What is a lumpectomy?
A lumpectomy is a common breast cancer treatment in which a tumor is removed from the breast, in addition to a small amount of surrounding breast tissue. This procedure is considered breast-conserving surgery because it leaves your breast intact, whereas a mastectomy involves the removal of the entire breast.
Your doctor uses breast imaging to determine whether you are a candidate for lumpectomy. If the abnormal tissue is confined to one area of the breast and can be easily removed, lumpectomy is a possibility.
At Penn Medicine, your surgery is performed by fellowship-trained breast surgeons who specialize exclusively in breast care. Using advanced surgical techniques and, when appropriate, oncoplastic approaches, our team works to remove the cancer while preserving the appearance of your breast whenever possible.
When is lumpectomy recommended for breast cancer?
If you have been diagnosed with breast cancer, your doctor may recommend a lumpectomy. If breast imaging detected a tumor that was small in size relative to your breast or a tumor that has only affected one area of your breast, you may also be a candidate for breast-conserving surgery. Lumpectomies can confirm a cancer diagnosis or be a first treatment option for patients with early-stage breast cancer that has not yet spread to surrounding areas.
Because lumpectomy is often paired with subsequent radiation therapy to reduce the risk of recurring breast cancer, you must be able to receive radiation exposure to be eligible for breast-conserving surgery.
A lumpectomy may also be used if imaging results have shown non-cancerous abnormalities, such as to remove a fibroadenoma of the breast.
What to expect during breast-conserving surgery
Our experienced breast cancer team considers both your diagnosis and your preferences when creating a surgical plan. If you do not need or want a mastectomy, we often recommend breast-conserving surgery followed by radiation therapy. For more advanced cancer, we may recommend chemotherapy to shrink the tumor before surgery.
We perform lumpectomies as outpatient procedures. A typical breast-conserving surgery involves:
- Locating the tumor: Before the surgery, tumor localization will be performed to locate the abnormal mass and tissue to be removed. This can be done using diagnostic imaging by a radiologist, traditional wire localization the same day as the surgery, radar localization, or felt by hand if the mass is large or superficial enough.
- Anesthetic: General anesthesia will be used to put you in a sleep-like state for the actual procedure.
- Incision: The breast surgeon will make an incision in your breast at the tumor or node site.
- Removing the tumor: The breast surgeon will then remove the tumor (or lymph nodes if you are having a sentinel node biopsy or axillary node dissection) and partial surrounding tissue, which will then be sent out to be reviewed in a lab by a pathologist.
- Closing the incision: The incision in the breast will then be closed using either removable or dissolvable stitches. Often, this part of the procedure involves measures to preserve the physical appearance of the breast. Breast surgeons also may work in tandem with a plastic surgeon whenever possible to perform breast reconstruction during the lumpectomy.
Surgeons look at the location and size of the tumor to determine the appropriate type of breast-conserving surgery. Whenever possible, we use advanced surgical techniques during a lumpectomy:
- SAVI SCOUT®: Surgeons can use this radar localization technology up to 30 days before the lumpectomy to target the tumor’s location when it is not able to be felt by hand.
- Hidden scar surgery: The surgeon makes incisions either around the areola or in the crease of the breast. This advanced planning reduces visible scarring.
- Oncoplastic surgery: Breast surgeons and plastic surgeons work together to treat patients whose breast shape and size benefit from a combined procedure. During one surgery, patients undergo a lumpectomy as well as a breast reduction and/or lift.
Breast-conserving surgery risks and safety
As with any surgery, lumpectomy surgery does present a few risks to patients. Associated risks of breast-conserving surgery include:
- Infection of the breast skin from incision
- Numbness, loss of sensation, or nerve pain at the incision site
- Physical changes to the area such as scarring or indentation
- Slightly uneven breasts, which can be addressed by our reconstructive plastic surgeons
- Fluid buildup
Despite these risks, lumpectomies are considered a routine breast cancer treatment at Penn Medicine. Our breast surgeons have decades of experience in breast conservation and take every precaution to prevent these risks from occurring, as well as implement several safety measures to ensure a seamless surgical experience and recovery at home.
Lumpectomy recovery, results, and follow up
After breast-conserving surgery, patients are moved to the outpatient recovery room, where we will monitor your vital signs, including heart rate and blood pressure, while the effects from anesthesia wear off. Most patients are able to return home the same day after our team reviews recovery instructions, which will include information about:
- Common post-op symptoms like pain and discomfort
- When you should call your provider for abnormal symptoms or other concerns
- Acceptable medication for pain management and frequency
- Incision care to prevent infection
- Restrictions on physical activity for safety and incision protection
- Instructions for any post-operative appointments
Our office will coordinate an initial follow-up appointment within two weeks of surgery. At the appointment, the surgeon will check your incision, discuss the results of the pathology report, and provide further instructions for subsequent visits.
Expert care for breast-conserving surgery
We understand that breast surgery is a sensitive procedure. Our breast surgeons are experts at removing abnormal tissue while maintaining the appearance of your breast. Through our breast cancer program at Penn Medicine, you’ll find:
- Expert surgeons: Our fellowship-trained surgeons only operate on breasts. They use their experience and in-depth knowledge to preserve as much healthy breast tissue as possible while removing abnormal tissue.
- Surgical precision: We use advanced imaging and radar localization technology called SAVI SCOUT® to successfully find and remove breast cancer. These steps minimize the amount of healthy tissue removed.
- Team approach: Whenever possible, breast surgeons and plastic surgeons at Penn Medicine work together to perform breast reconstruction during a lumpectomy. This reduces the amount of surgery you need and your overall recovery time.
- Comprehensive support: Our oncology nurse navigators answer any questions and coordinate your appointments before and after surgery. We also offer breast cancer support services through specialized social workers, nutritionists, and support groups.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
Locations
Our hospitals, multispecialty medical centers, pharmacies, labs and more offer outstanding, personalized care for patients all across the region.
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