Lumpectomy
Lumpectomy is a surgical procedure performed on a solid breast
mass to determine if it is malignant. The suspicious lump and some surrounding tissue is
excised and analyzed.
General information about
A breast lump may be a solid mass or a fluid-filled cyst. Lumps most commonly occur in
women, but can occur in men as well. Mammography
and ultrasound are two imaging techniques used to evaluate breast lumps, but many
people will need to have a tissue sample taken to determine if a suspicious lump is
cancerous.
Tissue from a solid mass can be removed by needle biopsy -- a procedure in which a needle is
placed into the lump to sample the tissue to check for cancer cells. When the entire lump
is surgically removed, the procedure is called a lumpectomy.
For a lumpectomy, general or local anesthesia with or without sedatives is used. Once the
area is pain-free, an incision is made and the lump is removed, as is the surrounding rim
of normal breast tissue. The lump is then sent to a laboratory for examination.
For a cyst, a needle and syringe are used to drain fluid. If the cystic fluid is clear
or green in color, not bloody, and the cyst disappears completely when drained, nothing
further needs to be done. If the fluid is bloody, it is sent to the laboratory for
analysis. If there is still a lump after the cyst fluid is drained, or if the lump
disappears but returns later, it is typically surgically removed.
Only a small portion of all breast lumps are malignant, but the risk increases with
age.
Why is a Lumpectomy performed
Lumpectomy is a surgical treatment for newly diagnosed breast cancer. It is estimated
that at least 50% of women with breast cancer are good candidates for this procedure. The
location, size, and type of tumor are of primary importance when considering breast cancer
surgery options. The size of the breast is another variable. The patient's psychological
outlook, as well as her lifestyle choices, should also be taken into account when
treatment decisions are made.
The severity of a cancer is evaluated or "staged" according to a fairly
complex system. This considers the size of the tumor and whether the cancer has spread
directly to adjacent tissues, such as the chest wall, the lymph nodes, and/or to distant
parts of the body. Women with early stage breast cancers are usually better candidates for
lumpectomy. In most cases, a course of radiation therapy after surgery is part of the
treatment. Chemotherapy or hormone treatment may also be prescribed.
Many studies have compared the survival rates of women who have had removal of a breast
(mastectomy) with those who have undergone lumpectomy and radiation therapy. The data is
clear that for women with comparable stages of breast cancer, survival rates are equal
between the two groups.
In some circumstances, a woman with later stage breast cancer may be able to have a
lumpectomy. Chemotherapy can be administered before surgery to decrease tumor size and the
chance of spread in selected cases.
General information about a Lumpectomy
Lumpectomy is a surgical treatment for newly diagnosed breast cancer. It is estimated
that at least 50% of women with breast cancer are good candidates for this procedure. The
location, size, and type of tumor are of primary importance when considering breast cancer
surgery options. The size of the breast is another variable. The patient's psychological
outlook, as well as her lifestyle choices, should also be taken into account when
treatment decisions are made.
The severity of a cancer is evaluated or "staged" according to a fairly
complex system. This considers the size of the tumor and whether the cancer has spread
directly to adjacent tissues, such as the chest wall, the lymph nodes, and/or to distant
parts of the body. Women with early stage breast cancers are usually better candidates for
lumpectomy. In most cases, a course of radiation therapy after surgery is part of the
treatment. Chemotherapy or hormone treatment may also be prescribed.
Many studies have compared the survival rates of women who have had removal of a breast
(mastectomy) with those who have undergone lumpectomy and radiation therapy. The data is
clear that for women with comparable stages of breast cancer, survival rates are equal
between the two groups.
In some circumstances, a woman with later stage breast cancer may be able to have a
lumpectomy. Chemotherapy can be administered before surgery to decrease tumor size and the
chance of spread in selected cases.
Risks of a Lumpectomy
The risks are those which are common to any surgical procedure, including bleeding,
infection, anesthesia reaction, or unexpected scarring. A lumpectomy may also cause loss
of sensation in the breast. The size and shape of the breast will be affected by the
operation. Fluid can accumulate in the area where tissue was removed, requiring drainage.
If lymph node dissection is performed, there are several potential complications. A
woman may experience decreased feeling in the back of her armpit; or experience other
sensations, including numbness, tingling, or increased skin sensitivity. An inflammation
of the arm vein, called phlebitis, can occur. There may be injury to the nerves
controlling arm motion.
Approximately 2-10% of patients develop lymphedema after axillary lymph node
dissection. This swelling of the arm can range from mild to very severe. It can be treated
with elastic bandages and specialized physical therapy, but it is a chronic condition,
requiring continuing care. Lymphedema can arise at any time, even years after surgery.
A new technique that may eliminate the need for removing many axillary lymph nodes is
being tested. The term "sentinel node biopsy" is most frequently used to refer
to this method. It is based on the idea that the condition of the first lymph node in the
network, which drains the affected area, can predict whether the cancer may have spread to
the rest of the nodes. If this first, or sentinel, node is cancer-free, it is thought
there is no need to look further. Many patients with early-stage breast cancers may be
spared the risks and complications of axillary node dissection as the use of this approach
continues to increase. |