A lumpectomy is a surgical procedure that involves the removal of a tumor and surrounding tissue. This tissue is examined to determine how far cancer has spread and identify what stage of breast cancer a woman has. This procedure can be used as part of a breast cancer treatment plan and is considered less invasive than a mastectomy. Learning about a lumpectomy can help women understand the reasons for and risks of this procedure.
Procedure
A lumpectomy can be done with anesthesia or sedation. During the procedure, a small incision is made near the breast tumor. The surgeon cuts out the lump, along with at least 1 cm of the surrounding normal breast tissue. The lump and normal tissue are sent to a pathology lab to be examined under a microscope. The results of this analysis can help doctors develop cancer treatment plans for their patients.
Contraindications
A lumpectomy should not be done on some women. If a woman has had previous radiation to the breast or chest area, this procedure should be avoided. A lumpectomy cannot be done on a woman who has two or more cancerous areas in the same breast, a tumor that is large in comparison to the breast itself, connective tissue diseases or a tumor larger than 2 inches that did not decrease in size after chemotherapy. This procedure should not be performed if a woman is going to be pregnant after surgery, which is when post-lumpectomy radiation is administered.
Risks
As with any surgical procedure, a lumpectomy has specific risks. Infection, bleeding and unexpected scarring may affect the breast. Once the lumpectomy is complete, the breasts may be asymmetrical and differ greatly in size and shape. Drainage may be required if excess fluid accumulates at the surgical site. Reactions to anesthesia can also occur, causing nausea, vomiting and other symptoms. If lymph node dissection is done during the lumpectomy, a woman may experience numbness, tingling, loss of sensation in the back of the armpit and increased skin sensitivity. The nerves that control arm motion can also be damaged during the procedure. Lymph node dissection can also cause lymphedema, which is swelling of the arm.
Recovery
Women who have had lumpectomies may be able to go home the same day as the procedure. If complications occur, they may be hospitalized for 1 to 2 days for treatment and observation. Normal activities can usually be resumed within 2 weeks. After this procedure, soreness should be expected. Soreness is worse during the first 3 days after the procedure but should ease with time. If fluid collects in the empty space left by the lumpectomy, drainage may be required. This can be done in the surgeon's office and usually does not cause serious problems.
Considerations
A lumpectomy is intended to be an alternative to mastectomy, allowing women to avoid the removal of an entire breast. However, the amount of tissue removed during a lumpectomy can be considerable. BreastCancer.org, which was founded by Dr. Marisa Weiss, reports that up to one-fourth of the breast may be removed during a lumpectomy. Women should discuss the procedure with their physicians and ask how much breast tissue will be removed before deciding to undergo a lumpectomy.
