A lumpectomy (also called a partial mastectomy) is a breast cancer surgery that removes a tumor plus a normal margin of surrounding healthy breast tissue. Healthcare providers consider lumpectomy to be breast-conserving surgery because it leaves your natural breast intact, compared to a mastectomy, which is removal of the entire breast. Usually, following lumpectomy surgery, radiation to the beast tissue is recommend to help prevent cancer regrowth in the breast.
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Who needs a lumpectomy?
You may be a candidate for a lumpectomy if:
- Cancer only affects one area of your breast.
- A tumor is relatively small compared to your breast size
- Your provider is confident you will have enough remaining tissue to reshape your breast after removing the tumor.
- You are able to complete radiation therapy.
When is lumpectomy not an option?
Your healthcare provider may not recommend a lumpectomy for several reasons. If you have multiple tumors in one breast or have a large cancer, you may not be a candidate for this procedure.
For most people, radiation therapy follows a lumpectomy. If your provider recommends you not receive radiation therapy or you do not want radiation, a lumpectomy may not be right for you. Providers may want you to avoid radiation if you received radiation therapy for previous breast cancer in the same breast or are currently pregnant.
Your provider may also advise against a lumpectomy and radiation if you have:
- A genetic mutation (change) that increases your odds of having breast cancer again.
- Inflammatory breast cancer.
- Lupus or another medical condition that raises your risk of radiation therapy side effects.
Why should I get radiation after surgery?
Most people have radiation treatments after lumpectomy surgery to destroy any remaining microscopic cancer cells. This combination is a standard treatment option for women with breast cancer. . It effectively treats cancer while preserving more of how your breast looks and feels.
Research has shown lumpectomy plus radiation offers long-term survival rates that are similar to those who have a mastectomy (removal of the entire breast).
What should I expect before a lumpectomy?
The details of your case (such as a tumor’s size or location) can affect how your breast looks after surgery. Your surgeon will review your imaging with the radiologist and design a surgical procedure which will focus on removing the entire cancer area.
In some cases, due to the larger size of the tumor, the breast surgeon may enlist the assistance of a plastic/reconstructive surgeon to perform combined team approach surgery called an oncoplastic lumpectomy. In an oncoplastic operation, the cancer is a bit bigger than suitable for a traditional lumpectomy (removing more than 20% of the breast volume), so the planned surgery takes into account the larger piece of breast tissue needing to be removed and allows for better scar placement, reshaping and nipple position. Often oncoplastic surgery requires a surgery on the other, normal breast to reduce the volume as well to match the cancer breast size.
It’s important to talk with your healthcare provider before surgery about how your breast may change. Your provider can tell you what breast surgery options are available.
Your provider will go over procedure details before surgery to help you feel comfortable about your care. Ask your provider to explain anything you don’t understand or are unsure about.
It’s important for your health and safety that you follow all of your provider’s instructions, such as when to stop taking certain medications before surgery.
Can a lumpectomy be done with local anesthesia?
Most people have the lumpectomy surgery performed using general anesthesia (being put to sleep). Occasionally, moderate sedation and local anesthesia (numbing the breast area) can be performed.
How is a lumpectomy done?
Lumpectomy surgery is usually an outpatient surgery (patients go home the same day). The procedure itself usually takes about one hour to complete. Breast cancer is not a cancer the surgeon can see (breast cancer is the same color as the breast tissue) so usually the cancer needs to be marked before surgery to help guide the surgeon. The method to localize the cancer in the breast can be performed with a small chip placement or wire insertion into the breast cancer by the radiologist just prior to surgery. .
During a lumpectomy, your surgeon carefully removes the tumor plus a margin of healthy breast tissue. Surgeons take a thin border of healthy breast tissue around the tumor to leave no cancer cells behind. But providers take care to remove only the tissue needed to treat cancer, to preserve as much of your natural breast as possible. Unfortunately, the surgeon cannot see the cancer and the pathologist cannot accurately evaluate the cancer at the time of surgery, so the pathology results of the surgery (final size of the cancer and whether or not there are clear margins) do take approximately seven to 10 days to determine.
The surgeon will likely then inject medication into the surgical area to help decrease the amount of pain you will experience after surgery. The surgeon will also place small marking clips into the lumpectomy site, to help aid the radiation oncologist know where to focus the radiation. The breast tissue is then sewn back together with dissolvable, internal stitches.
Does a lumpectomy tell my doctor if cancer has spread?
During the procedure, your surgeon may also check or remove lymph nodes to see if cancer has spread beyond the breast.
You may have an injection of blue dye or a small amount of radioactive material around the nipple area. This helps your surgeon know which lymph nodes to remove (sentinel lymph node biopsy). During surgery the surgeon will make a separate, small incision in the armpit area to remove a few lymph nodes for the pathologist to check.
The tissue then goes to a laboratory. Specialized tests identify whether or not cancer has spread into the lymph nodes. . These details help your provider know which treatments are most likely to be effective for you. You may get test results several days after your surgery.
What should I expect after lumpectomy surgery?
After surgery, your care team will monitor your health in a recovery room until they clear you to go home. Your healthcare provider may give you a prescription for pain medication before you leave. This medicine can relieve any discomfort you may feel soon after surgery. However, most patients can manage their pain with acetaminophen (such as Tylenol®) or ibuprofen and ice.
Your provider will tell you how to best recover at home, explaining:
- How to care for the incision site, including how often you should change dressings.
- How much and how often to take pain medication.
- How to do (and when to start) shoulder exercises, which can lessen any stiffness you feel.
- When to call your provider, including the most concerning symptoms you should watch out for.
- When it’s safe to wear a bra, take a shower or get back to normal activities.
What are the potential risks or complications of lumpectomy?
Every surgery has some risk. But lumpectomy is a common procedure that offers a high level of safety and effectiveness. It’s less invasive than mastectomy, a breast cancer surgery that removes the entire breast.
Potential complications of lumpectomy surgery include infection, bruising and swelling (called lymphedema) in your arm or hand closest to the affected breast.
How long does a lumpectomy take to heal?
Everyone heals at their own pace. You may find yourself extra tired right after surgery. Resting for a few days can give your body the time it needs to recuperate. Many people feel fully recovered two weeks after lumpectomy surgery.
When should I call the doctor?
An infection near the incision site can be a serious health risk. You should call your healthcare provider right away if you have any of these symptoms in or near the affected breast:
- Swelling.
- Fluid that builds up in or around the breast.
- Redness.
- Pain that gets worse after surgery.
