Mastectomy

Definition

Lumpectomy is the removal of part of the breast. It is considered a breast-conserving surgery.

Lumpectomy may be combined with a procedure to sample lymph nodes in the area (axillary dissection or sentinel node biopsy).

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

• Accumulation of blood in the wound
• Accumulation of clear fluid in the wound
• Lymphedema—swelling of the arm caused by accumulation of fluid in lymph nodes
• Infection
• Numbness of the nipple or underarm skin
• Change in the size and/or shape of the breast
• Blood clots
• Reaction to anesthesia

Some factors that may increase the risk of complications include:

• Obesity
• Poor nutrition
• Smoking
• Recent or long-term illness
• Use of certain medications
• Characteristics of the tumor to be removed

Reasons for Procedure

This procedure is done to treat breast cancer.

What to Expect

Prior to Procedure

Your doctor will likely do the following:

• Physical exam
• Mammogram
• Fine needle biopsy to test the breast tissue for cancer
• Blood and urine tests
• Wire-localization procedure—if the tumor was visible on mammogram, but is not able to be felt, the doctor will use a wire to mark the tumor

Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.

Do not eat or drink anything for 8-12 hours before surgery, unless your doctor tells you otherwise.

Anesthesia

General anesthesia—you will be asleep during the procedure

Description of Procedure

A small cut will be made in the breast. The tumor will be cut out, along with some of the surrounding tissue. Another incision near the armpit may be made so that lymph nodes can be removed. The nipple and areola will not be removed. Plastic tubes for drainage may be inserted. The incisions will be closed with stitches.

Lumpectomy

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Immediately After Procedure

Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:

• Pain medications
• Antibiotics to prevent infection
• Medication to prevent blood clots

Removed tissue will be examined. The findings may determine if any further surgery is needed. If you had cancer and it has spread, chemotherapy and/or radiation therapy may be needed.

How Long Will It Take?

About 1-3 hours

Will It Hurt?

Anesthesia will prevent pain during the procedure. Pain and discomfort after the procedure can be managed with medications.

Postoperative Care

The breast may change in size or shape after lumpectomy. There may be local skin discoloration from dye used to localize lymph nodes for biopsy. The dye may also discolor your urine for a short time after surgery.

Self-care measures and medications will help ease discomfort. Activity may be restricted for up to 1 month, but complete rest is not necessary. The care staff will help you with exercises to help maintain arm strength and prevent lymphedema. To prevent infection at the incision site, follow instructions on how to clean and care for the wound.

Call Your Doctor

Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
• If you have drains, report any problems that your doctor has discussed with you
• Oozing or discharge from nipples on either breast
• A lump, redness, or swelling in either breast
• If lymph nodes were removed: redness, warmth, swelling, stiffness, or hardness in the arm or hand
• Persistent nausea and/or vomiting
• Pain that you cannot control with the medications you've been given
• Cough, shortness of breath, or chest pain
• Pain and/or swelling in your feet, calves, or legs
• Symptoms of depression that last at least 2 weeks or longer
• New or unexpected symptoms

If you think you have an emergency, call for medical help right away.