausea and vomiting or diarrhea
Pain that is not controlled by your pain medication, worsening pain, or pain that changes
Unexpected drainage, pus, redness or swelling of your incision or drain tube
How might lumpectomy affect my everyday life?
A lumpectomy can help cure your noncancerous breast tumor or early stage breast cancer. The treated breast sometimes varies in size or shape from the other breast. It will take some time to adjust to the new appearance of your breast.
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- Breast Lump. Better Medicine. http://www.bettermedicine.com/article/breast-lump
- Lumpectomy. Breastcancer.org. http://www.breastcancer.org/treatment/surgery/lumpectomy/
- Lumpectomy. Susan G. Komen for the Cure. http://ww5.komen.org/BreastCancer/Lumpectomy.html