Lumpectomy: An Overview

What Is a Lumpectomy?

A lumpectomy is a surgical procedure that is considered a breast-conserving surgery. In this surgery, only the cancerous part and a minor portion of the surrounding tissue are removed. It helps treat early-stage breast cancer while allowing you to keep most of your breast.

This procedure is often compared to mastectomy, which removes the whole breast.

So, when you think of mastectomy vs. lumpectomy, the main difference is how much tissue is removed.

A lumpectomy is usually followed by radiation to lower the chance of cancer returning. You may also experience some changes afterward, such as mild thickening around the lumpectomy breast cancer site, which is often part of healing.

What Are the Types of Lumpectomy Procedures?

There are a few types of lumpectomy procedures mentioned below:

• Excisional Biopsy: This is the removal of a tumor for lab testing to confirm if it is cancerous or benign.

• Wide Local Excision: Take out the tumor and a little margin of healthy tissue to ensure no cancer remains.

• Quadrantectomy: It is the removal of about a quarter of the breast, including the tumor, the surrounding tissue, and the milk ducts.

• Re-Excision of Margins: Surgery is performed to remove further tissue when cancer cells are detected in the margins after primary surgery.

What Are the Indications of Lumpectomy?

The goal of lumpectomy is to remove cancer while preserving your breast’s appearance. Studies show that lumpectomy with radiation offers similar outcomes to mastectomy for early-stage cancers, which is why many patients compare mastectomy vs. lumpectomy when deciding.

Lumpectomy may be recommended if:

• You have a single small tumor (less than 1.57 inches).

• You have enough breast tissue, so removal will not distort breast shape.

• You can undergo both surgery and radiation.

It may also help remove noncancerous or precancerous abnormalities.

A lumpectomy may not be suitable for conditions associated with healing, such as scleroderma or lupus.

Who Should Not Have a Lumpectomy?

A lumpectomy may not be advised if you have:

• Multiple tumors in one breast.

• A large tumor compared to your breast size.

• Cancer involving the skin, chest wall, or aggressive types like inflammatory breast cancer.

• A BRCA (breast cancer gene).

• A gene mutation or recurrent cancer.

Radiation-related reasons you may not qualify:

• Prior radiation to the same breast.

• Conditions like scleroderma (an autoimmune disorder that causes thickening and hardening of tissue and skin due to excessive collagen production) or Sjogren’s syndrome (an autoimmune disorder that causes dry eyes and dry mouth).

• Pregnancy (lumpectomy can be done, but radiation must wait).

How Should a Person Prepare for a Lumpectomy?

A lumpectomy is usually an outpatient procedure, meaning you can go home the same day. Your doctor will take a full medical history, including any medicines or supplements you take. Blood-thinning medicines like aspirin should be stopped a week before surgery.

If you are having general anesthesia, you will need to fast for about eight hours. It is helpful to bring a family member or friend with you for support after surgery.

What Happens During a Lumpectomy?

• First, the surgeon finds the exact spot of the tumor using tests like a mammogram or an ultrasound.

• If the lump is not easily felt, the surgeon will place a thin wire, a small needle, or a tiny radioactive seed into the breast. This helps guide them to the correct area during surgery.

• If the breast lump is easily palpable, this step is not needed, as the surgeon can remove it without additional guidance.

• Sometimes, the cancer may spread to the armpit. In that case, the surgeon may remove the lymph nodes in that area.

• For early-stage breast cancer, the surgeon may remove only the first few lymph nodes where cancer is most likely to spread.

• If more checking is needed, the doctor may remove several lymph nodes from the armpit. This is called axillary lymph node dissection.

Removal of lymph nodes includes:

• Sentinel Node Biopsy - This technique removes a few nodes where the cancer drains. The removed tissue is diagnosed with cancer. Before the operation, a radioactive material or blue dye is injected into the region near the affected site and the skin beyond the affected area. This pigment will traverse to the sentinel node, permitting identification and extraction.

• Axillary Lymph Node Dissection - In this procedure, multiple lymph nodes in the armpit are removed.

The procedure of a lumpectomy, done under general anesthesia, begins with an incision made on the tumor or the region involving a wire. This is done to extract the tumor and adjacent tissues, followed by an analysis of these tissues. Finally, they will seal the incisions with great care to maintain the breast configuration, utilizing sutures. Followed by placing thin adhesive strips to keep it in place until it heals.

What Are the Benefits of a Lumpectomy?

A lumpectomy allows you to remove the cancer while keeping most of your breast. For early-stage breast cancer, studies show that lumpectomy with radiation offers similar survival rates to mastectomy. This is why many patients weigh mastectomy vs. lumpectomy when choosing their treatment.

Your doctor will suggest the best option based on the stage, type, and grade of the cancer.

What Are the Risks or Complications of a Lumpectomy?

Lumpectomy may not be effective if

• Cancer involves the whole breast or skin.

• The tumor is large, and your breast is small.

• There are multiple tumors in different areas.

• You had prior radiation to that breast.

Possible complications include:

• Bleeding or infection.

• Pain or tenderness.

• Swelling.

• Firm scar tissue.

• Changes in breast shape.

Some people notice thickening around the lumpectomy breast cancer site. This is usually due to scar tissue and healing, but it should always be checked if it changes or feels unusual.

Conclusion:

A lumpectomy is a breast-conserving procedure that is ideal for early-stage and smaller tumors. Compared to a mastectomy, it helps maintain breast appearance while still effectively treating the cancer.

Although there are possible risks, most patients recover quickly and go home the same day. Your surgeon will recommend the right treatment by considering your tumor size, breast size, health conditions, and overall treatment goals.

If you notice a lump in your breast or have questions regarding treatment options for your breasts, consult with breast cancer specialists online.

Key Takeaways

• A lumpectomy is a surgical procedure in which a small portion of tissue surrounding a breast lump is removed, and the majority of the breast is left intact.

• According to doctors, in the case of early-stage breast cancer, a lumpectomy with radiation therapy is just as effective as a mastectomy (removing the whole breast).

• If you notice any unusual breast changes, you should consult a doctor promptly to understand whether a lumpectomy is the right treatment option for you.