Home | Procedures | Lumpectomy
By Dr Pratapa Varma Penmetsa
Consultant- Surgical Oncology & Thoracic Surgery
Published on 18 October 2022

Article Context

  1. Overview
  2. Procedure
  3. Benefits and risks
  4. Care at Medicover
  5. Frequently Asked Questions

Overview

Lumpectomy is a wide local excision commonly performed on female breast cancer patients. In this procedure, doctors remove the cancerous tissue in the breast and some of the normal tissue surrounding it. It is sometimes called breast-conserving surgery(BCS).

Breast-conserving surgery is recommended for women with early-stage cancers. The main advantage is that a woman can retain the majority of her breast. However, most women will also require radiation therapy after a lumpectomy, which a radiation oncologist will manage.

Procedure

Before the Procedure

  • The healthcare provider will inquire about your medical history and conduct a physical examination. This is to ensure that you are in good health before the surgery. You may also need blood investigations.
  • You have to avoid eating or drinking 6-8hours before surgery.
  • Notify the doctor if you are pregnant or planning to conceive.
  • Report to your doctor if you have any sensitivities or allergies to medications, latex, tape, or anesthesia.
  • Tell your doctor about all of the drugs you are taking. This includes both OTC and prescription medications.
  • You should stop taking blood thinners like aspirin if you have a history of bleeding disorders at least one week or more before the surgery.

During the Procedure

  • Lumpectomy is wide local excision typically performed as a daycare procedure that takes approximately one hour to complete. The patient is put under general anesthesia before the procedure, meaning they are asleep and feel no pain. The patient may also be given local anesthesia, which means they will be awake but sedated.
  • A surgical oncologist makes an incision in the breast and removes cancer and some of the surrounding healthy breast tissue frozen section, which is sent to a pathologist for further evaluation and testing. The specimen is said to have clear margins if no cancer is detected in the borders of the removed tissue.
  • Complete lymph node dissection in the patient's armpit (axilla) under the same anesthesia to examine the spread of cancer. These tissue samples are also sent to a pathologist for analysis.
  • The surgeon will use metal clips to mark the excised area during a lumpectomy. These clips allow doctors to see the precise location of the lumpectomy on subsequent mammograms and may help in future radiation therapy.
  • The lumpectomy site and the skin are stitched together. A drain tube is usually not needed after a lumpectomy.

After the Procedure

  • The recovery period after a lumpectomy is relatively short, and simple pain medication is usually sufficient for pain.
  • The incision heals within a week after surgery. In the weeks following surgery, it is critical that the patient care for the incision area by changing dressings and watching for signs of infection such as redness, drainage, or swelling.
  • Most patients can return to normal activities within two weeks. Strenuous exercise, heavy lifting, and movements that cause pain at the surgical site should be avoided. Women find it beneficial to wear a comfortable and supportive bra.
  • Breast-conserving surgery is usually followed by radiation therapy and hormone therapy. Outcomes depend on the tumor's nature, how it responds to treatment, and cancer spread to the lymph nodes in the armpit.

Benefits

  • The main advantage of wide local excision is that the complete breast is not removed. Only the cancer portion, lymph nodes and some healthy tissues are removed.
  • The sensation of the breast is retained.
  • Less expensive
  • It is less invasive, so the recovery time is shorter and easier.
  • Better quality of life

Risks

As with any other surgical procedure, bleeding and infection at the surgical site are possible. Other risks of lumpectomy can include:

  • Pain or tenderness in the breast.
  • Swelling of the breast due to collection of fluid(seroma).
  • Hard scar tissue at the surgical site.
  • Alteration in the shape of the breast.
  • Breast numbness following a lumpectomy due to nerve damage.
  • If axillary lymph nodes are also removed, lymphedema may occur.

Care at Medicover

Medicover Hospitals is a renowned hospital offering advanced treatment and care for all types of cancers. The surgical oncologists working at the hospital have the experience of performing rare and critical surgeries. The hospital is equipped with top-notch infrastructure, cutting edge technology and the best cancer specialists to ensure the best treatment outcomes. Affordability clubbed with an open patient centric environment has made us one of the most revered hospitals in the country.

Frequently Asked Questions:

Lumpectomy, wide local excision used as part of a treatment plan for breast cancer. It is called breast conserving surgery. During lumpectomy, only the part of the breast that has cancer is removed. The cancer lump and some breast tissue around the lump are removed.

It is a daycare procedure, and no overnight hospital stay is needed. Most women should be able to function after returning home and can usually resume their regular activities within two weeks.

The bra should be well-fitted and supportive and should be worn during the night for 1 week.

Radiation therapy begins between six and twelve weeks after lumpectomy surgery. The entire breast is targeted and sometimes nearby lymph nodes also.

Usually Stage I and Stage II cancers are treated with either breast-conserving surgery.

A wire guided excision biopsy involves inserting a thin wire into the breast tissue to show a surgeon exactly where to remove tissue. If a mammogram or breast ultrasound shows an abnormal area but they can't feel anything when they examine you, your surgeon may use wire.

Patients who miss radiation therapy have an increased risk of recurrence of disease, even if they eventually complete the course of radiation treatment.

Lymphedema, or arm swelling, is a possible long-term side effect of lymph node surgery. Any excess fluid in the arms normally drains into the bloodstream through the lymphatic system and removing the lymph nodes can sometimes obstruct drainage from the arm causing fluid accumulation.

Mastectomy is the surgical removal of the entire breast. Breast-conserving surgery removes only the cancerous area and a small amount of normal tissue surrounding it. Breast-conserving therapy is the combination of wide local excision and radiation therapy.

The defect created is filled / replaced with oncoplasty technique done during the surgery itself. Scars will result from the surgery and can also cause a dent in the breast. Most women will appear near normal.

References