Lumpectomy

Lumpectomy is also called breast-conserving surgery or partial mastectomy. It is an operation in which the surgeon removes only the part of the breast containing the tumor and some of the surrounding normal tissue.

The tissue that is removed is later examined in a laboratory to see if any cancer cells are present in the margins — the normal tissue surrounding the tumor. If there are cancer cells in the margins, your surgeon may perform a re-excision, which is additional surgery to remove the remaining cancer.

Lumpectomy is often performed on ductal carcinoma in situ (DCIS) and smaller invasive tumors. Depending on the amount of tissue removed, the breast may look unchanged.

Following lumpectomy, most women undergo radiation treatments for five to seven weeks. The goal is to destroy any cancerous cells that remained in the breast following the lumpectomy.

A great deal of research has been done in recent years to determine if breast-conserving therapy and mastectomy are equally effective. The evidence shows that lumpectomy followed by radiation has the same survival benefit as mastectomy for women:

• whose cancer was confined to a single area of the breast, and
• whose tumor size was less than 4 cm and who had no cancer cells in the "margins" — the tissue around the tumor

If you are given the choice of a lumpectomy or mastectomy, you and your doctor should consider:

• Which one is most appropriate to completely remove the tumor
• The importance to you of keeping your breast
• Whether you would wear a prosthesis or have breast reconstruction
• Your ability to have daily radiation treatment for a few weeks
• Your risk of recurrence in the breast

It can also be helpful to talk to other women who have made these kinds of decisions.

What to expect with lumpectomy

Possible effects from surgery may include:

• Pain or tenderness at the site of surgery
• A reaction to the anesthesia (nausea, vomiting)
• Some bleeding, bruising, or swelling at the site of surgery

Questions to ask your surgeon about lumpectomy

• How long will I be in the hospital?
• Will I have local or general anesthesia?
• How long will the surgery take?
• Will you use staples or stitches to close the incision?
• If I get stitches, will I have to come back to have them removed?
• What will the scar look like?
• Will I need pain medication after surgery?
• Will I have a drain inserted during surgery?
• If I have a drain, will it be removed right away, or will I have to come back to have it removed?
• When can I take my first shower or bath?