Lumpectomy

What Is a Lumpectomy?

A lumpectomy is the surgical removal of a breast tumor, along with some surrounding tissue. It is a standard method for treating early-stage breast cancer, because it retains the shape and appearance of the breast. Lumpectomies are also used to remove non-cancerous or precancerous lumps, and to confirm cancer diagnoses from biopsy. Tumor excision is the primary surgical alternative to a whole-breast removal procedure, known as a mastectomy. Other terms for lumpectomy include partial mastectomy, breast-conserving surgery, and wide local excision.

Lumpectomies have proven effective in the treatment of breast cancer but come with a number of risks. If you or a loved one is concerned about breast cancer and is weighing treatment options, the oncologists and other caring professionals at Baptist Health can help.

Why Have a Lumpectomy? What Are the Benefits?

A lumpectomy is one of two primary options – a mastectomy is the other – for women contemplating surgery for breast cancer. A mastectomy might seem the safer alternative, because removing the entire breast would eliminate any tumors or cancerous cells that were missed during biopsy and diagnosis. Research has shown, however, that 20-year survival rates for mastectomies vs. lumpectomies, when supplemented by radiation therapy, are roughly the same. A lumpectomy has the added advantage of leaving the breast mostly untouched.

Factors that tend to favor lumpectomies over mastectomies include:

• Being diagnosed with an early form of breast cancer (stages 1 or 2)
• Having ductal carcinoma in situ
• Having only a single tumor
• Having a small tumor relative to breast size
• Being a good candidate for radiation or another form of adjuvant therapy.

Women with large tumors are sometimes provided with chemotherapy beforehand, to shrink the tumor prior to the lumpectomy. One or more lymph nodes might also be removed during the procedure. Both the lymph nodes and the tissue adjacent to the tumor will be analyzed by a pathologist following surgery, to look for evidence that the cancer has spread beyond its point of origin.

The benefits of a lumpectomy include:

• The breast remains largely intact
• Surgery has less of a psychological impact
• Faster recovery times than a mastectomy.

There are risks associated with lumpectomies as well. Among the physical effects are swelling, soreness, scarring, infections, numbness, and bleeding. If a large amount of tissue is removed, breast appearance may be somewhat altered.

How Do I Prepare for a Lumpectomy?

To prepare for a lumpectomy you should:

• Stop smoking beforehand, even if just for a few days
• Inform your physician of all current medications. He or she may ask you to stop taking some of them for a short while before the procedure (e.g., blood thinners such as aspirin). 
• Forgo solid food and liquids immediately prior to surgery.
• Prepare for the possibility of an inpatient stay by packing essentials and making arrangements with family or friends for transportation and visitation (if allowed).

What Should I Expect During a Lumpectomy?

Here’s what will happen on the day of the procedure:

• Arrive at the hospital or surgical center as instructed.
• A lumpectomy typically takes 15 to 40 minutes and can be treated as an outpatient procedure. However, if complications arise, be prepared for an inpatient stay.
• You will be prepped for surgery and given a general anesthesia. You will be unconscious while surgery is performed.
• Your surgeon will begin by marking the areas for removal. He or she will use a thin wire or radioactive marker to pinpoint the location of the breast tumor and a blue dye to stain the lymph nodes closest to the tumor. These will be targeted for excision.
• The incisions will be closed with sutures. These will disintegrate on their own or be removed at a later date by your surgeon.
• When you awake, you may find a tube inserted at the point of incision. This allows fluid drainage from the surgical site.

After the procedure, you will be taken to a recovery room, where your vitals will be monitored. You may feel some pain. Members of your medical team will instruct you on how to care for yourself on returning home. You will be provided with prescriptions for any necessary pain medication and antibiotics.

How Do I Recover from a Lumpectomy?

At home you will need to:

• Keep the surgical site dry and clean. You’ll be able to bathe but may need to take precautions to keep the site from getting wet.
• The drainage tube will remain in place for a couple of weeks. You will receive instructions on how to manage it.
• The amount of pain will vary with the quantity and location of tissue removed. Take only doctor-prescribed pain medications; aspirin and other blood-thinning agents can lead to unwanted bleeding.
• Stiffness and swelling of the armpits are common following breast-conserving surgery. You may be prescribed certain exercises to keep your shoulder limber.
• You should be able to resume normal activities within a month.

An important part of your recovery will be the post-surgical visit with your physician. He or she will share the pathology report that was prepared, based on the analysis of the breast and lymphatic tissues removed from your body. You will be able to discuss possible follow-up treatments, including hormone therapy, chemotherapy, or radiation therapy.

Learn More About Lumpectomies at Baptist Health

The oncologists and other medical experts at Baptist Health are part of your frontline defense against this form of cancer. Contact your Baptist Health provider today with questions or to request and appointment.