Lumpectomy (Breast Lumps Removal)

What is a lumpectomy?

A lumpectomy is a type of breast cancer treatment which involves surgically removing a tumour in your breast that can either be malignant or benign. Also known as partial mastectomy or breast-conserving surgery, lumpectomy removes only the part of your breast where the tumour is located.

A lumpectomy helps you retain more of your breast's natural look and shape after cancer. This surgery is different from a mastectomy, in which all of the breast tissue is removed.

After a lumpectomy, the doctor may recommend radiation therapy to reduce the risk of breast cancer recurrence.

Why do you need a lumpectomy?

Your doctor may recommend a lumpectomy to prevent the spread of cancer to other parts of your body while conserving the appearance of your breast.

It is usually the treatment of choice if:

• Only one area of the breast has cancer
• The breast tumour is small, when compared to the size of your breast

Who should not undergo lumpectomy?

Your doctor may not recommend a lumpectomy if you:

• Have a history of previous radiation therapy in the region of treatment
• Have more than one tumour in one area of your breast
• Have scleroderma (hardening of the skin)
• Have systemic lupus erythematosus (chronic disease that causes inflammation in connective tissues)
• Are pregnant

What are the risks and complications of lumpectomy?

All surgeries involve some risk. Lumpectomy is a common procedure and is less invasive compared to a mastectomy. Nonetheless, there are potential risks such as:

• Breast pain or tenderness
• Swelling of the breast
• Changes in the size or shape of the breast
• Hard scar tissue in the surgical site
• Dimple that forms in the surgical site
• Persistent burning or shooting pain in the chest wall, armpit or arm
• Lymphoedema – a chronic condition wherein the lymphatic system fails to properly function, which leads to swelling of the breast, hands or other body parts

To lower the risk of developing complications, it is important to follow the aftercare guidelines given by your doctor. If you experience any side effects or complications, let your doctor know about it immediately. Early detection and intervention can help control the complications and prevent infection.

How do you prepare for a lumpectomy?

To prepare for a lumpectomy, you should inform your doctor about any medications, vitamins and supplements that you are taking, in case they adversely affect your surgery.

In general, you will be asked to:

• Stop taking aspirin and other blood-thinning medication, at least 1 week before the surgery
• Fast for 8 – 12 hours (no food and drinks) before surgery

What can you expect in a lumpectomy?

A lumpectomy can be done as a day procedure. It can also be an inpatient admission depending on the extent of surgery and whether any lymph node surgery or breast reconstruction is done at the same time.

During the procedure

You will be under general anaesthesia. During the lumpectomy:

• Your surgeon will make an incision in your breast.
• They will remove the tumour together with a rim of healthy tissue, and send it to the laboratory for analysis.
• Your surgeon will close the incision with stitches, trying to keep the shape and appearance of your breast.
• A separate incision may be made in your underarm to determine if cancer has already spread beyond the breast.

Since cancer can spread to other parts of the body, it is important to check if the lymph nodes under your arm, near your collarbone and inside your breast have been affected.

After the procedure

The results of the lumpectomy may take 1 – 2 weeks. Your doctor will explain the reports and outcomes of your surgery and decide if you need more treatment. The recurrence of breast cancer after a lumpectomy for most women is low, especially if it is followed by radiation therapy.

Care and recovery after a lumpectomy

For most women, the recovery process from breast cancer lumpectomy may take 2 – 3 days after the surgery. You can resume your normal activities as soon as the soreness or pain in the surgical site subsides (7 – 10 days).

In the meantime, you should:

• Get sufficient rest to facilitate your recovery.
• Take pain medications when necessary. As the incision heals, the intensity of the pain will gradually decrease. Take mild pain relievers with acetaminophen or ibuprofen to relieve post-surgery aches and discomfort.
• Wear a bra with good support. You will need to minimise movement that can cause additional pain so a good support bra worn day and night is essential.
• Continue your arm exercises. Your doctor will show you arm exercises that you can begin doing the morning after surgery.
• Inform your surgeon if you have any signs of infection such as fever, excessive swelling and severe pain.