What a lumpectomy is
A lumpectomy removes the breast tumour together with a small margin of normal tissue around it. The rest of the breast is kept. It is also called breast conserving surgery or wide local excision.
The aim is to take out all of the cancer while keeping the shape of the breast as natural as possible. The removed tissue is examined in the laboratory to check that the edges, called margins, are clear of cancer cells.
Who it suits
Lumpectomy is a good option for many early stage breast cancers, especially when:
- there is a single tumour in one area of the breast
- the tumour is small enough compared with the breast to remove it with a good cosmetic result
- you are able to have radiotherapy afterwards
It may not be suitable if cancer is found in several parts of the breast, if you have had radiation to the chest before, or if clear margins cannot be reached. In those cases a modified radical mastectomy is usually discussed.
For suitable patients, lumpectomy followed by radiotherapy gives long term survival similar to mastectomy, which is why it is offered whenever it is safe.
What happens to the lymph nodes
Lymph nodes in the armpit are checked at the same time. This may be a sentinel node biopsy, which removes only the first one or a few nodes, or a fuller axillary clearance if cancer is already known to be in the nodes. Dr. Naeem will explain which approach applies to you.
The operation
Lumpectomy is done under general anaesthesia and usually takes one to two hours including the lymph node part. If the lump cannot be felt, a marker or wire placed under imaging guidance may be used to find it. The cut is kept as small and as well hidden as possible.
Recovery
Many patients go home the same day or after one night. Discomfort is usually mild to moderate and settles within a week or two. If lymph nodes were removed, you may have a drain for a few days and will be shown arm exercises.
- Wear a supportive bra, day and night if advised, for comfort
- Most people return to normal light activity within one to two weeks
- Radiotherapy to the breast usually starts a few weeks after the wound has healed
If the margins are not clear
Sometimes the laboratory report shows cancer cells close to or at the edge of the removed tissue. When that happens, a second small operation called re-excision is often enough to make the margins clear. If clear margins still cannot be reached, mastectomy is discussed.
Possible complications
- bruising or a small collection of blood or fluid in the breast
- wound infection
- a change in the shape or size of the breast
- numbness or tingling around the scar or in the inner arm if nodes were removed
- arm swelling (lymphoedema), mainly after fuller lymph node removal
Contact the clinic if you notice fever, increasing redness or swelling, discharge from the wound, or pain that gets worse instead of better.
Questions patients ask
Is lumpectomy as safe as mastectomy?
For suitable early stage cancers, lumpectomy followed by radiotherapy has long term survival similar to mastectomy. The key is choosing the right patient and getting clear margins.
Do I always need radiotherapy after a lumpectomy?
In most cases yes, because radiotherapy lowers the chance of the cancer coming back in the same breast. Your oncologist will confirm this after the final report.
Will my breast look different?
Some change in shape or size is common, especially with larger tumours or smaller breasts. Dr. Naeem plans the incision to keep the result as natural as possible.
How soon can I go home?
Many patients go home the same day or the next morning. If a drain is placed, it is usually removed within a few days.
This page is a general guide. Your own plan depends on your reports and examination, so use it to prepare questions for your consultation.