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Lumpectomy of Breast

Last updated April 23, 2018

DoveMed.com

Breast Lumpectomy specimen showing cancer involving the breast tissue.


Background Information:

What are the other Names for the Procedure?

  • Breast Conservation Lumpectomy Surgery
  • Quadrantectomy of Breast
  • Segmental Lumpectomy of Breast

What is Lumpectomy of Breast surgical procedure?

  • Lumpectomy of Breast is a surgical procedure that involves the removal of an abnormality on the female breast, which is believed to be cancerous
  • A lumpectomy involves the removal of a cancerous lump from a female breast with some surrounding normal breast tissue. This usually results in no visual change in the appearance of the breast. Hence, it is also known as a Breast Conservation Lumpectomy Surgery

What part of the Body does the Procedure involve?

A Lumpectomy of Breast surgical procedure involves the breast(s).

Why is the Lumpectomy of Breast surgical procedure Performed?

A Lumpectomy of Breast procedure is performed to remove suspected cancerous tumor, within the breast.

What are some Alternative Choices for the Procedure?

A complete breast removal (mastectomy) is another surgical procedure that may be adopted in some circumstances, to remove cancerous tissues from the breast.

What are the Recent Advances in the Procedure?

Use of advanced anesthetic techniques has decreased the risks involved in a Lumpectomy of Breast procedure.

What is the Cost of performing the Lumpectomy of Breast surgical procedure?

The cost of Lumpectomy of Breast surgical procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding the Lumpectomy of Breast procedure and on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006

http://www.surgery.com/procedure/lumpectomy (accessed on 09/20/2014)

http://www.breastcenterlm.org/Treatment/Lumpectomy.aspx (accessed on 09/20/2014)

Prior to Lumpectomy of Breast surgical procedure:

How is the Lumpectomy of Breast surgical procedure Performed?

  • The Lumpectomy of Breast procedure is usually performed under general anesthesia
  • The surgeon excises the tumor with a margin of surrounding normal tissue. The amount of tissue removed, depends on the size of the tumor. This tissue is sent to the pathologist for examination under microscope
  • The surgeon may then remove lymph nodes (collection of immune cells) from the axilla (armpit) for further examination by a pathologist
  • Sometimes, the sentinel node is first removed to check for cancer (sentinel node biopsy)
  • The first lymph node to receive tissue fluid from the breast is called a sentinel node. This is the first node to get infiltrated by cancer, when it spreads. If this is cancer-free, no further lymph node removal is necessary
  • The surgical wound is sutured. A drain maybe left in place to prevent fluid accumulation

Where is the Procedure Performed?

The Lumpectomy of Breast procedure is performed at a hospital.

Who Performs the Procedure?

A general surgeon or an oncological surgeon may perform a Lumpectomy of Breast surgery.

How long will the Procedure take?

A Lumpectomy of Breast procedure usually takes an hour to perform; however, larger tumors may take longer, to be surgically removed.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Lumpectomy of Breast surgical procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken prior to a Lumpectomy of Breast
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Normally local anesthesia is not used; however do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for Lumpectomy of Breast procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Lumpectomy of Breast surgical procedure?

Before a Lumpectomy of Breast procedure, the patient has to undergo certain tests, such as:

  • Routine blood and urine analysis
  • Chest X-ray
  • Mammogram
  • MRI of breast
  • Fine needle aspiration of breast
  • Core biopsy of breast

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Lumpectomy of Breast procedure?
  • Why is this procedure necessary?  How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • What are the costs involved?

During the Lumpectomy of Breast surgical procedure:

What kind of Anesthesia is given, during the Procedure?

General anesthesia by injection and inhalation is administered, prior to the Lumpectomy of Breast procedure.

How much Blood will you lose, during the Procedure?

There is no much blood loss during the Lumpectomy of Breast surgical procedure, unless any complications arise.

What are the possible Risks and Complications during the Lumpectomy of Breast surgical procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

  • Obesity: Generally greater the degree of obesity, greater is the surgical risk
  • Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
  • Advancing age
  • Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
  • Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
  • Poorly functioning liver, as evidenced by increased blood liver function tests
  • Hypertension (increased blood pressure), especially if it is poorly controlled
  • Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
  • Poor lung function, as evidenced by abnormal lung function tests
  • History of bleeding disorders
  • Longstanding illness, such as autoimmune disorders, chronic infections
  • Poor immune system due to a variety of causes
  • The possible risks or complications that may arise during the Lumpectomy of Breast surgery are:
  • Excessive bleeding
  • Infection of the surgical wound
  • Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after the Lumpectomy of Breast surgical procedure?

  • At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise
  • Lumpectomy with lymph node dissection may necessitate a short period of hospital stay; usually 1-2 days

After the Lumpectomy of Breast surgical procedure:

What are the possible Risks and Complications after the Lumpectomy of Breast surgical procedure?

The possible risks and complications that may arise after the Lumpectomy of Breast procedure are:

  • Excessive bleeding
  • Infection in the surgical wound
  • Loss of sensation or numbness
  • Asymmetry of the breasts
  • Fluid accumulation at the site, where tissue was removed
  • Occasionally, the need for additional surgical procedures
  • Obstruction of the lymphatic system leading to swelling of the arm (lymphedema). This complication is very rare though

What is the Prognosis after the Surgery?

A complete recovery from a Lumpectomy of Breast procedure is normally achieved. The prognosis is usually excellent, without any serious complications being noted.

When do you need to call your Physician?

Do contact your physician, if you notice any of the following symptoms:

  • Pain that worsens and swelling of the surgical wound
  • Bleeding or fluid drainage from the surgical wound
  • The occurrence of any symptom that causes uneasiness, such as nausea or vomiting
  • Signs of an infection
  • Dizziness
  • Muscle aches, headache
  • Fever, feeling sick
  • Complications associated with prescription medications used in treatment

What Post-Operative Care is needed at Home after the Lumpectomy of Breast surgical procedure?

At home, the following post-operative care is recommended, after a Lumpectomy of Breast procedure:

  • Resume regular/daily activities as early as possible, which aids in a faster recovery
  • Avoid lifting heavy weights for a few days following the surgery
  • A support bra may have to be worn for a few days, after the procedure
  • Exercises to prevent fluid accumulation and swelling of the arm may be advised
  • Resume showering and keep the wound clean and dry. Avoid taking baths, until the surgical wound is completely healed. Gently wash the surgical wound with an unscented soap
  • Complete the course of prescribed medication under advice of the physician
  • Take stool softeners to prevent constipation
  • Take antibiotic medication to help combat or prevent infection
  • Avoid taking nonprescription medications, such as aspirin. However, individuals may take acetaminophen to relieve pain (as prescribed)
  • Avoid all activities that are physically strenuous for about 2 weeks, after the procedure
  • Resume driving a few days after being discharged from the healthcare facility, or as determined by your physician
  • Individuals are advised to eat lightly the rest of the day following surgery. They may then eat a well-balanced diet, which can aid in a faster recovery

How long does it normally take to fully recover, from the Procedure?

It usually takes approximately 2 weeks to recover from the Lumpectomy of Breast procedure. Radiation therapy is usually required, before treatment is fully complete.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

  • The tissue removed is processed in the laboratory under a pathologist's supervision
  • Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
  • Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Lumpectomy of Breast surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The outpatient facility or a hospital
  • An anesthesiologist (if anesthesia was administered)
  • A pathologist
  • General surgeon or oncological surgeon

The patient is advised to inquire and confirm the type of billing, before the Lumpectomy of Breast surgical procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Sept. 25, 2014
Last updated: April 23, 2018