Lumpectomy: 7 things to know - MD Anderson

A lumpectomy is a type of breast cancer surgery in which the tumor and a small amount of surrounding tissue called the margin is removed. The ... MyChart DonateToday Locations Careers ContactUs Languages Español عربى 中文 Türkçe RequestanAppointment RequestanAppointment NewPatients CurrentPatients ReferringPhysicians Patients&Family BecomingOurPatient BecomingOurPatient WhyMDAnderson PlanningforCare GettingtoMDAnderson WhileYou'reHere InternationalCenter ServicesandAmenities Insurance&Billing Diagnosis&Treatment Diagnosis&Treatment CancerTypes ANewDiagnosis TreatmentOptions CareCenters&Clinics Emotional&PhysicalEffects PatientSupport ClinicalTrials SupportingaLovedOne SupportingaLovedOne CaregiverRoles&Challenges ChildrenandTeens TakingCareofYourself HelpinganMDAndersonPatient DealingwithLoss LifeAfterCancer LifeAfterCancer Legal&FinancialImpactsofCancer Social&EmotionalImpactsofCancer Follow-upCare Long-TermEffectsofCancer SurvivorshipWeek RequestanAppointment CurrentPatients Findinformationandresourcesforcurrentandreturningpatients. ClinicalTrials LearnaboutclinicaltrialsatMDAndersonandsearchourdatabaseforopenstudies. Prevention&Screening ManageYourRisk ManageYourRisk TobaccoControl Diet BodyWeight PhysicalActivity SkinSafety HPV Hepatitis FamilyHistory FamilyHistory GeneticTesting HereditaryCancerSyndromes GeneticCounselingandTestingFAQs CancerScreenings CancerScreenings BreastCancerScreening CervicalCancerScreening ColorectalCancerScreeningExams EndometrialCancerScreeningExams LiverCancerScreeningExams LungCancerScreeningExams MobileMammography OvarianCancerScreeningExams ProstateCancerScreeningExams SkinCancerScreeningExams Women'sScreeningExams Men'sScreeningExams CancerPreventionCenter  TheLydaHillCancerPreventionCenterprovidescancerriskassessment,screeninganddiagnosticservices. Donors&Volunteers Donate Donate RaiseMoney HonorLovedOnes CreateYourLegacy Endowments CaringFund Volunteer Volunteer On-SiteVolunteers VolunteerEndowment PatientExperience TeenVolunteerLeadershipProgram OtherWaystoHelp OtherWaystoHelp GiveBlood Children'sArtProject DonateGoodsorServices AttendEvents CordBloodBank CorporateAlliances CorporateAlliances CurrentAlliances DonateToday  Yourgiftwillhelpsupportourmissiontoendcancerandmakeadifferenceinthelivesofourpatients. ForPhysicians ReferaPatient ReferaPatient ReferringProviderTeam InsuranceInformation InternationalReferrals myMDAndersonforPhysicians SecondOpinionPathology HealthCareProviderResourceCenter ClinicalTrials ClinicalTrials PhysicianRelations PhysicianRelations PhysicianAdvisoryCouncil PhysicianRelationsContinuingEducationProgram ClinicalTools&Resources ClinicalTools&Resources ClinicalCalculators ClinicalPracticeAlgorithms myMDAndersonforPhysicians  OurpersonalizedportalhelpsyoureferyourpatientsandcommunicatewiththeirMDAndersoncareteam. Research Departments,LabsandInstitutes Departments,LabsandInstitutes DepartmentsandDivisions Labs ResearchCentersandPrograms Institutes SpecializedProgramsofResearchExcellence(SPORE)Grants ResearchAreas ResearchAreas BasicScience TranslationalResearch ClinicalResearch Prevention&PersonalizedRiskAssessment ResearchResources ResearchResources ExcellenceinScience CoreFacilitiesandServices OfficeofClinicalResearch OfficeofSponsoredPrograms OfficeofResearchAdministration VirtualResearchSeminars ClinicalTrials  Aspartofourmissiontoeliminatecancer,MDAndersonresearchersconducthundredsofclinicaltrialstotestnewtreatmentsforbothcommonandrarecancers. Education&Training Degrees&Programs Degrees&Programs SchoolofHealthProfessions MDAndersonUTHealthGraduateSchool SummerResearchPrograms Clinical&ResearchTraining Clinical&ResearchTraining GraduateMedicalEducation ClinicalEducationforNon-Physicians ResearchTraining PostdoctoralTraining SkillsTraining&Simulation ProfessionalEducation ProfessionalEducation CME/ConferenceManagement ObserverPrograms ContinuingEducation&ReviewCourses EducationDesign&Innovation ComparativeEffectivenessTraining(CERTaIN) PatientHomeVisits CancerSurvivorshipProfessionalEducation LeadershipInstitute GlobalOutreach GlobalOutreach GlobalAcademicPrograms ProjectECHO NursingEducation&Training NursingEducation&Training ClinicalNurseResidencyProgram PostGraduateFellowshipinOncologyNursing ArgyrosPostdoctoralResearchFellowshipinOncologyNursing ProfessionalStudentNurseExternPrograms NursingAcademicOnlineOrientation EducationResources EducationResources AboutHouston WhyTrainatMDAnderson Videoconferencing Alumni Alumni GivingtotheEducationFund Activities DistinguishedAlumnusAward AlumniStories ApplytoSHP Choosefrom12alliedhealthprogramsatSchoolofHealthProfessions. GMEFellowships Learnaboutourgraduatemedicaleducationresidencyandfellowshipopportunities. Cancerwise 2021 05 Lumpectomy:7thingstoknow Top JumpTo: Back May18,2021 Lumpectomy:7thingstoknow BY KellieBramletBlackburn LastupdatedJune4,2021 Alumpectomyisthemostcommontypeofsurgeryusedinbreastcancertreatment.AtMDAnderson,ourbreastcancersurgeonsperformaround900lumpectomieseachyear.  Sowhatisalumpectomy,andwhatshouldbreastcancerpatientsexpectfromtheprocedureandtherecovery?Andhowdoesitcomparetoamastectomy?  Wespokewithbreastsurgeon PuneetSingh,M.D.,aboutthebenefitsofalumpectomyandwhatpatientscanexpect. Whatisalumpectomy?  Alumpectomyisatypeofbreastcancersurgeryinwhichthetumorandasmallamountofsurroundingtissuecalledthemarginisremoved.Thepurposeofalumpectomyistoremovethecancerouscells.  Itisalsocommonlyreferredtoasbreastconservationsurgerybecauseitleavesmostofthebreastintactcomparedtoamastectomy.  Onitsown,alumpectomydoesnotindicateifcancerhasspread,butitmaybeperformedalongwithasentinellymphnodebiopsy.Thisisaprocedureinwhichsurgeonsremovenearbylymphnodestodetermineifthecancerhasspread.  Alumpectomymayalsobeperformedwithbreastreconstruction,orreconstructioncanbedoneatanothertime,dependingonthepatient’sdiagnosisandwishes.  Whoshouldgetalumpectomy?  Alumpectomyisoftenthetreatmentofchoiceforpatientswithearlystagebreastcancer,butitcanbeagreatsurgicaloptionformanytypesofbreastcancer.  “Wetypicallyrecommenditforpatientswhohavesmaller,early-stagecancer,andweconsiderthesizeofthetumorcomparedtotheoverallsizeofthebreast,”Singhsays.  Typically,alumpectomyisfollowedbyfourtosixweeksof radiationtherapy toensurethattherearenomoreremainingcancercells,solumpectomiesarenotrecommendedtopatientswhocan’twithstandradiation.Somepatientswhohavechemotherapy firstmayconsideritaswell.  Whataretheadvantagesanddisadvantagesofalumpectomy?  Landmarkstudiesdatingbacktothe1970sand80sshowthatpatientswhohavealumpectomyandradiationtherapyhavethesamelowriskforrecurrenceaspatientswhohaveafullmastectomy,orremovaloftheentirebreast.  “Patientsneedtopickwhat’srightforthem,butalumpectomyprovidesthesameverylowrateofrecurrenceaswithamastectomy,butwithashorterandeasierrecovery,”Singhsays.  Whenpairedwiththerightsurveillanceaftertreatment,alumpectomymayalsobeanoptionforbreastcancerpatientswhocarrygeneticmutationslikeBRCA1andBRCA2thatputthematagreaterriskforcancer.  “BRCA-positivepatientsmayassumethatamastectomyistheonlytreatmentoptionforthem,butthat’snotalwaysthecase,”Singhsays.  Alumpectomyallowspatientstoconservemoreofthebreast.Thismaymakeitamorecosmeticallyappealingoption.Italsoallowsmostpatientstopreservethenippleandthesurroundingarea,andmaintainmoresensationorfeelingthantheymightwithamastectomy.  “Somepatientssayitdidn’tevenfeellikethey’vehadsurgeryfollowingalumpectomy,”Singhsays.  Whatshouldpatientspreparingforalumpectomyexpect?  Typically,alumpectomyisashort,outpatientprocedure.Mostpatientsreceivegeneralanesthesia,butcareteamsmayalsouseanIVwithasedative,orrelaxingmedication,andalocalanestheticisusedtonumbtheareabeingoperatedon.  Theproceduretypicallytakesabout15to40minutes.“ButatMDAndersonitmaytakealittlelongerbecausewehavesuchathoroughreviewprocessduringthesurgery,”Singhsays.  AtMDAnderson,afterasurgeonremovesthetissue,it’sreviewedbyapathologistwhousesimagingtoreviewtheentirespecimenasawholeandthenreviewsitagain,sectionbysection.Finally,inamultidisciplinarydiscussion,thepathologist,radiologistandsurgeonwillreviewtheimagestogetheranddecideifmoretissueneedstoberemoved.  In2018,MDAndersonsurgeonspublishedastudythatdemonstratedthatthisdetailedintraoperativereviewofthetissueresultedinamuchhigherclearmarginrate.Thismeansthatmorepatientswerecancer-freeaftertheirlumpectomies.  Thesurgerymaytakelongerifthepatientalsodecidestohavebreastreconstructionatthesametimeasthelumpectomyanddependingonthetypeofreconstructionthepatientchooses.MDAndersonplasticsurgeonsworkwithpatientstodetermineifreconstructionisrightforthem,andifso,whichprocedurebestsuitstheirneeds.Lumpectomypatientsoftenchooseoneofthefollowingtypesofreconstruction:localtissuerearrangement,breastliftand/orreductionorlatissimusdorsiorsimilarflap.  Whatislumpectomyrecoverylike?  Shortlyafterlumpectomyiscomplete,thepatientwillbeabletogohome.ThankstoourEnhancedRecoveryProgram,mostMDAndersonpatientsrecoveryquicklywithlittlepain.  “Somedon’tevenneedpainmedicationorcantakeoverthecounterdrugs,likeibuprofen,”Singhsays.  Recoverymaybelongerifapatienthasbreastreconstructionatthetimeofthelumpectomy.  Willpatientsneedasecondsurgeryafteralumpectomy?  Afterthelumpectomy,theremovedtissueisstudiedbyapathologist.Iftheyfindcancercellsinthenormaltissuesurroundingthetumor,theymayperformasecondsurgery.“Butthankstoourthoroughreviewprocess,mostMDAndersonpatientsdon’tneedasecondsurgery,”Singhsays.  Patientswhochoosereconstructionmayhaveanadditionalsurgeriesdependingonwhattypeofreconstructiontheychoose.  Howwillalumpectomychangeapatient’sappearance?  “Alumpectomy’scosmeticimpactreallyvariesgreatlyfrompatienttopatientanddependsonthesizeofthetumorcomparedtothesizeofthebreastandhowmuchofthebreastisbeingremoved,”Singhsays.  AtMDAnderson,breastsurgeonsworkcloselywithplasticsurgeonstoperformreconstructionthatmeetsthepatients’needsandwishes.  “Makesuretohaveathoroughconversationwithyoursurgicalteamaheadoftimetodiscussyouroptionsforbreastreconstructionandchoosewhat’sbestforyou,”Singhadvisespatientspreparingforalumpectomy.“Withaskilledteamthatlistenstotheirpatient’sgoals,alumpectomycanbeasimple,curativeoptionformanyearly-stagebreastcancerpatients.” RequestanappointmentatMDAndersononlineorbycalling1-877-632-6789.   Alumpectomyisthemostcommontypeofsurgeryusedinbreastcancertreatment.AtMDAnderson,ourbreastcancersurgeonsperformaround650lumpectomieseachyear. Sowhatisalumpectomy,andwhatshouldbreastcancerpatientsexpectfromtheprocedureandtherecovery?Andhowdoesitcomparetoamastectomy? WespokewithPuneetSingh,M.D.,abreastsurgeon,aboutthebenefitsofalumpectomyandwhatpatientscanexpect. Whatisalumpectomy? Alumpectomyisatypeofbreastcancersurgeryinwhichthetumorandasmallamountofsurroundingtissuecalledthemarginisremoved.Thepurposeofalumpectomyistoremovethecancerouscells. Itisalsocommonlyreferredtoasbreastconservationsurgerybecauseitleavesmostofthebreastintactcomparedtoamastectomy. Onitsown,alumpectomydoesnotindicateifcancerhasspread,butitmaybeperformedalongwithasentinellymphnodebiopsy.Thisisaprocedureinwhichsurgeonsremovenearbylymphnodestodetermineifthecancerhasspread. Alumpectomymayalsobeperformedwithbreastreconstruction,orreconstructioncanbedoneatanothertime,dependingonthepatient’sdiagnosisandwishes. Whoshouldgetalumpectomy? Alumpectomyisoftenthetreatmentofchoiceforpatientswithearlystagebreastcancer,butitcanbeagreatsurgicaloptionformanytypesofbreastcancer. “Wetypicallyrecommenditforpatientswhohavesmaller,early-stagecancer,andweconsiderthesizeofthetumorcomparedtotheoverallsizeofthebreast,”Singhsays. Typically,alumpectomyisfollowedbyfourtosixweeksofradiationtherapytoensurethattherearenomoreremainingcancercells,solumpectomiesarenotrecommendedtopatientswhocan’twithstandradiation.Somepatientswhohavechemotherapyfirstmayconsideritaswell. Whataretheadvantagesanddisadvantagesofalumpectomy? Landmarkstudiesdatingbacktothe1970sand80sshowthatpatientswhohavealumpectomyandradiationtherapyhavethesamelowriskforrecurrenceaspatientswhohaveafullmastectomy,orremovaloftheentirebreast. “Patientsneedtopickwhat’srightforthem,butalumpectomyprovidesthesameverylowrateofrecurrenceaswithamastectomy,butwithashorterandeasierrecovery,”Singhsays. Whenpairedwiththerightsurveillanceaftertreatment,alumpectomymayalsobeanoptionforbreastcancerpatientswhocarrygeneticmutationslikeBRCA1andBRCA2thatputthematagreaterriskforcancer. “BRCA-positivepatientsmayassumethatamastectomyistheonlytreatmentoptionforthem,butthat’snotalwaysthecase,”Singhsays. Alumpectomyallowspatientstoconservemoreofthebreast.Thismaymakeitamorecosmeticallyappealingoption.Italsoallowsmostpatientstopreservethenippleandthesurroundingarea,andmaintainmoresensationorfeelingthantheymightwithamastectomy. “Somepatientssayitdidn’tevenfeellikethey’vehadsurgeryfollowingalumpectomy,”Singhsays.  Whatshouldpatientspreparingforalumpectomyexpect? Typically,alumpectomyisashort,outpatientprocedure.Mostpatientsreceivegeneralanesthesia,butcareteamsmayalsouseanIVwithasedative,orrelaxingmedication,andalocalanestheticisusedtonumbtheareabeingoperatedon. Theproceduretypicallytakesabout15to40minutes.“ButatMDAndersonitmaytakealittlelongerbecausewehavesuchathoroughreviewprocessduringthesurgery,”Singhsays. AtMDAnderson,afterasurgeonremovesthetissue,it’sreviewedbyapathologistwhousesimagingtoreviewtheentirespecimenasawholeandthenreviewsitagain,sectionbysection.Finally,inamultidisciplinarydiscussion,thepathologist,radiologistandsurgeonwillreviewtheimagestogetheranddecideifmoretissueneedstoberemoved. In2018,MDAndersonsurgeonspublishedastudythatdemonstratedthatthisdetailedintraoperativereviewofthetissueresultedinamuchhigherclearmarginrate.Thismeansthatmorepatientswerecancer-freeaftertheirlumpectomies. Thesurgerymaytakelongerifthepatientalsodecidestohavebreastreconstructionatthesametimeasthelumpectomyanddependingonthetypeofreconstructionthepatientchooses.MDAndersonplasticsurgeonsworkwithpatientstodetermineifreconstructionisrightforthem,andifso,whichprocedurebestsuitstheirneeds.Lumpectomypatientsoftenchooseoneofthefollowingtypesofreconstruction:localtissuerearrangement,breastliftand/orreductionorlatissimusdorsiorsimilarflap. Whatislumpectomyrecoverylike? Shortlyafterlumpectomyiscomplete,thepatientwillbeabletogohome.ThankstoourEnhancedRecoveryProgram,mostMDAndersonpatientsrecoveryquicklywithlittlepain. “Somedon’tevenneedpainmedicationorcantakeoverthecounterdrugs,likeibuprofen,”Singhsays. Recoverymaybelongerifapatienthasbreastreconstructionatthetimeofthelumpectomy. Willpatientsneedasecondsurgeryafteralumpectomy? Afterthelumpectomy,theremovedtissueisstudiedbyapathologist.Iftheyfindcancercellsinthenormaltissuesurroundingthetumor,theymayperformasecondsurgery.“Butthankstoourthoroughreviewprocess,mostMDAndersonpatientsdon’tneedasecondsurgery,”Singhsays. Patientswhochoosereconstructionmayhaveanadditionalsurgeriesdependingonwhattypeofreconstructiontheychoose. Howwillalumpectomychangeapatient’sappearance? “Alumpectomy’scosmeticimpactreallyvariesgreatlyfrompatienttopatientanddependsonthesizeofthetumorcomparedtothesizeofthebreastandhowmuchofthebreastisbeingremoved,”Singhsays. AtMDAnderson,breastsurgeonsworkcloselywithplasticsurgeonstoperformreconstructionthatmeetsthepatients’needsandwishes.  “Makesuretohaveathoroughconversationwithyoursurgicalteamaheadoftimetodiscussyouroptionsforbreastreconstructionandchoosewhat’sbestforyou,”Singhadvisespatientspreparingforalumpectomy.“Withaskilledteamthatlistenstotheirpatient’sgoals,alumpectomycanbeasimple,curativeoptionformanyearly-stagebreastcancerpatients.” RequestanappointmentatMDAndersononlineorbycalling1-877-632-6789. Topics Surgery RadiationTherapy BreastCancer ReadMorebyKellieBramletBlackburn BreastsurgeonPuneetSingh,M.D.,performssurgery. Alumpectomycanbeasimple,curativeoptionformanyearly-stage breastcancerpatients. PuneetSingh,M.D. Physician ShareYourStory RequestanAppointment CoronavirusPrecautions Help#EndCancer GiveNow Yourgiftwillhelpmakeatremendousdifference. $100 DonateBlood Ourpatientsdependonbloodandplateletdonations. Learnmore Volunteer Changethelivesofcancerpatientsbygivingyourtimeandtalent.