Breast Cancer Surgery
Surgery is usually
the first choice of treatment for breast cancer.
In the past, most women were treated by a radical
mastectomy - the removal of the entire breast
and muscles of the chest. Surgical techniques
have been refined and studies have shown that
it is now possible and safe to conserve most
of the breast while treating a breast cancer.
In fact, in our practice approximately 70 percent
of women undergo breast conserving treatments
like lumpectomy, rather than mastectomy - far
more than the national rate. Evidence shows
that lumpectomy followed by radiation therapy
is likely to be equally effective as mastectomy
in most women. Your surgeon will advise you as
to whether this is an appropriate option for
Standard Treatments for Breast
Mastectomy with immediate or delayed reconstruction
What is a lumpectomy?
A lumpectomy (also known as
a partial or segmental mastectomy) is the surgical
removal of a breast lump or abnormal area seen
on a mammogram. When removing the lump, a small
amount of surrounding normal tissue is also
removed. This is done to make sure that all
the cancerous tissue has been removed. The tissue
is then examined by a pathologist to see if
any of the cancer cells are present in the surrounding
tissue. If there are no cancer cells present,
this is called a
"clean margin". If cancer cells are
present in the surrounding tissue, your surgeon
will recommend additional steps, which may include
a re-excision to remove additional tissue in
an attempt to clear the margins. The goal is
to achieve removal of all cancer cells with
the best cosmetic result possible when performing
breast conservation surgery.
Most often your surgeon
will also do a sentinel lymph node procedure or
axillary (underarm) dissection at the same time.
Lymph node dissection is done through a separate
incision under your arm. This is done to determine
whether any of the cancer cells have spread to
the lymph nodes.
Lumpectomy with needle-localization
for non-palpable lumps
If your surgeon cannot
feel the lump to be removed, the radiologist will
be asked to insert a guide wire into your breast
prior to surgery to pinpoint the area of concern.
If you require this procedure, on the day of your
surgery you will begin your day in the radiology
department. The radiologist or breast surgeon
will then use mammography or ultrasound to insert
a thin wire to be left in place for surgery as
a guide for your surgeon to locate the area of
the abnormality. The wire is then covered with
a dressing to hold it in place. The average time
for this procedure is 30-50 minutes. You are then
taken to the operating room where you will receive
a local anesthetic to numb your breast, as well
as general anesthesia to make you sleep through
the procedure. The surgeon uses the wire as a
guide to locate the lump. An incision (cut) is
made and the abnormal tissue as well as the wire
is removed. When the surgery is completed, a dressing
is placed over the incision and you are taken
to the recovery area to recover. In general, you
can expect to be in the operating room for 30-90
minutes and in recovery for 1-2 hours.
What are the risks of lumpectomy?
All surgery involves risk. Your
surgeon will discuss the risks of your lumpectomy
related to your specific medical history. In general,
there can be some scarring or change in the shape
of the breast, depending on the size of the area
being removed. Other risks and complications associated
with breast surgery include: wound infection,
swelling around the incision from an accumulation
of blood or clear fluid (uncommon) that may require
drainage, and reactions to anesthesia (low risk).
Do I need to stay in the hospital
Most of our patients do not need
to stay overnight in the hospital unless they
require a complete axillary dissection, have
nausea and vomiting, or have pain which requires
more active pain control.
How will I look and feel
Post-surgery breast size
depends on how much tissue was removed. There
will be a scar from the incision. Initially there
will be some swelling and discomfort. You will
be given a prescription for pain medication to
take at home if needed. If a complete axillary
dissection was done, you will have a drain. Instructions
for how to care for the drain will be given to
you before you leave the hospital.
Post Operative instructions
Bring a bra with you to wear when you go home.
Most women prefer a soft cotton bra, or stretch
or athletic bra. Some women also find it comfortable
to wear the bra at night when sleeping to give
You will have a dressing on the area of the incision.
Please leave this clean and dry until we see you
in the office usually 7-10 days after your surgery.
You will be given a prescription for pain medication
prior to being discharged from the hospital. Take
the medication as needed for pain as prescribed
by your surgeon.
Resume your normal activities as tolerated.
During the first week or so at home, you can expect
to have tenderness in the incision and mild swelling
of the area. You may also notice that under the
incision the breast tissue is firm or hard. This
is normal and will usually subside within several
Please call our office at 847-797-9000 if you
have a fever greater then 101.0, increasing redness
along the incision, or drainage from the incision
When do I learn the results of
It takes approximately 3-4 working
days to get the pathology results. Your surgeon
will call you with the results.
Will I need radiation therapy
after a lumpectomy?
Standard care after a lumpectomy
for most women includes 5-6 weeks of radiation
therapy treatment in order to eliminate any cancer
cells that may remain after surgery. There are
some newer procedures for radiation treatment
called IMRT and Mammosite that require less time
for radiation. These new procedures require a
specific profile for use, such as size of tumor,
lymph node status, and age. You can discuss with
your surgeon whether you are a candidate for these
If you have further questions,
please call us at