Types of Surgery: Lumpectomy

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The Abramson Cancer Center of the University of Pennsylvania
Last Modified: January 22, 2002

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About Lumpectomy for Breast Cancer

Rena Rowan Breast CenterThis "Helpful Facts" sheet is designed to give you basic information on lumpectomy for breast cancer. More detailed information can be provided by your doctor or nurse. If you have other questions or would like additional information please talk to your doctor or nurse.

What is a Lumpectomy?
A lumpectomy (also known as a partial mastectomy or breast conserving surgery) is the surgical removal of a breast lump or abnormal area seen on mammogram. This procedure keeps the breast looking much the same as it did prior to surgery. When removing the lump, a small amount of surrounding normal tissue is also removed. This is done to make sure that all of the cancerous tissue has been removed. The tissue is then examined by a pathologist to see if any cancer cells are present in the surrounding normal tissue that was taken out. If there are no cancer cells in the tissue from around the tumor, this is called "clean margins." If cancer cells are found, your surgeon will recommend additional steps, which may include a "re-excision" to remove the additional cancer tissue.

Lumpectomy with Needle Localization for Non-Palpable Lumps
If the lump or abnormal area is not palpable (not able to be felt), you will begin in Radiology on the day of your procedure. The radiologist will use mammography or ultrasound to guide a needle into the area of concern and will then place a wire in your breast to help pinpoint the specific area to be removed. The wire is then covered with a dressing to hold it in place. The average time for this part of the procedure is 30-60 minutes. You are then taken to the operating room where you will receive a local anesthetic to numb your breast, as well as, sedation through a needle in your arm to make you sleep through the procedure. The surgeon uses the wire as a guide to precisely locate the lump. An incision (cut) is made and the abnormal tissue, along with the wire, is removed. When the surgery is complete, a dressing is placed over the incision and you are taken to the post anesthesia care unit (PACU) to recover. In general, you can expect to be in the operating room for 60 to 90 minutes and in the PACU for about 1-2 hours.

What are the Risks of Lumpectomy?
All surgery involves risk. Your surgeon will discuss the risks of the lumpectomy with you. There can be some scarring or change in the shape of the breast, depending on the size and location of the lump. Your surgeon will discuss what you can expect. Other risks and complications associated with breast surgery are listed below:

  • " Wound infection: Infections following surgery can usually be treated with antibiotics.
  • " Swelling Around the Incision: Although very uncommon, an accumulation of blood and/or clear fluid in the wound could occur. This condition might require drainage of the blood or fluid.
  • " Bleeding: Bleeding during or after breast cancer surgery is rare.
  • " Reactions to anesthesia: There are always risks associated with anesthesia such as breathing problems, or a reaction to the medications used for anesthesia. However these risks are extremely low.

How Long Will I Stay in the Hospital?
Most women do not need to stay overnight in the hospital unless an axillary lymph node dissection is performed. An axillary lymph node dissection is the surgical removal of the lymph nodes in the underarm area to determine if breast cancer has spread beyond the breast to the lymph nodes.

How Will I Look and Feel After Lumpectomy?
Post-surgery breast size depends on how much tissue is removed. There will be a scar from the incision. Initially, there may be some swelling and discomfort. You will be given prescription pain medication to take at home if needed.

When Do I Learn the Results of the Lumpectomy?
It takes approximately 5 to 7 working days to get pathology results. The results will be discussed with you at your first post-operative visit.

Will I Need Radiation Therapy After a Lumpectomy?
After a lumpectomy, most women receive six to seven weeks of radiation therapy, in order to eliminate any cancer cells that may remain after surgery.

What is Radiation Therapy?
Radiation therapy is a highly targeted, effective way to destroy cancer cells. Radiation therapy decreases the chance of breast cancer coming back after surgery. Despite what some people may believe, radiation therapy is relatively easy to tolerate. Most side effects are restricted to the area being treated. Side effects of radiation therapy may include:

  • " A reaction around your breast skin that may be similar to a sunburn, with a mild to moderate pink color, or redness, and/or itching, burning, soreness, and peeling.
  • " Fatigue during the final weeks of treatment.
  • " Fullness, swelling, and stiffness of the breast. Once treatment is over, these symptoms will diminish and go away.
  • " Brief shooting pains in the chest area. This is due to swelling and irritation of the tissue. Soon after treatment is over, they will go away.

You will have a more detailed discussion about radiation therapy with the Radiation Oncologist. To find out more about radiation therapy, please request the "Helpful Facts" sheet called About Radiation Therapy for Breast Cancer.

Is Lumpectomy an Effective Cancer Treatment?
A lot of research has been done in recent years to determine if lumpectomy is as effective as mastectomy for treating breast cancer. Evidence shows that lumpectomy followed by radiation is likely to be equally as effective as a mastectomy for someone who has:

  • " One site of cancer in their breast, and
  • " A tumor less than four centimeters, which is removed with "clear margins" (no cancer cells in the tissue immediately surrounding the tumor).

Your surgeon will advise you when a lumpectomy is an option for you to consider, and will help you weigh your options.


News
BCS: MarginProbe Reduces Re-Excision Rate Post-Lumpectomy

Sep 13, 2012 - A novel device that emits an electric field and detects cancerous tissue from its characteristic returning signal, known as MarginProbe, may reduce the rate of re-excision for patients undergoing lumpectomy for breast cancer, without a significant increase in the volume of tissue excised, according to a study presented at the American Society of Clinical Oncology's annual Breast Cancer Symposium, held from Sept. 13 to 15 in San Francisco.



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