Lumpectomy

Dr Jesse Hu
Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

What Is Lumpectomy?

A lumpectomy is a surgical intervention primarily used in the treatment of breast cancer. This procedure involves the removal of the cancerous tumour and a small margin of surrounding healthy tissue from the breast, while preserving as much of the breast as possible.

Often referred to as breast-conserving surgery, lumpectomy aims to achieve a balance between effective cancer treatment and aesthetic outcome.

It is typically followed by radiation therapy to eliminate any remaining microscopic cancer cells, enhancing the treatment’s efficacy.

Indications for Lumpectomy

The key indications for choosing lumpectomy include:

Early-Stage Breast Cancer

A lumpectomy is typically recommended for patients with stage I or II breast cancer, where the tumour is relatively small (usually less than 5 cm in diameter) and confined to a specific area of the breast.

Desire to Preserve Breast

Many patients opt for lumpectomy over mastectomy due to the desire to preserve as much of their breasts as possible.

Single Tumour

The procedure is most effective when there is a single tumour. If multiple areas of the breast are affected, a more extensive surgery might be required.

Surgical Procedure

The lumpectomy procedure is typically performed under general anaesthesia and may take between one to two hours, depending on the complexity of the surgery.

 

The process is outlined as follows:

Before the procedure, imaging tests such as mammography or MRI may be used to guide the surgeon. The patient is placed on the operating table and the surrounding breast area is cleaned and sterilised.

The surgeon makes a small incision near the tumour site. The size and location of the incision depend on the tumour’s location within the breast.

The surgeon removes the tumour and a margin of healthy tissue to ensure that all cancerous cells are excised. The amount of tissue removed varies based on the tumour size and location.

In some cases, a sentinel lymph node biopsy is performed during the lumpectomy. This involves injecting a dye or radioactive substance to identify and remove the lymph nodes most likely to contain cancer cells if the cancer has spread.

After the tumour and necessary margins are removed, the surgeon closes the incision with sutures, often employing techniques to minimise scarring and preserve the breast’s shape.

Post-surgery, the patient is moved to a recovery area where vital signs are monitored as the anaesthesia wears off. Most patients can go home the same day unless complications arise.

Postoperative Care

Effective postoperative care focuses on managing discomfort, preventing infection, and ensuring proper healing of the surgical site.

Pain Management

Patients may experience pain and tenderness around the incision site. Pain relief medications are typically prescribed to manage discomfort during the initial recovery period.

Wound Care

Proper incision site care is essential to prevent infection. Instructions may include keeping the area clean and dry and changing dressings according to the surgeon’s recommendations.

Activity Restrictions

Patients are generally advised to avoid strenuous activities and heavy lifting for a specified period. This helps prevent stress on the surgical site and ensures proper healing.

Follow-Up Appointments

Regular follow-up appointments with the surgeon are necessary to monitor the healing process, remove sutures if needed, and address any concerns such as swelling or changes in breast appearance.

Support Garments

Wearing a supportive bra without underwires can help reduce discomfort and support breast shape during healing.

Radiation Therapy

If radiation therapy is part of the treatment plan, it usually begins a few weeks after surgery once the incision has sufficiently healed.

Potential Complications

While lumpectomy is generally considered a safe procedure, patients should be aware of some potential risks and complications.

  • Infection: Infection at the incision site can manifest as redness, swelling, pain, or discharge. Treatment typically involves antibiotics and close monitoring.
  • Bleeding and Hematoma Formation: Some patients may experience bleeding or the formation of a hematoma (a collection of blood outside of blood vessels) at the surgical site, which might require additional intervention.
  • Scarring and Changes in Breast Appearance: Scarring is inevitable with any surgery, and in some cases, the shape of the breast may change post-surgery.
  • Seroma Formation: A seroma is a build-up of fluids in the area where the tumour was removed. While often naturally absorbed by the body, large seromas may need to be drained.
  • Numbness or Changes in Sensation: Some patients may experience temporary or permanent changes in sensation in the breast or nipple due to nerve damage during surgery.

Dr Jesse Hu

Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

Dr Jesse specialises in managing both benign and malignant breast and thyroid conditions, which also includes breast pain, breast lumps, breastfeeding problems, neck lumps, amongst others.

Her dual expertise in cancer removal and plastic surgery techniques expands the design of individualized treatments, leading to holistic patient outcomes.

Dr Jesse was part of the teaching faculties of both NUS Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine, where she teaches and mentors the next generation of medical students and trainee doctors.

  • Surgical training at NUS School of Medicine
  • FRCS (Fellow of the Royal College of Surgeons) Edinburgh, UK in 2014
  • Completed 2 Health Manpower Development Program (HMDP) fellowships at Oxford University Hospital, UK in 2016

Dr Jesse is recognized as an authority in breast cancer and thyroid surgery and a sought-after conference speaker.

Read Full Bio

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    Lumpectomy

    Frequently Asked
    Questions

    How long does it take to recover from a lumpectomy?

    Recovery times can vary, but most patients can resume normal activities within a week, although full healing takes several weeks. Factors like overall health, the extent of the surgery, and the person’s healing rates affect recovery time.

    Can lumpectomy always preserve the appearance of the breast?

    While lumpectomy aims to conserve as much breast tissue as possible, changes in the shape and size of the breast can occur, especially if a large portion of tissue is removed. Reconstructive surgery may be considered in some cases.

    Is lumpectomy as effective as mastectomy in preventing cancer recurrence?

    For early-stage cancers, lumpectomy followed by radiation therapy is as effective as mastectomy in terms of survival rates. The choice between these surgeries often depends on personal preferences, medical advice, and specific cancer characteristics.

    What should I expect during the first follow-up visit after a lumpectomy?

    The first follow-up usually involves assessing the surgical site for proper healing, discussing the pathology report, and planning further treatment if necessary.