Surgical Procedures: Needle Localization Partial Mastectomy
Also referred to as: Needle localization Lumpectomy; Breast sparing surgery; Breast Conserving Therapy, BCT
What is a Needle Localization Partial Mastectomy?
A surgical procedure where a surgeon removes the breast cancer, using imaging guidance, but does not remove the whole breast. Needle localization is necessary when a breast cancer cannot felt by you or your surgeon.
On the day of surgery, a needle and wire will be placed in the breast to pinpoint the core biopsy clip or the area of cancer cells for the surgeon. This is done by a radiologist, often in the radiology department, who first injects the breast with numbing medicine, then, using imaging guidance (mammogram, ultrasound or MRI), will insert a needle into the breast. A thin, flexible wire is then threaded through the needle into the breast. Once the wire is placed, a mammogram is taken to help the surgeon plan the surgery.
In the operating room, under anesthesia, the cancer is surgically removed along with a small area of normal breast tissue surrounding the cancer. The wire is also removed. The borders (edges) of the tissue removed are referred to as surgical margins and should be clear of cancer. This helps reduce the risk of cancer growing back in the same breast.
Will I Stay Overnight?
No. This is usually done as outpatient or "same day" surgery.
Could I need More Surgery?
If the pathology report says that cancer is seen at or close to the surgical margin (edges of the tissue removed), more surgery may be recommended to obtain "clear margins".
What is Recovery Like?
Your surgeon will discuss specific recovery issues with you. In general, after 2-3 days you should be able to do normal activities except for heavy lifting and exercise which you should avoid doing for about 2-3 weeks. After surgery, you could experience any of the following side effects, which will resolve over time:
- Pain or sensitivity in surgery area
- Breast swelling
- Lump or firmness at the surgical site
Can I Prevent Infections?
Getting an infection after this procedure is not common. You can help prevent an infection by:
- Take a shower the night before surgery and wash your body with soap and water.
- On the second day after surgery make sure to shower or at least clean the incision with soap and water. Pat dry, do not rub the incision. Do this every day, or at least every other day, to keep the incision site clean.
- Do not immerse the incision site in water by soaking in a tub or swimming.
- Always wash your hands before and after touching the incision or changing the dressing.
What Will I need at Home?
- A supportive, preferably non-underwire, cotton bra or sports bra to wear the days and weeks after surgery.
- An ice pack, covered with a thin towel, to be applied intermittently to the surgical area in the first 24-48 hours. This can help minimize bleeding and swelling.
- 4 x 4 gauze pads to place inside your bra for comfort and protection (no need to use any tape). Gauze pads can be found at your supermarket or pharmacy.
- Clean, comfy pillow(s) to put under your arm while sitting or to help with positioning at night.
- You may experience constipation after surgery due to anesthesia and pain medications. Over-the-counter medications, diet, exercise (as simple as walking) and fluids may ease constipation. Ask your health-care team about over-the-counter medications that may work for you.
Care of the Incision(s)
If you have a post-surgical bandage, remove per your surgeon's instructions (often within 48 hours). Once the bandage is removed, you may shower, but do not scrub the incision. To dry, carefully pat the incision with a clean towel. Avoid lotions, powders or deodorant on or near the incision during the first 1-2 weeks until it is fully closed.
Most surgeons use dissolvable sutures so you won't see any sutures and they don't need to be removed. On the outside, some surgeons use surgical glue over the incision to give added protection, others use paper tape called "steri-strips" while some use nothing at all. Both glue and steri-strips can get wet in the shower.
How Can I Help Myself?
Walking is good. Take rest periods throughout the day as needed. Move your arm on the side of surgery as naturally as possible; do not feel as if you have to guard the area.
Deep breathing and relaxation are important to help with pain, keep lungs healthy after anesthesia and promote good drainage of lymphatic fluid. Try to perform deep breathing and relaxation exercises several times a day in the first week, or whenever you notice you are particularly tense.
- A simple exercise to do on your own: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.
- Find more relaxation exercises on OncoLink.
This hand-out provides general information only. Please be sure to discuss the specifics of your surgical plan and recovery with your surgeon.