Procedures & Services:
Breast Conserving Surgery
Your surgeon will only remove a portion of the affected breast when performing breast conserving surgery. How much needs to be removed depends on the size and location of the cancer. Lumpectomy removes the breast tumor and a surrounding margin of normal tissue. Partial mastectomy or quadrantectomy removes more breast tissue than a lumpectomy. One-quarter of the breast is removed in a quadrantectomy. Radiation therapy is typically given after a breast conserving surgery. If adjuvant chemotherapy is to be given as well, the radiation is usually delayed until the chemotherapy is completed.
If the pathologist finds there is cancer at the edge (margin) of the piece of tissue removed by breast-conserving surgery, the surgeon may need to go back and remove more tissue (re-excision). A mastectomy may be needed if clear surgical margins cannot be achieved. For most women with stage I or II breast cancer, breast conserving surgery (lumpectomy/partial mastectomy plus radiation therapy) is as effective as mastectomy. Several studies confirm that cure rates of patients treated with these approaches are equal. However, breast conserving surgery is not an option for all women with breast cancer.
The larger the portion of breast removed, the more likely it is that there will be a distortion of the breast after surgery. If the breasts may look very different after surgery, it may be possible to have some type of reconstructive surgery, or to have the unaffected breast reduced in size to make the breasts more symmetrical. Immediate reconstruction may be possible during the initial surgery. It's important to talk with your surgeon (and possibly a plastic surgeon) before surgery to get an idea of how your breasts are likely to look afterward, and to learn what your options might be.
what to do before surgery
- Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition.
- After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
- Blood transfusion and/or blood products may rarely be needed depending on your condition.
- It is recommended that you shower with an antibacterial soap the night before or morning of the operation.
- After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon and/or anesthesiologist has told you to take with a sip of water the morning of surgery.
- Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and large doses of Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.
- Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
- Quit smoking and arrange for any help you may need at home.
HOW IS A BREAST CONSERVING SURGERY PERFORMED?
You will most likely be asked to check into the hospital the morning of your surgery.
- Breast conserving surgery is usually performed under a general anesthesia. It usually takes about an hour.
- If a sentinel lymph node biopsy is to be done, it is usually accomplished first.
- An incision is made over the palpable mass or near the localization wire.
- After the surgeon removes the intended part of the breast, the incision is closed.
WHAT SHOULD I EXPECT AFTER SURGERY?
Our goal is for your surgery and recovery to be as comfortable and convenient as possible. After breast conserving surgery, you may experience temporary pain and swelling at the excision site.
- Most Patients are able to engage in light activity while at home after surgery. Patients can remove any dressings and shower the day after the operation.
- Post-operative pain is generally mild and patients may require a pain pill or pain medication.
- Most patients can resume normal activities within a day or two, including driving, walking up stairs, light lifting, and work.
- You should call and schedule a follow-up appointment within 2 weeks after your operation.
WHAT COMPLICATIONS CAN OCCUR?
Breast biopsy is generally considered extremely safe. As with any operation, there is a risk of a complication. Complications during the operation may include:
- Bleeding or hematoma
- Rarely infection of the wound
- Skin wound separation
- Adverse reaction to general anesthesia
WHEN TO CALL YOUR DOCTOR
Be sure to call your physician or surgeon if you develop any of the following symptoms after surgery:
- Persistent fever over 101 degrees F (39 C)
- Chills
- Bleeding
- Pain that is not relieved by your medications
- Persistent nausea or vomiting
- You are unable to eat or drink liquids
- Persistent cough or shortness of breath
- Purulent drainage (pus) from the incision
- Redness surrounding the incision that is worsening or getting bigger