What Is A Lumpectomy?

A lumpectomy is a surgical procedure used to treat breast cancer. Also called breast-conserving surgery, partial mastectomy, segmental mastectomy, or wide local excision, the goal of this approach is to get rid of the tumour and a small portion of the surrounding healthy tissue (the margin) to make sure no cancer cells are left behind. The aim is to treat breast cancer while keeping as much of the breast's appearance and function as possible. 

Do I Need A Lumpectomy?

If you have early-stage breast cancer or a small, localised tumour then a lumpectomy is likely to be recommended.  The procedure is most appropriate for Stage 1 or Stage 2 cancer, however, if the tumour is small in comparison to the breast size it could be considered for a more advanced stage cancer. Some patients may prefer to keep as much breast tissue as possible, opting for a lumpectomy over a mastectomy.

It's important to note that a lumpectomy isn't suitable for everyone. This procedure is generally appropriate if the size and location of the tumour would not cause breast deformity by being removed. Other factors such as multiple tumours in different areas of the breast or a history of radiation therapy may make a lumpectomy unsuitable. It is also possible for a lumpectomy to be performed for benign (non-cancerous) tumours or abnormal growths. 

What Can I Expect During A Lumpectomy?

A lumpectomy can be a major or minor surgery depending on the complexity of what you need and the size of the tumour. The procedure is usually performed under general anaesthesia so that you are unconscious when your surgeon removes the cancer. 

During A Lumpectomy

During the procedure, an incision is made near the tumour or around the areola, depending on the tumour location. Next, the surgeon removes the tumour and a margin of healthy tissue. The margin is then checked to ensure that there are no cancer cells present (clear margin), as the presence of these cells could mean that you need further surgery. 

The surgery typically takes 1-2 hours, and depending on how complicated your operation is (including whether any lymph nodes were removed), you might be able to go home the same day or be kept for one or two days for monitoring. 

After A Lumpectomy

Recovery depends on you as an individual and the extent of the surgery. General advice would be to rest and avoid strenuous activities, keep the incision area clean and dry, and care for the wound according to the doctor’s instructions. Your follow-up appointments will be an important part of monitoring for possible complications.  

Most patients will need radiation therapy of the breast after a lumpectomy to make sure that any remaining cancer cells are destroyed. If you are also having chemotherapy the radiotherapy will likely be done afterwards.

What Is A Sentinel Lymph Node Biopsy?

The lymph nodes under your arm will be assessed before your operation, using information from ultrasounds and other tests done during the diagnosis of breast cancer. If cancer cells are present, you will require axillary lymph node dissection or clearance, which is the surgical removal of all or most of the lymph nodes.  

If your lymph nodes look normal on scans, you will have a sentinel lymph node biopsy during the lumpectomy. Because the lymph nodes drain fluid from the breast, this is one of the first places the cancer might spread to.

A sentinel lymph node biopsy involves using a tracer (mildly radioactive liquid) and possibly dye, in order to track which nodes the breast tissue drains into first. Some of these nodes are then removed during the lumpectomy operation and sent to the laboratory to establish whether they have cancer cells present. 

What Is The Difference Between A Lumpectomy And A Mastectomy?

While both a lumpectomy and a mastectomy are surgical procedures to treat breast cancer, they differ in how much tissue is removed and how they affect the breast's appearance. A lumpectomy preserves most of the breast, while a mastectomy involves the removal of the entire breast (sometimes including nearby lymph nodes and chest muscles).

Larger or more aggressive tumours may require a mastectomy, while others opt for this procedure in order to reduce the risk of cancer recurrence. Both procedures could require radiation therapy afterwards, but it may be more essential in the case of a lumpectomy. Reconstructive surgery could also be done after a mastectomy to restore the beast's appearance.

When choosing which procedure would be best, the stage, size, and spread are considered. Your preference for how much tissue you would like to keep is also important.  It's essential to discuss these factors with your healthcare provider to determine the most appropriate treatment option for your individual situation.

What Are The Risks For A Lumpectomy?

As with any surgery, a lumpectomy carries some risks and potential complications. These include excessive bleeding during the operation, infection at the surgical site, and some chance of cancer recurrence. Other problems you might encounter are seroma (fluid collection at the surgery site), nerve damage, shoulder stiffness, swelling in the hand or arm, changes in breast appearance after surgery, pain, and scarring.

Blood clots are another potential risk. To remedy this, the staff will get you moving after the operation, and you may need to wear anti-embolism stockings or have injections to thin the blood. It's crucial to discuss the potential risks and complications with your healthcare provider before undergoing a lumpectomy to make an informed decision about your treatment.

Why Is A Lumpectomy A Recommended Treatment?

This surgical procedure aims to remove a cancerous or abnormal growth from the breast tissue while keeping most of the breast intact.  It's often recommended for early-stage breast cancer or small, localised tumours. While lumpectomy has its benefits, it's essential to weigh the risks and potential complications and discuss your options with your healthcare provider to determine the best course of treatment for your individual situation.