Is Lumpectomy a Major Surgery?

What is a lumpectomy?

Lumpectomy is a surgical procedure to remove a mass (cancerous or non-cancerous) from the breasts. In a lumpectomy, only the affected portion of the breast is removed, without removing the surrounding healthy breast tissue. Lumpectomy is also called breast-conserving surgery. Lumpectomy is a commonly performed surgery but still major surgery with risks and potential complications. Later on, additional treatments may be required following a lumpectomy such as chemotherapy and radiation therapy. For non-cancerous (benign) tumors, a lumpectomy may suffice.

Fibroadenoma is the most common type of benign, non-cancerous tumor of the breasts. It usually occurs in young, pre-menopausal women aged between 15 and 40 years. It may also arise during pregnancy or breastfeeding. They usually do not cause complications and can be treated easily with surgery.

Breast cancer arises from the cells of the breasts and can spread to other parts of the body (metastasis). Although extremely rare, breast cancer can sometimes occur in men. If the growth is relatively small, without local invasion, and limited to one breast, a lumpectomy can be done. If not, other surgical procedures may be required.

When should a lumpectomy be not done?

Lumpectomy may be contraindicated in the following cases:

• Multiple tumors in the breast that cannot be removed with a lumpectomy, which could affect the appearance of your breast
• Radiation therapy to the breast before surgery
• Cancer that has spread throughout the breast or opposite breast and involving the overlying skin
• Having a large tumor with small breasts, which may cause a poor cosmetic result
• If there is no access to radiation therapy because radiation therapy may be required for cancerous growths after a lumpectomy
• History of scleroderma (a condition that causes hardening of the skin and other tissues), making healing difficult after surgery
• History of systemic lupus erythematosus (SLE), an auto-immune, chronic inflammatory disease

How is a lumpectomy performed?

During the procedure:

A lumpectomy is usually performed under general anesthesia, so there will be no pain or discomfort during the procedure. The surgeon makes a cut over the tumor or area of the abnormal tissue. The tumor is completely removed along with a margin of surrounding healthy tissue and then sent to the lab for examination by a pathologist.

The surgeon then closes the wound with stitches (sutures) that may be absorbable and dissolve on their own or removed later by the surgeon.

After the procedure:

• Painkillers and antibiotics would be administered.
• The dressing may be removed after 48 hours.
• Patients may be discharged the same day or 24 hours after the surgery.
• Post-operative pain, swelling, and bruising are normal and usually resolve in a week.
• Patients can resume daily activities 24-72 hours after the surgery.
• Complete recovery may take around two to four weeks.

What are the complications of a lumpectomy?

Some possible complications include:

• Bleeding
• Hematoma (blood clot formation)
• Infection
• Pain
• Swelling 
• Bruising 
• Reaction to anesthesia 
• Decreased sensation or numbness around the surgical site, which is usually transient 
• Formation of unsightly hard scar tissue or keloid at the surgical site
• Change in the shape, symmetry, and appearance of the breast
• Recurrence of the tumor if tumor cells are left behind