Lumpectomy, Wide Local Excision

What Is Lumpectomy?

A Lumpectomy is also called wide local excision or breast-conserving surgery.

A Lumpectomy is a surgical procedure to remove a malignant tumour and removes a lump along with some of the surrounding normal tissue from a woman’s breast.

Lumpectomy is a type of breast conservation or preservation surgery.

Indications for a Lumpectomy

• Early-stage breast cancer
• Breast cancer shrunk by neoadjuvant treatments

Lumpectomy Surgery

The aim of the procedure is to remove the abnormal tissue and retain the normal appearance of the breast. Lumpectomy can be performed as a day stay or inpatient procedure and is usually done under general anesthesia although it sometimes can be done under a local anaesthetic.

The tumour may need to be located preoperatively by a radiologist if it cannot be felt. At operation, an incision is made in a cosmetically acceptable place.

The surgeon then removes the tumour along with a small layer of surrounding tissue and sends it to the laboratory for investigation. The breast is often reshaped or ‘remodelled’ to improve the appearance and avoid any resultant ‘divots’. Your surgeon may also remove lymph nodes in your armpit (axilla) to see if the cancer has spread to the lymph nodes. This may or may not require a further incision.

At the end of the procedure, the incisions are closed with dissolvable sutures and a soft waterproof dressing is placed over the surgical area.

After the Lumpectomy Procedure

• Make sure you get enough rest so that you can return to normal activities in a few days.
• Your doctor may prescribe medications and antibiotics to reduce pain and inflammation.
• Keep the dressing undisturbed to avoid infection.  Showering is permitted.  Your specialist will remove the dressing at the post-op appointment.
• A follow-up appointment should be scheduled 1-2 weeks after surgery to examine your progress and to discuss the pathology and further treatments.

All cancer patients are discussed in a multi-disciplinary meeting with other cancer specialists and specialist involved in their care to determine the best treatments to ensure all cancer has been eradicated and will not return.

Radiation therapy is usually recommended after lumpectomy to reduce the chances of local recurrence.

Risks and Complications of a Lumpectomy Procedure

As with any surgery, Lumpectomy procedures are usually safe but may involve

• The risk of infection,
• Bleeding,
• Pain,
• Swelling in your arm,
• Hard scar tissue formation at the site of surgery,
• A change in the size and shape of the breast.
• Shoulder pain and stiffness, numbness (especially under your arm), and
• Accumulation of blood or fluid (seroma) in the surgical site.