Introduction
A lumpectomy, also known as breast-conserving surgery or a partial mastectomy, is a surgical procedure designed to remove a cancerous tumor or abnormal tissue (the “lump”) from the breast, along with a small margin of surrounding healthy tissue. Unlike a full mastectomy, which removes the entire breast, a lumpectomy aims to conserve as much of the natural breast as possible while effectively treating the cancer. It is often a preferred option for women diagnosed with early-stage breast cancer where the tumor is relatively small compared to the overall breast size. To ensure all microscopic cancer cells are destroyed and to reduce the risk of recurrence, a lumpectomy is almost always followed by a course of radiation therapy.

Surgical Procedure
A lumpectomy is typically performed as an outpatient procedure under general anesthesia, though local anesthesia with heavy sedation may be used in some cases.
Before the surgery, if the lump cannot be easily felt, a radiologist may perform a wire localization or use a radioactive seed to pinpoint the exact location of the tumor for the surgeon. During the procedure, the surgeon makes an incision over or near the tumor. The lump and a rim of normal, healthy tissue surrounding it (the margin) are carefully excised.
Often, during the same operation, the surgeon will perform a sentinel lymph node biopsy. This involves making a separate small incision under the arm to remove one or a few of the first lymph nodes to which cancer is most likely to spread. This helps determine the stage of the cancer. The breast incision is then meticulously closed with dissolvable stitches to preserve the breast’s cosmetic appearance as much as possible.

Surgical Risks
Standard surgical risks apply, including adverse reactions to anesthesia, bleeding, and the formation of blood clots.

General Complications
Common, usually temporary complications following a lumpectomy include:
– Pain, tenderness, and a feeling of firmness or pulling in the breast and underarm area.
– Swelling and bruising around the surgical site.
– Changes in the shape or size of the breast, which may become more apparent after radiation therapy.
– Temporary numbness or altered sensation in the breast or underarm.

Rare but Serious Complications
– Infection of the surgical wound, requiring antibiotics or, rarely, surgical drainage.
– Lymphedema: Swelling in the arm or hand on the side of the surgery, particularly if lymph nodes were removed.
– Positive Margins: If the pathology report indicates cancer cells are present at the edge of the removed tissue (a “positive margin”), a second surgery (re-excision) may be required to remove more tissue.

Pre-operative Preparation
– Consultations: Detailed discussions with a surgical oncologist and a radiation oncologist to understand the full treatment plan.
– Medical Tests: Recent mammograms, breast ultrasounds, or MRIs to accurately map the tumor.
– Medication Management: Stop taking blood-thinning medications, aspirin, and certain supplements at least a week before surgery to reduce bleeding risks.
– Fasting: No food or drink for 8 to 12 hours prior to the procedure.

Post-operative Care
Because it is usually an outpatient procedure, patients can go home the same day after recovering from anesthesia. Pain is typically manageable with prescribed or over-the-counter pain relievers. A supportive surgical bra is often provided and should be worn day and night to minimize movement and reduce swelling.

Wound Care
– Keep the dressing clean and dry. You will receive instructions on when you can safely shower (often after 24-48 hours).
– Do not take baths or swim until the incision is completely healed and cleared by your doctor.
– The stitches are usually dissolvable and will not need to be removed. Steri-Strips covering the incision will eventually peel off on their own.
– Monitor the incision for signs of infection, such as increasing redness, heat, swelling, or foul-smelling drainage.

Diet
– Resume a normal, healthy diet. Ensure adequate protein intake to support tissue healing.
– Stay hydrated and eat high-fiber foods to prevent constipation, a common side effect of pain medications and anesthesia.

Post-discharge Notes
Recovery from a lumpectomy is generally faster than a mastectomy, often taking 1 to 2 weeks.
– Avoid heavy lifting, strenuous exercise, and repetitive arm movements for at least 2 to 4 weeks.
– Perform gentle arm exercises as instructed by your healthcare team to maintain mobility and prevent stiffness in the shoulder.
– Radiation therapy usually begins a few weeks after the surgical incisions have fully healed.
– Contact your doctor if you experience a fever, severe pain, excessive swelling, or signs of infection. Attend all scheduled follow-up appointments.