About Lumpectomy
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What is a lumpectomy?
Lumpectomy is a surgery performed to remove a lump in the breast, along with the tissue surrounding it. During lumpectomy, lymph nodes may also be removed by making a second incision near the underarm. Lumpectomy intends to preserve a normal appearance of the breast after the surgery.
Patients who undergo lumpectomy are often women whose breast cancer is at an early stage. However, patients who have cancer that has spread to different areas in a single breast, and who have already received radiation therapy are not usually suitable for a lumpectomy. Pregnant women are also not eligible for a lumpectomy.
After a lumpectomy, radiation therapy that goes on for 5 to 8 weeks is also used to cure the remaining breast tissue.
How to prepare for a lumpectomy?
- Before a lumpectomy, the doctor examines the patient and performs some tests. These include:
- Physical examination
- Mammogram
- X-ray
- Blood test
- Urine test
- Fine-needle biopsy
- Wire-localization procedure for impalpable tumors
- The patient should inform the doctor about
- Health and medical conditions such as pregnancy or heart disease
- Any medication the patient may be taking
- The doctor will inform the patient about the surgical procedure and what to expect from it.
- The doctor will decide which type of anesthesia should be given to the patient after determining the extensiveness of the surgery.
How is a lumpectomy performed?
Firstly, the patient¡¯s breast, chest and upper arm are cleaned. Then an incision over the tumor in the breast is made. If the tumor cannot be accessed, the incision is made around the areola. The tumor is then cut along with the surrounding layer of tissue. This surgery aims to remove the tumor with minimal damage to the breast. However, a testable size of tissue needs to be removed to be sent for tests that will determine if it is a limited cancer or if it has spread.
A second incision may be made near the underarm to remove axillary lymph nodes. These will also be tested for cancer. The test results will determine if the cancer has spread to other areas in the body.
After removing the tissues and the lymph nodes, a drainage tube may be placed which can be later removed. The bleeding is stopped and the wound is closed with stitches that will dissolve in due course. The site is then bandaged.
Duration of procedure/surgery : 1 to 3 hours.
Days admitted : Lumpectomy is usually done on an outpatient basis. However, in some cases patients may need to be admitted for a day or two in the hospital.
Anesthesia : General or local anesthesia depending on the extensiveness of the surgery.
Recovery : - If the results show that the patient has cancer, follow-up treatments with the doctor will be scheduled.
- There is not much pain after the surgery. However, if there is pain, the doctor will prescribe some pain medication.
- Most patients can resume normal activities in a week.
- The surgery area will heal in approximately one month.
Risks : The risks involved in a lumpectomy are as follows:
- Bleeding
- Adverse reaction to medication
- Infection
- Change of appearance of the breast. E.g. scar, dimpling, or shape difference between the two breasts.
- Microscopic sized lumps may not be removed by the surgery. Another surgery may be required if this happens.
- The breast area may become numb.
After care : - The incision region should be dressed and changed according to the doctor¡¯s orders.
- A fluid drain may be kept for 1 to 2 weeks, which may need to be drained from time to time.
- The patient should avoid strenuous activities such as jogging or lifting heavy objects for 1 to 2 weeks.
- The patient may be asked to do some special exercises to keep the arm flexible.
- There will be scarring in the surgery area. Clothing and bra choices may be discussed with the patient.
The doctor should be informed if there are any signs of:
- Infection, redness, swelling, and tenderness
- Growing pain
- Bleeding and over discharge of fluid
- Breathing difficulty
- Chest pain
- Nausea and vomiting
- Infection and pus formation in the underarm
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