Lumpectomy - The

Procedure

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Lumpectomy (also called breast conserving surgery, partial mastectomy or wide excision) is often
done under general anesthesia, which means you are unconscious (asleep) during the surgery. In
some cases, regional anesthesia may be used.
The surgeon makes an incision (cut) in the breast and removes the tumor, along with a small rim of
normal tissue around the tumor. He/she then closes the incision with stitches, trying to keep the
breast looking as much like it did before surgery. The surgeon may also make an incision in the
underarm area and remove some lymph nodes.
In some cases, more than one surgery is needed to get clean margins. Clean (also called uninvolved
or negative) margins mean there is only normal tissue (and no cancer cells) at the edges of the
tissue removed from the breast. Learn more about assessing margins.
The tissue removed during surgery is sent to a pathologist for detailed testing. Learn about the
results of the tests and other information found in your pathology report.

Finding the tumor in the breast

In some cases, the surgeon uses special methods to help find the exact area of the breast that
contains the tumor.

Wire-localization (needle-localization) at the

time of surgery

Sometimes breast cancers found by mammography (or other imaging) are nonpalpable (cannot be
felt). If the tumor is nonpalpable, a procedure called wire-localization or needle-localization will be
done just before surgery.
A radiologist uses a mammogram, breast ultrasound or breast MRI as a guide and inserts a very thin
wire into the breast in the area of the cancer. Local anesthesia is used with this procedure.
The surgeon then uses this wire as a guide to find and remove the tumor during surgery. The wire
will also be removed during surgery.

Radio-opaque clip during a needle biopsy

A core needle biopsy is often used to diagnose breast cancer. It removes a small amount of tumor
tissue. During a core needle biopsy, a radio-opaque clip is often placed in the breast to mark the
location of the tumor. (You cannot feel the clip.)
Later, when you have breast surgery, the surgeon uses the clip as guide to find and remove the
tumor. The clip will also be removed during surgery.

Assessing margins (Was the entire

tumor removed during surgery?)
A pathologist checks the tissue removed during surgery. By looking at the tissue under the
microscope, the pathologist determines whether the entire tumor was removed. The pathologist
looks at the rim of tissue (called a margin) around the tumor to check whether it contains cancer
cells.
Learn more about assessing tumor margins.

Assessing lymph nodes (Has

cancer spread to the lymph
nodes?)
During lumpectomy for invasive breast cancer, some of the lymph nodes in the underarm area
(axillary nodes) are removed to check for cancer cells. The axillary nodes are often the first place
breast cancer spreads. The presence or absence of cancer in these nodes is one of the most
important factors affecting cancer stage and prognosis.

Learn more about assessing axillary lymph nodes.

Length of hospital stay

The length of the hospital stay after lumpectomy depends largely on whether axillary lymph nodes
are removed. If you have a sentinel node biopsy or you do not have axillary nodes removed, you will
likely go home the day of your surgery.
If you have axillary dissection, you may go home the same day or you may stay overnight in the
hospital. A tube (surgical drain) may be placed in the underarm area to collect fluid. This drain stays
in for a week after surgery.
You should discuss the expected length of your stay with your surgeon and insurance provider.
Learn more about sentinel node biopsy and axillary dissection.

What to expect after lumpectomy

After lumpectomy, you will likely have temporary soreness in your chest, underarm and shoulder.
You will also likely have numbness along the surgical incision (scar).
If axillary lymph nodes are removed during surgery, you may also have some numbness in your arm
and there is some risk of lymphedema. Lymphedema is a condition where fluid collects in the arm (or
other area such as the hand, fingers, chest or back), causing it to swell.
Learn more about the management of surgery-related pain.
Learn more about lymphedema.

Cosmetic issues
Women may choose lumpectomy over mastectomy to keep their breast and have it look (as much as
possible) like it did before surgery. However, lumpectomy will change the look of the breast. Because
some tissue is removed, the breast may be smaller and firmer. There will be a scar and some
numbness.
Radiation therapy (usually given after lumpectomy) can also affect the look of the breast. It can
further shrink the breast and change its texture or feel.

Sometimes, factors like the location and size of the tumor can make it unlikely that a woman will be
happy with the look of her breast after lumpectomy. In these cases, mastectomy (with or without
reconstruction) may be the better option.
In rare cases, a woman may consider having reconstructive surgery (either at the time of their
lumpectomy or later) to maintain a more natural appearance of the breast, or to match the size and
shape of the opposite breast. These surgeries are complex. You may wish to meet with a plastic
surgeon to discuss your options.
Learn more about breast reconstruction.

Transportation, lodging, child care

and elder care assistance
You may not live near the hospital where you will have your surgery. Sometimes, there are programs
that offer help with local or long-distance transportation and lodging. Some also offer transportation
and lodging for a friend or family member going with you. There are also financial assistance
programs to help you with child care and elder care.
Learn more about transportation, lodging, child care and elder care assistance.

Susan G. Komens Bre

1-877 GO KOMEN

Calls to our breast care helpline are answered by a trained and caring staff member Monday through Friday from 9:00 a.m. to 10:

breast cancer questions or concerns, including breast cancer survivors and their families. You can also email the breast care helpl
Updated 7/28/15 - See more at:
http://ww5.komen.org/BreastCancer/LumpectomyTheSurgicalProcedure.html#sthash.JXs0ZPlB.dpuf