Breast Conserving Surgery- Lumpectomy

What is Lumpectomy?

A Lumpectomy is also called wide local excision or breast-conserving surgery.

A Lumpectomy is a surgical procedure to remove a malignant tumour and removes a lump along with some of the surrounding normal tissue from a woman’s breast. 

Advantages of Breast-conserving Surgery? 

Lumpectomy is a type of breast conservation or preservation surgery. Your breast is left in place, and your appearance will not be changed as much as it would be following a mastectomy.

Candidates for a Lumpectomy?

You may be a candidate for a lumpectomy if:

• Early-stage breast cancer
• Cancer only affects one area of your breast.
• A tumour is relatively small compared to your breast size,
• Breast cancer shrunk by neoadjuvant treatments.
• Your provider is confident you will have enough remaining tissue to reshape your breast after removing the tumour.
• You can complete radiation therapy.

Considerations Related to Breast Conserving Surgery?

• Further breast cancer surgery may be required.
• Your breast may differ in shape, weight and size, and feel different after surgery.
• You will need a mammogram and ultrasound of both breasts every year.
• Cancer can come back in the breast, although the risk is low (about 0.5 to 1% per year).

Preparation for a Lumpectomy Procedure

Your doctor will perform a physical examination of the breasts. A mammogram is done to detect soft tissue abnormalities of the breast, and a biopsy is performed to obtain a tissue sample. 

Based on the findings of the mammogram and biopsy, you may be advised to undergo a lumpectomy.

The tumour may need to be located preoperatively by a radiologist if it cannot be felt. At operation, an incision is made in a cosmetically acceptable place. 

Lumpectomy Surgery

The procedure aims to remove the abnormal tissue and retain the normal appearance of the breast. Lumpectomy can be performed as a day stay or inpatient procedure and is usually done under general anaesthesia, although it sometimes can be done under a local anaesthetic.

The surgeon then removes the tumour and a small layer of surrounding tissue and sends it to the laboratory for investigation. The breast is often reshaped or ‘remodelled’ to improve the appearance and avoid any resultant ‘divots’. Your surgeon may also remove lymph nodes in your armpit (axilla) to see if cancer has spread to the lymph nodes. This may or may not require a further incision.

At the end of the procedure, the incisions are closed with dissolvable sutures, and a soft waterproof dressing is placed over the surgical area.

After the Lumpectomy Procedure

• Make sure you get enough rest to return to normal activities in a few days.
• Your doctor may prescribe medications and antibiotics to reduce pain and inflammation.
• Keep the incision clean and dry to avoid infection. Showering is permitted.
• A follow-up appointment should be scheduled 1-2 weeks after surgery to examine your progress and to discuss the pathology and further treatments.

All cancer patients are discussed in a multi-disciplinary meeting with other cancer specialists and specialists involved in their care to determine the best treatments to ensure cancer has been eradicated and will not return.

Radiotherapy is almost always recommended after breast conservation surgery. It involves going to the hospital for daily treatment for 3 to 6 weeks.



Risks and Complications of a Lumpectomy Procedure

As with any surgery, Lumpectomy procedures are usually safe but may involve 

• the risk of infection, 
• bleeding, 
• pain, 
• swelling in your arm, 
• hard scar tissue formation at the site of surgery, 
• a change in the size and shape of the breast.
• shoulder pain and stiffness, numbness (especially under your arm), and 
• accumulation of blood or fluid (seroma) in the surgical site.