Breast Conservation Surgery (Lumpectomy)

Breast Conservation Surgery (Lumpectomy)

WHAT IS BREAST CONSERVING SURGERY?

Breast-conserving surgery, also called lumpectomy or wide local excision, involves the removal of the tumor with a rim of normal tissue. There are a variety of techniques that can be used to reshape the breast and preserve its appearance after the tumor is removed, known as Oncoplastic breast surgery.
Breast-conserving surgery is recommended if the cancer is small compared to the size of your breast. It is almost always combined with radiotherapy.
Research has shown that breast-conserving surgery followed by radiotherapy is as effective as mastectomy in treating early breast cancer. The chance of the cancer coming back in another part of the body is the same with either type of surgery.
WHAT ARE THE ADVANTAGES OF BREAST-CONSERVING SURGERY?
• Your breast is left in place and your appearance will not be changed as much as it would be following a mastectomy.
• It also won’t have mastectomy complications.
WHAT ARE THE DISADVANTAGES OF BREAST-CONSERVING SURGERY?
• You may require further surgery if the initial operation does not completely remove all the cancer (positive margins).
• Radiotherapy is almost always recommended after breast conservation surgery. It involves going to the hospital for daily treatment for 3 to 6 weeks.
• Your breast will look different. How different it looks depends on the size and location of the cancer and the size and shape of your breast. Your treated breast may be slightly larger and heavier than your other breast or it may become smaller over time. This is due to a combination of surgery and radiotherapy and the effect is difficult to predict.

The operation is performed under general anesthesia. An incision is made in the skin of the breast and the tumor (along with any inserted wires) is removed. Metal clips may be left to mark the cavity – this is to guide radiotherapy. The clips are made of titanium (the same metal used for joint replacement surgery) and can be safely left in the breast. The breast is then reshaped to preserve its appearance.
Surgery for invasive breast cancer will usually involve a separate procedure to remove some or all of the lymph nodes in the armpit to be tested for cancerous cells. There are 2 types of axillary surgery – sentinel node biopsy (removal of a few nodes) and axillary dissection (removal of all the lymph nodes). Recommendations for treatment of the lymph nodes are separate from recommendations to breast treatment. For example, breast-conserving surgery can be combined with sentinel node biopsy or axillary dissection.
WHAT ARE THE RISKS INVOLVED IN BREAST-CONSERVING SURGERY?
All surgery has risks despite the highest standard of practice. The following possible complications are listed to inform not to alarm. There may be other complications that are not listed.
• Bleeding
• Infection
• Seroma, a build-up of fluid in the cavity where the tissue has been removed. Sometimes it can cause a swelling and the fluid may need to be removed with a needle and syringe.
• Scarring
• Breast pain and swelling which may last for months

Physical Activity after breast-conserving Surgery:
You are encouraged to do as much walking as is comfortable. Avoid activities that create a lot of ‘breast bounce’ for 4 weeks.
You should not drive until your doctor permits you.

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