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Breast-conserving surgery removes the cancer
and surrounding tissue. The goal is to take just enough tissue so that the
breast looks as normal as possible after the surgery but the chance of the
cancer coming back is low.
The size and location of tumors differs
from one person to another, so the amount of tissue removed during surgery also
varies. To make it simple, you can think of two general breast-conserving
surgeries: a lumpectomy and a partial mastectomy.
Some of the lymph nodes under the arm may also
be removed during breast-conserving surgery. This is done with a separate incision. If cancer is found
in those lymph nodes, more lymph nodes may be removed.
Most people who have
breast-conserving surgery also have
radiation therapy. You may also have
hormone therapy, or both.
A lumpectomy can be done with
local anesthesia if you are not having lymph nodes
removed. If you are having lymph nodes removed or are having a partial
mastectomy, you will have
After your surgery,
you will be taken to a recovery room. A nurse will be able to help with any
nausea, pain, or anxiety you might have.
Many people go home the
day of the surgery, but you may stay in the hospital for a day or two. Your
doctor or nurse will give you instructions on pain control and caring for the
surgical wound. Typically, you can remove the bandage and take a shower on the
day after surgery. Women can wear a bra if it is comfortable. Some doctors
recommend wearing a bra day and night for a few days for support.
Most people are able to get back to normal activity within a few days.
But be sure to wait for your doctor to tell you when you can start with more
strenuous physical activity. This will depend on the extent of the surgery and
on other treatment you might be having.
If you are going to have radiation therapy, it will not
start until the wound heals. This usually takes at least 2 weeks.
Breast-conserving surgery is done in
early-stage breast cancer to remove as much cancer as possible and give the
greatest chance of a cure.
For early-stage breast cancer, breast-conserving surgery with radiation therapy has the same survival rate as mastectomy.1
Complications of breast-conserving surgery are
unusual but include infection, bleeding, poor wound healing, or a reaction to
the anesthesia used in surgery. Blood or clear fluid may also collect in the
wound and need to be drained. You may have breast pain and feelings of pulling, pinching,
tingling, or numbness.
Compared to women who have a mastectomy, women who have breast-conserving surgery have a slightly higher chance of the cancer returning.
The more breast tissue that is removed during this surgery, the
more likely it is that there will be a noticeable change in the breast
afterwards. Experts suggest that before having breast-conserving surgery, women
talk with their doctors (and possibly a plastic surgeon) about what their
breasts might look like after the surgery.
Breast-conserving surgery can be considered after the cancer has been
staged. Breast-conserving surgery may not be the best
choice in some cases, depending on the size of the tumor or if there are several tumors that are too far apart.
Breast-conserving surgery is usually followed
by radiation. If you don't want to have radiation therapy or if you cannot have
radiation treatment, breast-conserving surgery is not usually a good choice.
Radiation therapy has to be done on a set schedule and takes
several weeks. If you do not think you can go to every appointment, talk to
your doctor about other treatment options.
Surgery is almost always recommended to treat breast
cancer. If breast-conserving surgery is not a good option for you, then total
or modified radical
mastectomy, which removes the entire breast and
sometimes the surrounding tissue, may be a better treatment choice.
Complete the surgery information form (PDF)surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Fisher B, et al. (2002). Twenty-year follow-up of a
randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus
irradiation for the treatment of invasive breast cancer. New England Journal of Medicine, 347(16): 1233–1241.
Other Works Consulted
Weber ES, Sherk SD (2009). Lumpectomy. In B Narins, ed., Gale Encyclopedia of Surgery and Medical Tests: A Guide for Patients and Caregivers, 10th ed., vol. 3, pp. 1013–1017. Farmington Hills, MI: Gale.
June 28, 2013
Sarah Marshall, MD - Family Medicine & Douglas A. Stewart, MD - Medical Oncology
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