Lumpectomy Surgery: One Procedure to Treat Breast Cancer

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What Is a Lumpectomy Breast Surgery?

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Breast Lump Before Surgery. Image: ADAM

What Is a Lumpectomy

A lumpectomy is a surgical procedure to remove a small area of breast tissue that is cancerous or suspected to be cancerous. The lumpectomy procedure is known by several names, including breast conservation surgery, excisional biopsy and partial mastectomy.

Lumpectomy surgery is typically performed by a surgical oncologist, a physician who specializes in the treatment of cancer with surgical interventions. The surgery can be performed on an inpatient or outpatient basis. If general anesthesia is used, the patient typically remains in the hospital overnight. If local anesthesia is used, the patient may go home the same day as the surgery.

This surgery is typically reserved for women who have a single, relatively small area of tissue that must be removed. Women 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 if a large amount of tissue is taken. In addition to the scar or scars left by surgery, there may be a visible change in skin texture over the site. There may also be an obvious lack of tissue in the area, even after the skin heals.

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During Lumpectomy Breast Surgery

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Lumpectomy Surgery. Image: ADAM

Lumpectomy Breast Surgery

After the skin is prepared for the procedure and anesthesia is given, the surgery begins with an incision over the site of the tissue to be removed. Once the skin is opened and the tissue that is to be removed identified, the surgeon will inspect the mass to determine what type of tissue it is made of.

In some cases, the mass may actually be a cyst, a small fluid-filled sac. If it is a cyst, the fluid will be aspirated until the cyst is emptied of fluid. The fluid will be saved for an analysis after the surgery.

In most cases, the lump of tissue is not a cyst and will be removed from the breast. In addition to the suspected cancerous tissue, the area around the mass will also be removed, an area called a margin. All of the tissue is saved for analysis later by a pathologist. The surgeon will also inspect the area to see if any additional structures of the body are affected by the lump, such as the muscle underlying the breast.

After the removal of the tissue, the surgeon will inspect the remaining breast tissue for any signs of cancer that may have spread outside of the lump that was removed. If there is no indication of further problematic tissue, the incision can be closed with sutures and the surgery is finished.

For some patients, the surgeon will also remove lymph nodes or take samples of lymph nodes for testing. This requires a separate incision under the arm. The surgeon may sample several lymph nodes or remove as many as 15 or 20 nodes in their entirety, depending on the patient’s needs. This is done to determine if cancer has spread from the initial mass in the breast, if it is cancerous.

The breast will be covered with a sterile bandage during the procedure, as will the underarm incision if lymph nodes are removed.

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Recovering After Lumpectomy Surgery

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After Lumpectomy. Image: ADAM

After Lumpectomy Surgery

After the surgery is completed and the patient has fully awakened from anesthesia, the recovery from surgery truly begins. If lymph nodes were removed, a drain is placed in the underarm area to remove excess fluid. The drain will be under a sterile bandage, and can be easily removed after surgery when the drainage is minimal.

Dissolvable sutures may be slowly absorbed into the body over time, rather than removed. Standard sutures will be removed by the surgeon during an office visit, usually within two weeks of the surgery.

After a typical lumpectomy, removing a mass less than 5 cm in size, the recovery typically takes three to four weeks. If the procedure requires the removal of more tissue, the recovery can take as long as six weeks.

During the recovery the first two to three days will be the most painful, with the pain easing somewhat each day thereafter. During the recovery phase it is best to avoid any sort of activity that includes a bouncing movement, such as running, and is it essential to take care of your incision.

Lifting is discouraged during the weeks following recovery, as is any activity that requires the arms to be raised over the head, which can put strain on the incision and cause increased pain. A supportive bra, such as an athletic bra, can be worn continuously the first week or two to decrease movement of the breast to prevent pain and support the incision.

If the lump is examined and found to be cancerous, radiation treatments are recommended to treat any cancerous areas that may not have been located during the surgery.

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Sources:

Sources:

Breast Cancer in Men. American Cancer Society http://www.cancer.org/Cancer/BreastCancerinMen/DetailedGuide/index

Breast Cancer Treatment By Stage. American Cancer Society http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Treatment_by_Stage_Breast_Cancer_5.asp?rnav=cri

Breast Reconstruction. Susan G. Komen Foundation http://cms.komen.org/Komen/AboutBreastCancer/Treatment/3-5-8?ssSourceNodeId=99&ssSourceSiteId=Komen

Radiation Therapy & You. National Institutes of Health. http://www.cancer.gov/cancertopics/radiation-therapy-and-you/page2

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