Lumpectomy

Overview & Description

A lumpectomy is a surgical procedure used to diagnose or treat breast cancer. The procedure removes the breast lump and a margin of healthy tissue. The rest of the breast is left intact.

Who is a candidate for the procedure?

A woman is a candidate for lumpectomy if the following conditions apply:

  • A diagnosis of breast cancer is suspected.
  • The size and location of the cancer are such that removal of the lump will still result in a breast that is acceptable to the woman.
  • Cancer is only in a single site within the breast.
  • The cancer to be removed is not a recurrence of cancer previously found in that breast.

    • How is the procedure performed?

    The woman is put to sleep with conscious sedation or general anesthesia. The skin over the affected breast, chest, and upper arm is cleaned. An incision is made around the previous biopsy site and the surrounding skin is removed. The goal is to remove all of the cancerous breast tissue and leave the rest of the breast intact. Bleeding is stopped and the wound is irrigated. A small drain may be placed in the wound. The incision is carefully closed to minimize scarring.

    Some lymph nodes under the arm may be removed to see if cancer has spread. This is called an axillary node dissection. It requires a separate incision in the underarm area. A small drain may be used here, too. The incision is carefully closed to minimize scarring. The lymph nodes removed are sent to a lab for analysis.

    Bandages are applied and the woman is awakened.

    Preparation & Expectations

    What happens right after the procedure?

    The woman will be kept in the surgery recovery room for a short period of time. She will have an intravenous line, or IV, and oxygen tube. The throat may be sore from the breathing tube used during the surgery. She will be asked to cough and breathe deeply to clean out the lungs and prevent pneumonia. Pain medication will be given as needed. The woman may be thirsty and nauseated, and she will have a bulky bandage and drains.

    Back in the hospital room, the woman will usually need help getting up the first time. After that, she will be encouraged to get up and move about. Most women can go home the next day. The bandages and drains remain in place until they are removed by the surgeon. Home care instructions are given.

    Home Care and Complications

    What happens later at home?

    The woman may need to periodically empty a reservoir attached to the drains. Care must be taken to keep all items clean to prevent infection. Proper hand-washing is very important before and after emptying the drains or changing dressings. The color and amount of drainage should be noted and reported to the surgeon.

    Pain medications are given, but the pain usually is not severe. The surgeon will let the woman know what activities are allowed in the first few days after surgery.

    After recovering from lumpectomy, most women undergo radiation therapy for the breast cancer. Women may have chemotherapy if the lab report shows that cancer has spread to the lymph nodes.

    Many women feel sad or depressed after a lumpectomy. They may have concerns about body image and sexuality. Any diagnosis of cancer brings with it the fear of death. A healthcare provider can provide support with these issues and can recommend other resources for support.

    What are the potential complications after the procedure?

    Surgery can cause bleeding, infection, or allergic reaction to anesthesia. Other complications of mastectomy include the following:

  • Fluid can accumulate under the skin flaps if the drains are not being emptied often enough, or if they become plugged.
  • Cell death of the skin edges of the incision is uncommon, but it may occur if the skin flaps are very thin or if there is tension at the incision site.
  • Numbness along the skin in the underarm area and upper arm is caused by damage to the nerves that travel through the area of the lymph nodes removed during surgery. Although it might take some time, this complication may go away.
  • Postmastectomy pain syndrome, or a severe, sharp, shooting, or burning pain along the chest wall. This is frequently caused by nerve damage.
  • Swelling of the arm on the side of the surgery, which is called lymphedema, is often a late complication, which means that it can occur months or even years after surgery. The cause is not known, but it is frequently associated with local infection.

    • The following steps can help prevent lymphedema.

  • Do not have blood drawn from the involved arm.
  • Avoid having injections in the involved arm.
  • Avoid having blood pressure taken in the involved arm.
  • Avoid any injury to the involved arm, such as cuts, insect bites, or burns.
  • Keep physically active, within the limits set by the healthcare provider.

    • Any new or worsening symptoms should be reported to the healthcare provider.

    Attribution

    Author:Susan Woods, MD
    Date Written:
    Editor:Ballenberg, Sally, BS
    Edit Date:05/30/01
    Reviewer:Fern Carness, RN, MPH
    Date Reviewed:05/13/01