A lumpectomy (also known as a partial or segmental mastectomy) is the surgical procedure which involves in the removal of a breast lump or abnormal area seen on a mammogram. When removing the lump, a small amount of surrounding normal tissue is also removed. This is done to eliminate the cancerous tumor completely. The tissue is then examined by a pathologist to see if any of the cancer cells are present in the surrounding tissue. If there are no cancer cells present, this is called a “clean margin”. If cancer cells are present in the surrounding tissue, your surgeon will advocate additional steps, which may include a re-excision to remove additional tissue in an attempt to clear the margins. The goal is to achieve removal of all cancer cells with the best healing result possible when performing breast conservation surgery.
A lumpectomy is typically done in a hospital setting, but specialized outpatient facilities are sometimes preferred. The surgery is usually done while thepatient is under general anesthetic. Local anesthetic with additional sedation may be used for some patients. The tumor and surrounding margin of tissue is removed and sent to the pathologist. The surgical site is closed. If axillary lymph nodes were not removed before, a second incision is made in the armpit. The fat pad which contains lymph nodes is removed from this area and isalso sent to the pathologist for analysis. This portion of the procedure is called an axillary node dissection; it is critical for determining the stage of the cancer. Typically, 10-15 nodes are removed, but the number may vary. Surgical drains may be left in place in either location to prevent fluid accumulation. The surgery may last from one to three hours.
The recovery period is very short for a simple lumpectomy. You should have little pain. If you do feel pain, you can take pain medicine, such as acetaminophen (Tylenol).
The skin should heal in about a month. You will need to take care of the surgical cut area. Change dressings as your doctor or nurse tells you to. Watch for signs of infection when you get home (such as redness, swelling, or drainage).You may need to empty a fluid drain a few times a day for 1 to 2 weeks. Your doctor will remove the drain later. Most women can go back to their usual activities in a week or so. Avoid heavy lifting, jogging, or activities that cause pain in the surgical area for 1 to 2 weeks. If cancer is found, you will need to schedule follow-up treatment with your doctor.