Breast-conserving Surgery (Lumpectomy)

Breast-conserving surgery (sometimes called a lumpectomy) removes the cancer while leaving as much normal breast as possible. Search prod Verenespañol | Downloadthistopic[PDF] SurgeryforBreastCancer Breast-conservingSurgery(Lumpectomy) Mastectomy LymphNodeSurgeryforBreastCancer ExercisesAfterBreastCancerSurgery Home CancerA-Z BreastCancer TreatingBreastCancer SurgeryforBreastCancer Breast-conservingSurgery(Lumpectomy) Breast-conservingsurgery(BCS)removesthecancerwhileleavingasmuchnormalbreastaspossible.Usually,somesurroundinghealthytissueandlymphnodesalsoareremoved.Breast-conservingsurgeryissometimescalledlumpectomy,quadrantectomy,partialmastectomy,orsegmentalmastectomydependingonhowmuchtissueisremoved. Whatyoushouldknowbeforehavingbreast-conservingsurgery Howmuchofthebreastisremoveddependsonthesizeandlocationofthetumor,yourbreastsize,andotherfactors. Breast-conservingsurgeryallowsawomantokeepmostofherbreast,butmakesitlikelyshewillalsoneedradiation. AfterBCS,mostwomenwillhaveradiationtherapy.Somewomenmightalsogetothertreatments,suchashormonetherapyorchemotherapy. ChoosingBCSplusradiationovermastectomydoesnotaffectawoman’schancesoflong-termsurvival. Ifyouthinkyouwantbreastreconstruction,talktoyourdoctorbeforeyourbreastcancersurgery. NotallwomenwithbreastcancercanhaveBCS.TalktoyourdoctortofindoutwhetherBCSisanoptionforyou. SideeffectsofBCSmayincludepain, ascarand/ordimplewherethetumorwasremoved,afirmorhardsurgicalscar,andsometimeslymphedema,atypeofswelling,inthearm. Whocanhave breast-conservingsurgery? Breast-conservingsurgery(BCS)isagoodoptionformanywomenwithearly-stagecancers.Themainadvantageisthatawomankeepsmostofherbreast.However,mostwomenwillalsoneedradiationtherapy,givenbyaradiationoncologist(adoctorwhospecializesinradiation).Womenwhohavetheirentirebreastremoved(mastectomy)forearly-stagecancersarelesslikelytoneedradiation,buttheymaybereferredtoaradiationoncologistforevaluationbecauseeachpatient’scancerisunique. BCSmightbeagoodoptionifyou: Areconcernedaboutlosingabreast Arewillingtohaveradiationtherapyandareabletogettotheappointments(ifyouneedhelpgettingtoandfromyourappointmentsseeRoadtoRecovery). HavenotalreadyhadthatbreasttreatedwithradiationtherapyorBCS Haveonlyoneareaofcancerinthebreast,ormultipleareasinonequadrant(multifocal)thatarecloseenoughtoberemovedtogetherwithoutchangingthelookofthebreasttoomuch Haveatumorsmallerthan5cm(2inches),thatisalsosmallrelativetothesizeofthebreast Arenotpregnantor,ifpregnant,willnotneedradiationtherapyimmediately(toavoidriskingharmtothefetus) Donothaveagenemutation(change)suchasaBRCAorATMmutation,whichmightincreaseyourchanceofasecondbreastcancer DonothavecertainseriousconnectivetissuediseasessuchassclerodermaorSjögren'ssyndrome,whichmaymakeyouverysensitivetothesideeffectsofradiationtherapy Donothaveinflammatorybreastcancer Donothavepositivemargins(seeWasallthecancerremoved?below) Recoveringfrombreast-conservingsurgery Thistypeofsurgeryistypicallydoneinanoutpatientsurgerycenter,andanovernightstayinthehospitalusuallyisnotneeded.Mostwomenshouldbeabletofunctionaftergoinghomeandcanoftenreturntotheirregularactivitieswithin2weeks.Somewomenmayneedhelpathomedependingonhowextensivetheirsurgerywas. Askamemberofyourhealthcareteamtoshowyouhowtocareforyoursurgerysiteandaffectedarm.Usually,youandyourcaregiver(s)willgetwritteninstructionsaboutcareaftersurgery.Theseinstructionsmightinclude: Howtocareforthesurgerysiteanddressing Howtocareforyourdrain,ifyouhaveone(Thisisaplasticorrubbertubecomingoutofthesurgerysitethatremovesthefluidthatcollectsduringhealing.) Howtotellifaninfectionisstarting Tipsonbathingandshoweringaftersurgery Whentocallthedoctorornurse Whentostartusingyourarmagainandhowtodoarmexercisestopreventstiffness Whenyoucanstartwearingabraagain Theuseofmedicines,includingpainmedicinesandpossiblyantibiotics Anyrestrictionsonactivity Whattoexpectregardingsensationsornumbnessinthebreastandarm Whattoexpectregardingfeelingsaboutbodyimage Whentoseeyourdoctorforafollow-upappointment ReferraltoaReachToRecoveryvolunteer.ThroughourReachToRecoveryprogram,aspeciallytrainedvolunteerwhohashadbreastcancercanprovideinformation,comfort,andsupport. Possiblesideeffectsofbreast-conservingsurgery Aswithalloperations,bleedingandinfectionatthesurgerysitearepossible.Other sideeffectsofbreast-conservingsurgerycaninclude: Painortendernessora "tugging"sensationinthebreast Temporaryswellingofthebreast Hardscartissueand/oradimplethatformsatthesurgicalsite Swellingofthebreastfromacollectionoffluid(seroma)thatmightneedtobedrained Changeintheshapeofthebreast Neuropathic(nerve)pain(sometimesdescribedasburningorshootingpain)inthechestwall,armpit,and/orarmthatdoesn’tgoawayovertime.Thiscanalsohappeninmastectomypatientsandiscalledpost-mastectomypainsyndromeorPMPS.  Ifaxillarylymphnodesarealsoremoved,othersideeffectssuchaslymphedemamayoccur. Wasallthecancerremoved? DuringBCS,thesurgeonwilltrytoremoveallthecancer,plussomesurroundingnormaltissue.Thiscansometimesbedifficultdependingonwherethecancerislocatedinyourbreast. Aftersurgery,adoctor,calledapathologist,willlookcloselyatthetissuethatwasremovedinthelab.Ifthepathologistfindsnoinvasivecancercellsatanyoftheedgesoftheremovedtissue,itissaidtohavenegativeorclearmargins.ForwomenwithDCIS,atleast2mm(0.08inches)ofnormaltissuebetweenthecancerandtheedgeoftheremovedtissueispreferred.IfDCIScancercellsarefoundnear theedgesofthetissue(withinthe2mm),itissaidtohaveaclosemargin.Ifcancer(invasiveorDCIS)cellsarefoundattheedgeofthetissue,itissaidtohavea positive margin. Havingapositivemarginmeansthatsomecancercellsmaystillbeinthebreastaftersurgery,sothesurgeonoftenneedstogobackandremovemoretissue.Thisoperationiscalledare-excision.Ifcancercellsarestillfoundattheedgesoftheremovedtissueafterthesecondsurgery,amastectomymightbeneeded. Breastreconstructionsurgeryafterbreast-conservingsurgery Beforeyoursurgery,talktoyourbreastsurgeonabouthowbreast-conservingsurgerymightchangethelookofyourbreast.Thelargertheportionofbreastremoved,themorelikelyitisthatyouwillseeachangeintheshapeofthebreastafterward.Ifyourbreastslookverydifferentaftersurgery,itmaybepossibletohavesometypeofreconstructivesurgeryortohavethesizeoftheunaffectedbreastreducedtomakethebreastsmoresymmetrical(even).Itmayevenbepossibletohavethisdoneduringtheinitialsurgery.It'sveryimportanttotalkwithyourdoctor(andpossiblyaplasticsurgeon)beforethecancersurgerytogetanideaofhowyourbreastsarelikelytolookafterward,andtolearnaboutyouroptions. Treatmentafterbreast-conservingsurgery Mostwomenwillneedradiationtherapytothebreastafterbreast-conservingsurgery.Sometimes,tomakeiteasiertoaimtheradiation,smallmetallic-likeclips(whichwillshowuponx-rays)maybeplacedinsidethebreastduringsurgerytomarktheareawherethecancerwasremoved. Manywomenwillhavehormonetherapyaftersurgerytohelplowertheriskofthecancercomingback.Somewomenmightalsoneedchemotherapyaftersurgery.Ifso,radiationtherapyandhormonetherapyareusuallydelayeduntilthechemotherapyiscompleted. Writtenby References TheAmericanCancerSocietymedicalandeditorialcontentteam Ourteamismadeupofdoctorsand oncologycertifiednurseswithdeepknowledgeofcancercareaswellasjournalists,editors,andtranslatorswithextensiveexperienceinmedicalwriting. BernsteinJL,HaileRW,StovallM,etal.Radiationexposure,theATMGene,andcontralateralbreastcancerinthewomen'senvironmentalcancerandradiationepidemiologystudy. JNatlCancerInst.2010;102(7):475–483. HenryNL,ShahPD,HaiderI,FreerPE,JagsiR,SabelMS.Chapter88:CanceroftheBreast.In:NiederhuberJE,ArmitageJO,DoroshowJH,KastanMB,TepperJE,eds. Abeloff’sClinicalOncology.6thed.Philadelphia,Pa:Elsevier;2020. JagsiR,KingTA,LehmanC,MorrowM,HarrisJR,BursteinHJ.Chapter79:MalignantTumorsoftheBreast.In:DeVitaVT,LawrenceTS,LawrenceTS,RosenbergSA,eds. DeVita,Hellman,andRosenberg’sCancer:PrinciplesandPracticeofOncology.11thed.Philadelphia,Pa:LippincottWilliams&Wilkins;2019. NationalCancerInstitute.PhysicianDataQuery(PDQ).BreastCancerTreatment–HealthProfessionalVersion.2021.Accessedathttps://www.cancer.gov/types/breast/hp/breast-treatment-pdqonJuly7,2021. NationalComprehensiveCancerNetwork(NCCN).PracticeGuidelinesinOncology:BreastCancer.Version4.2021.Accessedathttps://www.nccn.org/professionals/physician_gls/pdf/breast.pdfonJuly7,2021. OhJ.L.(2008)MultifocalorMulticentricBreastCancer:UnderstandingItsImpactonManagementandTreatmentOutcomes.In:HayatM.A.(eds)MethodsofCancerDiagnosis,TherapyandPrognosis.MethodsofCancerDiagnosis,TherapyandPrognosis,vol1.Springer,Dordrecht.https://doi.org/10.1007/978-1-4020-8369-3_40. OJVilholm,SCold,LRasmussenandSHSindrup.Thepostmastectomypainsyndrome:anepidemiologicalstudyontheprevalenceofchronicpainaftersurgeryforbreastcancer. BritishJournalofCancer (2008)99,604–610. SabelMS.Breast-conservingtherapy.InChenW,ed.UpToDate.Waltham,Mass.:UpToDate,2021.https://www.uptodate.com.AccessedJuly7,2021.   References BernsteinJL,HaileRW,StovallM,etal.Radiationexposure,theATMGene,andcontralateralbreastcancerinthewomen'senvironmentalcancerandradiationepidemiologystudy. JNatlCancerInst.2010;102(7):475–483. HenryNL,ShahPD,HaiderI,FreerPE,JagsiR,SabelMS.Chapter88:CanceroftheBreast.In:NiederhuberJE,ArmitageJO,DoroshowJH,KastanMB,TepperJE,eds. Abeloff’sClinicalOncology.6thed.Philadelphia,Pa:Elsevier;2020. JagsiR,KingTA,LehmanC,MorrowM,HarrisJR,BursteinHJ.Chapter79:MalignantTumorsoftheBreast.In:DeVitaVT,LawrenceTS,LawrenceTS,RosenbergSA,eds. DeVita,Hellman,andRosenberg’sCancer:PrinciplesandPracticeofOncology.11thed.Philadelphia,Pa:LippincottWilliams&Wilkins;2019. NationalCancerInstitute.PhysicianDataQuery(PDQ).BreastCancerTreatment–HealthProfessionalVersion.2021.Accessedathttps://www.cancer.gov/types/breast/hp/breast-treatment-pdqonJuly7,2021. NationalComprehensiveCancerNetwork(NCCN).PracticeGuidelinesinOncology:BreastCancer.Version4.2021.Accessedathttps://www.nccn.org/professionals/physician_gls/pdf/breast.pdfonJuly7,2021. OhJ.L.(2008)MultifocalorMulticentricBreastCancer:UnderstandingItsImpactonManagementandTreatmentOutcomes.In:HayatM.A.(eds)MethodsofCancerDiagnosis,TherapyandPrognosis.MethodsofCancerDiagnosis,TherapyandPrognosis,vol1.Springer,Dordrecht.https://doi.org/10.1007/978-1-4020-8369-3_40. OJVilholm,SCold,LRasmussenandSHSindrup.Thepostmastectomypainsyndrome:anepidemiologicalstudyontheprevalenceofchronicpainaftersurgeryforbreastcancer. BritishJournalofCancer (2008)99,604–610. SabelMS.Breast-conservingtherapy.InChenW,ed.UpToDate.Waltham,Mass.:UpToDate,2021.https://www.uptodate.com.AccessedJuly7,2021.   LastRevised:October27,2021 SurgeryforBreastCancer Breast-conservingSurgery(Lumpectomy) Mastectomy LymphNodeSurgeryforBreastCancer ExercisesAfterBreastCancerSurgery AmericanCancerSocietymedicalinformationiscopyrighted material.Forreprintrequests,pleaseseeourContentUsagePolicy. MoreInBreastCancer AboutBreastCancer RiskandPrevention EarlyDetectionandDiagnosis UnderstandingaBreastCancerDiagnosis Treatment BreastReconstructionSurgery LivingasaBreastCancerSurvivor BackToTop Close * Close Imageof Previous Next Close Close SelectAHopeLodge