What’s a Lumpectomy? (And Is It Right for You?)

A lumpectomy removes tumors while preserving the size and shape of the breast. While radiation is often necessary after, it’s an effective and less invasive option for many people with an early-stage diagnosis.

When you’re diagnosed with breast cancer, treatment options will depend on many factors. Your doctor will work with you to find the best option for your specific needs while considering your stage, age, preferences, and other considerations.

A lumpectomy is typically an outpatient surgery where you can go home the same day. A lumpectomy only removes a portion of the breast, so it often helps to retain the breast shape and size. While the surgical process is less invasive, it’s still a very effective option for treating certain types of breast cancer.

When considering a lumpectomy, you can work with your doctor to review your specific needs and desires to determine if it’s the right option for you.

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What is a lumpectomy?

A lumpectomy, also known as a partial mastectomy or breast-conserving surgery, is a common treatment option for breast cancer.

During the procedure, a surgeon removes the tumor and margin (healthy tissue that surrounds the tumor) while leaving the majority of the breast intact.

The amount of breast tissue removed can vary. The surgeon removes the tumor plus additional tissue from the breast in order to ensure they get all the cancer cells.

During the same procedure, a surgeon will typically remove 1–3 lymph nodes from under your arms. This is called a sentinel node biopsy. They do this so they can test the nodes for cancer. This can help guide future treatment decisions.

Who should get a lumpectomy?

A lumpectomy may be a good option if you’re diagnosed with early-stage breast cancer and want to preserve breast tissue.

The American Cancer Society suggests you may be a good candidate for a lumpectomy if:

• your tumor is less than 5 centimeters (2 inches) in diameter
• your tumor is small in relation to the size of your breast
• you have not had previous radiation on the breast
• you are willing and able to get to radiation appointments following the procedure
• you do not have a gene mutation, such as BRCA or ATM, that puts you at higher risk of a second tumor
• you have only one cancerous tumor, or all areas are concentrated in one place
• you do not have inflammatory breast cancer
• you do not want to lose a breast
• you are not pregnant or can delay radiation until after the birth of the baby
• you’re not living with certain serious connective tissue diseases that eliminate radiation as a treatment option

Even if you’re a good candidate, you can discuss your concerns or wants with a doctor or surgeon. They may be able to advise you on other treatment courses and help you decide on the procedure and therapy that will work best for you.

What are the advantages or disadvantages of a lumpectomy?

A lumpectomy leaves as much healthy breast tissue in place as possible. This may be a good option for you if you’re concerned about losing a breast.

You may want to discuss how much tissue a surgeon will need to remove during the procedure. They can often provide reconstructive surgery during the lumpectomy so that you maintain a similar shape and size in your breasts. This is known as an oncoplastic lumpectomy.

Another benefit is that because it’s a less invasive surgery, the recovery time is likely to be faster than for other procedures like a full mastectomy.

Another possible advantage of the procedure combined with radiation is an increased survival rate. In a 6-year follow-up study of over 48,000 women, researchers found sufficient evidence to suggest that a lumpectomy combined with radiation improved survival rates compared with a mastectomy with or without additional radiation.

The researchers recommended surgeons do not consider a lumpectomy with radiation as equal to a mastectomy because the lumpectomy showed better results.

One downside of a lumpectomy is that almost all people who undergo the procedure will require follow-up treatment with radiation. This means you will need to be able to get to several appointments over the course of several weeks. A typical schedule often looks like 5 days a week for 3–5 weeks.

There’s also the possibility that your surgeon will determine that not all the cancerous cells were removed during the procedure. This could mean additional surgery to remove more tissue.

What should you expect if you are preparing for a lumpectomy?

A lumpectomy is generally done in an outpatient setting, either in a hospital operating room or an outpatient facility.

In most cases, you can expect to go home the same day, though you will want someone with you who can drive you home and possibly help you with some daily tasks.

You should ask the performing surgeon or surgical team about special restrictions and considerations for the day or so leading up to the procedure. They can advise you on when to stop eating or drinking, what medications to stop or keep taking, and any other things you should know before arriving.

Once you arrive at the facility, a team will help prepare you for the procedure. This may involve steps such as:

• using imaging tests to locate the exact location of the tumor(s)
• preparing the breast with local anesthesia, injection of dyes, or markings to help guide surgical insertion points
• inserting an intravenous (IV) into your arm or hand to administer general anesthesia

The procedure typically lasts about 60–90 minutes. It can take longer if you have reconstructive surgery during the same procedure.

Immediately following the procedure, you’ll be moved to a recovery room where healthcare professionals will monitor your blood pressure, heart rate, temperature, and pain level. In most cases, you’ll go home the same day, but if you have a more extensive procedure or any complications come up, you may need to stay for observation overnight or longer.

What is the recovery process for a lumpectomy like?

Most people can return to their usual activities within 2 weeks. How much help and time you will need during recovery will depend on the extensiveness of your procedure and how your body recovers.

You will likely start to feel better within a couple of days. The team performing the procedure should be able to give you guidance on care at home, limitations, and concerns. This can include instructions on:

• caring for the dressing (bandages over the incision), incision, and surgical drain
• taking pain medications
• looking for signs of infection
• exercising during recovery

Will you need a second procedure or other treatments?

Almost everyone who has a lumpectomy requires radiation. Doctors use radiation to make sure they address any remaining cancer cells in the breast. Radiation typically takes several weeks to complete with daily appointments.

In some cases, the surgeon may find that not all the cancerous tissue was removed during the lumpectomy. If this happens, you may need a second lumpectomy or other procedures to remove additional tissue or lymph nodes.

It’s also possible to have a recurrence in the same breast. If you have a local recurrence, you may need a second surgical procedure to remove it.

Some people may need adjuvant chemotherapy or targeted therapy after a lumpectomy. Your doctor will work with you to determine the right treatment plan for you.

How will my appearance change after a lumpectomy?

While this procedure removes less breast tissue than some other options, there are likely to be changes to the appearance of your breast. You can discuss having reconstructive surgery at the same time as the lumpectomy, which may help.

Possible side effects of a lumpectomy can include:

• hard scar tissue forming
• dimpling at the site of the incision
• a change in breast shape
• swelling of the breast that goes away
• pain, tenderness, or a sensation of tugging on the breast
• swelling in the breast from fluid collection that may require drainage
• neuropathic pain in the armpit, arm, or chest wall that does not go away
• development of lymphedema (swelling that often occurs in the arm) due to removed lymph nodes

Takeaway

A lumpectomy is one of the many treatment options for breast cancer. Whether a lumpectomy is right for you depends on many factors, including the stage, size, and type of your cancer diagnosis.

A lumpectomy is a less invasive surgery but usually requires additional treatments.

Lumpectomies are an effective treatment method for many people with breast cancer, but speaking with your doctor and treatment team is the best way to determine if this is the right choice for you.