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Lumpectomy

Definition
A lumpectomy is a surgical procedure used to diagnose or treat breast cancer. The procedure removes the breast lump, leaving the rest of the breast intact.

Who is a candidate for the procedure?
A woman is a candidate for lumpectomy if:
  • a diagnosis of breast cancer is needed or if the pathology of the lump is unknown.
  • 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 general anaesthesia. 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 leave a pleasing appearance.

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 minimise scarring. The lymph nodes removed are sent to a laboratory for analysis.

Bandages are applied. The woman is awakened in the operating room and taken to the recovery area.

What happens right after the procedure?
When the woman awakens after surgery, she will have a bulky bandage on her chest. The bandage stays in place until removed by the surgeon. She may have a drain in her breast and possibly under her arm.

The woman will be receiving intravenous, or IV, fluids through a needle in her arm. She may have a sore throat from the breathing tube used during the surgery and feel thirsty and/or nauseous. Nurses will encourage her to cough and breathe deeply. This cleans out the lungs and prevents pneumonia. Analgesia can begin as soon as needed.

Once in her hospital room, she will need help getting up from the bed the first time. The woman may go to the bathroom and walk around as soon as she feels able. She may go home the same day or the next day but usually needs to remain in hospital for a longer period if axillary dissection has been done.

Home-care instructions may include the following:
  • Fluid draining from the wound may need to be emptied from a reservoir attached to each drain. The colour and amount of drainage should be noted and reported to the doctor. Usually drains are removed before the patient leaves hospital.
  • Care must be taken to keep all items clean when handling drains or bandages. It is important to wash hands well before and after emptying drains or changing bandages.
  • Information about activities that are allowed and those to be avoided in the first few days after surgery will be given.
Analgesics will be prescribed, although discomfort after the surgery is not usually severe.

After recovering from lumpectomy:
  • Most women undergo radiation therapy for the breast cancer.
  • Women may have chemotherapy if the laboratory report shows that cancer spread to the lymph nodes.
What are the potential complications after the procedure?
Bleeding and infection are possible complications of lumpectomy.

Author: Susan Woods, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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