Lumpectomy
Lumpectomy is a form of breast-conserving surgery to remove cancer or other abnormal tissue from the breast. You may also hear it called an excisional biopsy, wide excision, or a partial mastectomy.
A lumpectomy is technically a partial mastectomy because a part of the breast tissue is removed. Unlike a mastectomy however, a lumpectomy removes only the tissue of concern and a small rim of normal tissue around it. The amount of tissue removed and the appearance of the breast after lumpectomy can vary depending upon each individual situation, but the breast usually looks as close as possible to how it did before surgery. Most often, the general shape of the breast and nipple area are kept although the breast may feel smaller and firmer.
Indications:
- Lumpectomy may be recommended to remove certain noncancerous or precancerous breast abnormalities.
- Once you have noticed or discovered a lump in your breast, a lumpectomy can help confirm the diagnosis of cancer or rule it out.
- A lumpectomy may be recommended if a biopsy has shown that you have cancer and that the cancer is believed to be small.
Pre-Operative Evaluation:
Before you are scheduled for any breast cancer surgery, you should expect a detailed consultation with the surgeon discussing all of your surgical options and how surgery will be coordinated with other treatments such as chemotherapy and radiation if recommended. There are many factors that help to determine the timing and sequence of your treatment plan and your surgeon will work to explain these factors to you in developing your individualized surgical plan.
Routine blood work and heart studies such as an EKG can be ordered prior to surgery based on your age and the presence of any existing medical conditions.
You may be instructed to stop taking some medications before surgery. Make sure your surgeon knows all the prescription and over-the-counter medications you take, including natural or nutritional supplements. For more information related to preparation for surgery click here.
Procedure:
The Lumpectomy Procedure is usually performed under a general anesthesia, so you will not feel anything. Local anesthetic (numbing medication) will be injected in the area. The procedure itself is performed through an incision in the breast near the lump that follows the shape of your breast for the best cosmetic and healing outcome. The tumor along with some of the surrounding healthy tissue will be removed and the incision will be meticulously closed with suture. The suture will all be under the skin, so there will be no stitches to remove after surgery.
Additional procedures may be performed just before or at the time of the lumpectomy. Please keep in mind that each patient situation is different, which is why our highly trained and experienced surgeons are here to guide you through these complex decisions.
Information about additional procedures is also shared here if you would like to learn more:
Wire Localization of the lump may be performed just before surgery. The wire localization consists of a radiologist placing a very thin wire in the area of the tumor with the guidance of radiology equipment. This is commonly recommended when the lump can't be easily felt, or palpated, under the skin. The wire marks the area that needs to be removed by the surgeon and will be removed during the lumpectomy. If wire localization is required, the appointment will be coordinated for you around your planned surgery time.
Wire localization may not be necessary especially if the lump in your breast can be easily felt through the skin.
Lymph Node Removal, also called a Sentinel Node Biopsy, may be recommended at the same time as the lumpectomy to determine if the cancer has spread outside the breast if there are no concerns about enlarged lymph nodes before your surgery. During this procedure your surgeon will make a small incision in the axilla (armpit) to remove the first one or two nodes into which a tumor drains (sentinel nodes). Local anesthetic (numbing medication) will be injected in the area. Once removed, the incision will be meticulously closed with suture. The suture will all be under the skin, so there will be no stitches to remove after surgery. The nodes are then sent to be tested for cancer.
In order to identify the sentinel node(s) a radioactive and/or blue dye must be injected into the area of the tumor or the skin just above the tumor. This dye will travel to the sentinel node(s) allowing your surgeon to identify and remove them. If a lymph node removal is recommended, the appointment will be coordinated for you around your planned surgery time.
If no cancer is present, no further lymph nodes need to be removed. If cancer is present, the surgeon will discuss options such as radiation to the area or an axillary node dissection (removal of additional nodes.)
Axillary Node Dissection may be recommended if a previous lymph node biopsy shows signs of cancer. During this procedure your surgeon will make an incision in the axilla (armpit) to remove a number of lymph nodes on the side of the tumor. Once removed, the incision will be meticulously closed with suture. The suture will all be under the skin, so there will be no stitches to remove after surgery. A drain may be placed. If so, drain care instructions are attached below for your reference.
Recovery:
This varies from patient to patient. You may have lifting and activity restrictions after surgery. Plan to avoid bouncing activities like jogging, raising elbows over your shoulders and repetitive arm movements for the first week following surgery. It is very important that you plan to wear a supportive bra for 24 hours/day for the first week unless you are showering.
While recovery instructions may be tailored to individualize a plan of care based upon your specific needs, these instructions are common following lumpectomy surgery:
- You will need to arrange for a ride home the day of your surgery and we recommend someone stay with you for the first 24 hours at home.
- When you leave the facility after surgery, we will want you to go home and rest. Avoid making any other plans on the day of your surgery. Starting the following day, you can increase your activity as you feel up to it.
- Avoid fried foods, milk products and citrus juices for around one day after your surgery. Suggestions for foods to eat include soup, sandwich, pasta, potatoes, toast, and applesauce.
- You will likely be given a prescription for pain medication following your surgery. The recovery nurse will discuss a pain control plan following surgery specific to you and your needs including activities like ice applied over incisions and a medication regimen. Often times we will recommend taking Tylenol and Advil (same as Motrin, Ibuprofen) or Aleve in addition to the narcotic pain medication.
- It is often suggested to start taking a stool softener twice daily the day following your procedure. You will want to continue this regimen as long as you are taking narcotic pain medications.
- You may be able to shower within a couple of days after your surgery. If a drain is placed, you can reference the drain care instructions attached.
- The dressings applied to your surgical site will be specific to your procedure. If surgical glue is used, there will be no dressings to remove. If bandages are applied, they can usually be removed at home in 24-48 hours. You will receive care instructions specific to your procedure.
For additional information for after surgery preparation click here.
For More Information
To listen to our board certified surgeons answer your most frequently asked questions, please visit our FAQ page.
To Schedule an Appointment
To find out more about Breast Procedures offered at CSA Surgical Center in Columbia, Missouri please call Columbia Surgical Associates at 573-443-8773 and schedule an appointment with a board-certified general surgeon.