by Krisha McCoy, MS
Anatomy and Physiology
A woman's breasts are composed of glandular tissue and ducts, fat, connective tissue, blood vessels, and lymph vessels. The glands produce and secrete milk for breastfeeding an infant.
Changes in the breast are common. A woman's breast tissue changes over the course of her lifetime. It also changes during her menstrual cycle or if she is taking hormones.
One type of breast change is the development of a lump or mass. Breast masses are often found upon self-examination or by a mammogram. Most are not cancerous; about 80% of breast lumps that require a biopsy prove to be benign. A breast biopsy is necessary to determine if a mass is cancerous.
Reasons for Procedure
A lumpectomy can be used to both diagnose and treat a suspicious mass or lump in the breast. When used to treat breast cancer, a lumpectomy is often referred to as breast conservation therapy because it's intended to preserve the appearance of the breast.
In a lumpectomy, a suspicious mass, along with a margin of surrounding tissue, is removed from the breast and sent to a laboratory for examination. This differs from a simple biopsy in which the mass is removed but the surrounding tissue is left in place.
If the mass is found to be cancerous, a lumpectomy is usually combined with radiation therapy to ensure that all of the cancer has been successfully removed or treated. Additional treatments may include: Chemotherapy and hormonal therapy.
If your surgery requires general anesthesia, you should make some preparations in the days leading up to your procedure: Arrange for a ride to and from the hospital. The night before, eat a light meal and do not eat or drink anything after midnight. If you regularly take medications, ask your doctor about the need to temporarily discontinue them. Do not start taking any new medications before consulting your doctor.
Depending on what you and your doctor decide, a lumpectomy may be performed under local or general anesthesia. If local anesthesia is used, your doctor will numb the tissue around the lump before removing it, and you will be awake for the procedure. If general anesthesia is used, you will be kept asleep.
If your breast lump can be felt, your doctor will simply make an incision in your breast and remove the lump and surrounding tissue. Depending on the size of the lump, he or she may insert a temporary drain before stitching the incision closed.
If your lump is cancerous, your surgeon may also perform a sentinel node biopsy or an axillary lymph node dissection, in which he or she removes several lymph nodes from your underarm to see if any cancer cells have spread there.
If your lump cannot be felt, a radiologist may use a mammogram or ultrasound to guide the insertion of a needle and wire into the mass. Your surgeon will then make an incision at that location, remove the targeted area, place a drain if necessary, and stitch the incision closed.
Risks and Benefits
Complications associated with lumpectomy are rare, but may include: a slight change in the breast's appearance, such as dimpling, scarring, or asymmetry of the two breasts, accumulation of fluid in the wound, infection, loss of sensation to the nipple, complications of general or local anesthesia, and/or persistent bleeding.
Benefits of lumpectomy include: diagnosis of a breast lump as benign or cancerous, removal of a suspicious or cancerous mass, and/or avoidance of more extensive, disfiguring breast cancer surgery.
In a lumpectomy, or any procedure, you and your doctor must carefully weigh the risks and benefits to determine whether it is the most appropriate treatment choice for you.
After the Procedure
After a lumpectomy, little recovery time is necessary. You will probably go home the same day as the procedure.
Your doctor will want to see you several days after the procedure to examine the wound, remove any sutures or drains left in place, and to inform you of the results of the surgery. If your lump is cancerous, you and your doctor will discuss the need for additional treatments, such as radiation therapy, chemotherapy, and/or hormonal therapy.
Be sure to contact your doctor promptly if you experience: a fever over 101°F, increased pain, warmth, or redness at the incision site, swelling that does not subside in a few days, excessive bleeding or discharge at the incision site, cough, chest pain, or shortness of breath.
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