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  • Lumpectomy - The Procedure



    Lumpectomy Video
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    Breast Cancer 101 (Interactive Multimedia) - Lumpectomy
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    Recovery After Breast Surgery
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    Lumpectomy (also called breast conserving surgery, partial mastectomy or wide excision) is often done under general anesthesia, which means you are unconscious (asleep) during the surgery. In some cases, regional anesthesia may be used.

    The surgeon makes an incision (cut) in the breast and removes the tumor, along with a small rim of normal tissue around the tumor. He/she then closes the incision with stitches, trying to keep the breast looking as much like it did before surgery. The surgeon may also make an incision in the underarm area and remove some lymph nodes.

    In some cases, more than one surgery is needed to get clean margins. Clean (also called uninvolved or negative) margins mean there is only normal tissue (and no cancer cells) at the edges of the tissue removed from the breast. Learn more about assessing margins.

    The tissue removed during surgery is sent to a pathologist for detailed testing. Learn about the results of the tests and other information found in your pathology report.

    Finding the tumor in the breast

    In some cases, the surgeon uses special methods to help find the exact area of the breast that contains the tumor.

    Wire-localization (needle-localization) at the time of surgery

    Sometimes breast cancers found by mammography (or other imaging) are nonpalpable (cannot be felt). If the tumor is nonpalpable, a procedure called wire-localization or needle-localization will be done just before surgery.

    A radiologist uses a mammogram, breast ultrasound or breast MRI as a guide and inserts a very thin wire into the breast in the area of the cancer. Local anesthesia is used with this procedure.

    The surgeon then uses this wire as a guide to find and remove the tumor during surgery. The wire will also be removed during surgery.

    Radio-opaque clip during a needle biopsy

    A core needle biopsy is often used to diagnose breast cancer. It removes a small amount of tumor tissue. During a core needle biopsy, a radio-opaque clip is often placed in the breast to mark the location of the tumor. (You cannot feel the clip.)

    Later, when you have breast surgery, the surgeon uses the clip as guide to find and remove the tumor. The clip will also be removed during surgery.

    Assessing margins (Was the entire tumor removed during surgery?)

    A pathologist checks the tissue removed during surgery. By looking at the tissue under the microscope, the pathologist determines whether the entire tumor was removed. The pathologist looks at the rim of tissue (called a margin) around the tumor to check whether it contains cancer cells.

    Learn more about assessing tumor margins.

    Assessing lymph nodes (Has cancer spread to the lymph nodes?)

    During lumpectomy for invasive breast cancer, some of the lymph nodes in the underarm area (axillary nodes) are removed to check for cancer cells. The axillary nodes are often the first place breast cancer spreads. The presence or absence of cancer in these nodes is one of the most important factors affecting cancer stage and prognosis.

    Learn more about assessing axillary lymph nodes.

    Length of hospital stay

    The length of the hospital stay after lumpectomy depends largely on whether axillary lymph nodes are removed. If you have a sentinel node biopsy or you do not have axillary nodes removed, you will likely go home the day of your surgery.

    If you have axillary dissection, you may go home the same day or you may stay overnight in the hospital. A tube (surgical drain) may be placed in the underarm area to collect fluid. This drain stays in for a week after surgery.

    You should discuss the expected length of your stay with your surgeon and insurance provider.

    Learn more about sentinel node biopsy and axillary dissection.

    What to expect after lumpectomy

    After lumpectomy, you will likely have temporary soreness in your chest, underarm and shoulder. You will also likely have numbness along the surgical incision (scar).

    If axillary lymph nodes are removed during surgery, you may also have some numbness in your arm and there is some risk of lymphedema. Lymphedema is a condition where fluid collects in the arm (or other area such as the hand, fingers, chest or back), causing it to swell.

    Learn more about the management of surgery-related pain.

    Learn more about lymphedema.

    Cosmetic issues

    Women may choose lumpectomy over mastectomy to keep their breast and have it look (as much as possible) like it did before surgery. However, lumpectomy will change the look of the breast. Because some tissue is removed, the breast may be smaller and firmer. There will be a scar and some numbness.

    Radiation therapy (usually given after lumpectomy) can also affect the look of the breast. It can further shrink the breast and change its texture or feel.

    Sometimes, factors like the location and size of the tumor can make it unlikely that a woman will be happy with the look of her breast after lumpectomy. In these cases, mastectomy (with or without reconstruction) may be the better option.

    In rare cases, a woman may consider having reconstructive surgery (either at the time of their lumpectomy or later) to maintain a more natural appearance of the breast, or to match the size and shape of the opposite breast. These surgeries are complex. You may wish to meet with a plastic surgeon to discuss your options.

    Learn more about breast reconstruction.

    Transportation, lodging, child care and elder care assistance

    You may not live near the hospital where you will have your surgery. Sometimes, there are programs that offer help with local or long-distance transportation and lodging. Some also offer transportation and lodging for a friend or family member going with you. There are also financial assistance programs to help you with child care and elder care.

    Learn more about transportation, lodging, child care and elder care assistance

    Susan G. Komen’s Breast Care Helpline:
    1-877 GO KOMEN (1-877-465-6636)

    Calls to our breast care helpline are answered by a trained and caring staff member Monday through Friday from 9:00 a.m. to 10:00 p.m. ET and from 6:00 a.m. to 7:00 p.m. PT. Our helpline provides free, professional support services to anyone with breast cancer questions or concerns, including breast cancer survivors and their families. You can also email the breast care helpline at helpline@komen.org.

    Updated 07/28/15


    010673.gif   Lumpectomy
    010673.gif Surgery
    Mastectomy    010674.gif  
    Mastectomy – the Surgical Procedure  010674.gif
    Deciding Between Mastectomy and Lumpectomy Plus Radiation Therapy   010674.gif
    Breast Reconstruction   010674.gif
    Questions for Your Provider - Surgery  010674.gif

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