Lumpectomy (Partial Resection)

The surgical removal of a small portion of breast tissue that is malignant or thought to be cancerous is known as a lumpectomy. It's also known as a partial mastectomy or breast-conserving surgery. Depending on a variety of criteria, lumpectomies may be an option in some cases of breast cancer but not all. Whether you have a lumpectomy or a mastectomy (total removal of one or both breasts) will significantly impact your post-operative treatment.

 

Lumpectomy

Lumpectomy is the surgical resection of a breast tumor and some surrounding tissue. Because it keeps the breast's shape and appearance, it is a common procedure for treating early-stage breast cancer. Additionally, lumpectomies are performed to confirm cancer diagnoses from biopsies and to remove non-cancerous or pre-cancerous tumors. The main surgical alternative to a mastectomy, which involves removing the entire breast, is tumor excision. Breast-conserving surgery, wide local excision, and partial mastectomy are other terms for the lumpectomy.

Although they have a variety of risks, lumpectomies are beneficial in the treatment of breast cancer. The doctors and other caring experts can provide support if you or a loved one is worried about breast cancer and considering treatment options.

 

Purpose of Lumpectomy

This procedure is often only performed on patients who need to remove a single, very tiny region of tissue. Patients with a large tumor might require a mastectomy or another more invasive procedure that would remove considerably more breast tissue.

After the mass has been removed, it can be analyzed to see if it is cancerous and, if it is, to acquire important information about the tumor that can help inform your treatment strategy.

Although a lumpectomy is less disfiguring than a mastectomy and normally doesn't require reconstructive plastic surgery afterward, it can nevertheless result in major changes to the appearance of the breast if a significant quantity of tissue is removed. In addition to the scar or scars left behind after surgery, the skin's texture near the surgical site may also change noticeably. Even when the skin heals, it could still be clear that tissue is missing from the area.

 

Lumpectomy vs Excisional Biopsy

These methods may seem identical, yet they each have a different purpose. After breast cancer has been identified, a lumpectomy is done to remove the entire tumor as well as a healthy margin of surrounding tissue. Excisional biopsies are performed as diagnostic tests, not as surgical interventions.

 

Lumpectomy vs Mastectomy

For women considering breast cancer surgery, a lumpectomy or a mastectomy are the two main options. Because removing the entire breast would get rid of any tumors or malignant cells that were missed during biopsy and diagnosis, a mastectomy may seem to be the safer option. However, studies have shown that when radiation therapy is added, the 20-year survival rates for mastectomies and lumpectomies are about equal. The additional benefit of a lumpectomy is that the breast is largely unaffected. The following factors make lumpectomies more suitable than mastectomies:

• Receiving an early breast cancer diagnosis (stages 1 or 2)
• Having ductal carcinoma in situ
• Having just one tumor
• A tiny tumor in comparison to breast size
• Being an excellent candidate for radiotherapy or another type of adjuvant treatment.

Before a lumpectomy, chemotherapy may be given to women who have large tumors to reduce the size tumor. During the surgery, one or more lymph nodes might also be removed. After surgery, a pathologist will examine the lymph nodes and the tissue surrounding the tumor to look for signs that cancer has spread from its original site. The advantages of a lumpectomy are as follows:

• The breast is largely undamaged.
• Surgery doesn't have as much of an emotional impact.
• quicker healing than after a mastectomy.

 

Lumpectomy Preparation

During the lumpectomy, your surgeon might wish to examine your lymph nodes. In that situation, you'll require a sentinel lymph node biopsy in addition to a lymphoscintigraphy, both of which will take place before your lumpectomy date.

You might be able to schedule a preoperative consultation at the hospital where you're having a lumpectomy. This gives you the chance to ask questions, get the paperwork out of the way, and make sure you know where to go on the big day. To avoid surprises later, read consent forms carefully before you sign them.

These things will all be taken care of when you show up for your lumpectomy if you don't have a pre-op visit. Before your surgery, you should not hesitate to contact your doctor with any questions you may have.

The facility will probably ask you to show up a few hours before your treatment is scheduled. The actual procedure should take between one and two hours.

If you are having an outpatient procedure, you can spend a few hours in recovery before being discharged and sent home.

Lumpectomies can be carried out either as an inpatient or an outpatient procedure. They are typically carried out in surgical facilities or hospitals rather than in doctors' offices.

You may wish to wear something simple to change out of as you will be wearing a surgical gown during the procedure.

If you're going to wear the same outfit home, give it some thought: You’ll likely be instructed to wear a soft but supportive bra, like a sports bra. Underwires might not feel comfortable. After the procedure, you shouldn't lift your arms above your head, therefore a button-down shirt is a necessity.

Before your surgery, be sure to discuss any prescription medications and nutritional supplements you may be taking with your healthcare providers. Some of them might need to be avoided for a week before surgery, particularly if they can cause more bleeding. Aspirin, ibuprofen, fish oil, and vitamin E are a few typical over-the-counter medications that can have this effect. Your operation can be postponed if you don't stop taking them when you should.

Before surgery, you should fast for eight to twelve hours. You should check with your doctor in advance to see if you can take any prescribed drugs with a little water.

Make sure you have your insurance card, photo ID, a method of paying your co-pay, and any paperwork your healthcare provider may have provided you when you show up for your pre-op visit or surgery.

Bring a list of your current drugs and your medical history with you as well. Any relevant allergies you may have to drugs, latex, adhesive, etc., should be mentioned to your healthcare professional. Be sure to let them know if you have any food sensitivities if you're staying the night.

Bring a book or electronic device to pass the time before the operation. Regular personal care supplies like a toothbrush and everything else you need to make yourself more comfortable are required if you want to remain the night.

If you are having a lumpectomy under general anesthesia or in an outpatient clinic, you should make arrangements to have someone drive you home after the treatment.

 

Lumpectomy Surgery

An expert in cancer surgery known as a surgical oncologist often performs lumpectomy procedures.

When you get there for surgery, you'll check in and start getting ready. Try to arrive early enough to handle paperwork and co-pays before the time for your treatment is planned. Usually, the facility will mention what time they prefer you to arrive.

 

Before the Surgery

Once everyone has been admitted, you will change into a hospital gown, and your clothing will be stored in a secure location. Your vital signs will be taken, and a nurse will enquire about you. Your breast may be marked to ensure that the proper breast is operated on and possibly to show where the cut should start. A few members of the surgical team, including your surgeon and the anesthesiologist, will visit you to speak with you. They will explain the procedure to you, the type of anesthetic you will receive, and perhaps even give you anti-nausea medication. Your hand will be inserted with an intravenous (IV) line so that you can receive fluids, anesthetic, and possibly other medications through it.

 

During the Surgery

General anesthesia or a light sedative with a local anesthetic to numb the surgical site can both be used to do a lumpectomy. Which one you get is somewhat based on personal preference and the extent of the procedure.

Once you're ready, the doctor will use a heated, specially designed scalpel to create the incision, cauterizing your tissue to help reduce bleeding. Because it usually follows the shape of your breast, the incision can heal appropriately.

The surgeon will examine the mass to identify the type of tissue it is made of after opening the skin and locating the tissue that has to be removed.

In certain cases, the mass can be a cyst, a tiny sac filled with fluid. The fluid will be evacuated and preserved for later analysis if that is the case.

The tissue lump will typically not be a cyst, and it will be excised from your breast. The margin, which is the region surrounding the tumor, will also be excised along with the tissue that is thought to be malignant. If cancer cells have invaded that area, this is performed for safety.

A pathologist will later examine all of the tissue that has been collected. The surgeon will also examine the area to determine if the lump has affected any other body parts, such as the muscle under the breast.

The surgeon will then look for any signs of malignancy in the remaining breast tissue. The incision can be stitched closed if there are no signs of more abnormal tissue.

To check for cancer spread, the surgeon may occasionally additionally remove lymph nodes or take samples from them. A different incision under the arm is necessary for this. Depending on the situation, the surgeon might remove 15 or 20 lymph nodes or just sample a few. After surgery, a drain will be removed after it has fulfilled its function of removing extra fluid.

 

After the Surgery

After being brought to a recovery room, you will be kept under observation until you awaken from anesthesia. If you are heading home that day, you will receive follow-up instructions before you can leave as long as there are no problems. Then, if you plan to stay overnight, you will be taken to your hospital room. Before you leave, make sure you understand how to take any prescription medications and whom to call if issues develop.

 

Lumpectomy Recovery

A typical lumpectomy, which involves removing a mass smaller than 5 centimeters, results in a three- to the four-week recovery period.

The healing process could take up to six weeks if additional tissue needs to be removed during the treatment.

Instead of being removed, dissolvable sutures can be gradually dissolved by the body over time. Typically, after two weeks of the procedure, the surgeon will remove the standard sutures during an office visit.

Most likely, the first two to three days will be the most painful, with subsequent days seeing a small improvement in the pain. Make sure you care for your incision as instructed.

Lifting, as well as any activity that requires jumping or raising your arms above your head, is not advised during the first few weeks after recovery since it might stretch the incision and make the pain worse. Until you receive permission, wait to start exercising again.

For the first week or two after surgery, you might be told to wear a compression bra continuously since it will lessen breast movement, alleviate pain, and support the incision.

Take your painkillers as prescribed. Call your doctor to discover what more you can do if your pain can't be effectively managed. Keep bandages dry, and if you have a surgical drain, follow the instructions.

 

Lumpectomy Results

You will get the pathology report after the tests on your tumor are finished. This offers crucial information that can help you choose your next course of treatment. For instance, the surgeon may need to eliminate more tissue to reduce the chance of recurrence if the margin contains cancer cells.

Radiotherapy is advised to address any malignant spots that might not have been identified during the surgery if the lump is evaluated and determined to be cancerous.

Keep your follow-up appointment with your healthcare practitioner so you may go over your results and the next action to take.

 

Lumpectomy Cost

A partial mastectomy (lumpectomy) can cost anywhere between $3,700 and $9,700. If you have insurance, speak with your provider to find out whether you will pay any fees and when those fees are due. Additionally, confirm that your insurance covers the hospital, the facility, and the tests that will be performed on your tumor after it has been removed. If you have a co-pay, unless otherwise instructed, plan to pay it before operation.

 

Conclusion

A positive sign that you may be a candidate for a lumpectomy is that, even if you do have breast cancer, it is probably localized to a tiny area. After the mass is excised and tested, you will know a lot more, and knowledge is power when it comes to choosing the best course of action for treating cancer.