Lumpectomy Procedure
With a lumpectomy, the surgeon removes the tumor, along with a margin (a small rim of normal tissue around the tumor). In some cases, a person may get 2 lumpectomies in the same breast.
Lumpectomy surgery
A lumpectomy (also called a breast-conserving surgery, a partial mastectomy or a wide excision) is often done under general anesthesia. This means you’re asleep during the surgery. In some cases, local anesthesia with sedation, or regional anesthesia may be used.
During surgery:
- The surgeon makes an incision (cut) in the breast and removes the tumor, along with a small rim of normal tissue around it.
- The surgeon closes the skin with stitches, trying to keep the breast looking (as much as possible) like it did before surgery.
- The surgeon may also remove some lymph nodes in the underarm area.
The tissue removed during surgery is sent to a pathologist for testing.
Learn about test results and other information found in your pathology report.
Finding the tumor in the breast
In some cases, the surgeon uses special methods to help find the tumor in the breast.
Localization procedure at the time of surgery
Sometimes, breast cancers found by mammography or other imaging are nonpalpable (cannot be felt).
If the tumor is nonpalpable, a localization procedure will be done just before surgery. Local anesthesia is used for the localization procedure.
During the procedure:
- A radiologist will use a mammogram, breast ultrasound or breast MRI as a guide and insert a very thin wire, radioactive seed (radio-seed) or other marker into the breast in the area of the cancer.
- The surgeon uses the marker as a guide to find the tumor during surgery. The wire, seed or other marker will be removed during surgery.
After the tumor is removed, it’s usually X-rayed. The X-rays show whether the tumor with the wire, seed or other marker was in the removed tissue. This helps the surgeon be sure all the cancer visible on imaging was removed.
Radio-opaque clip during a needle biopsy
Most often, a core needle biopsy is used to diagnose breast cancer. It removes a small amount of tumor tissue.
During a core needle biopsy, a clip should be placed in the breast to mark the location of the tumor. This clip is radio-opaque, meaning it can be seen on an X-ray. You can’t feel the clip.
Later, during a lumpectomy, the surgeon uses the clip (along with the wire, radioactive seed or other marker) as a guide to find and remove the tumor. The clip is usually removed during the surgery.
Assessing margins (Was the entire tumor removed?)
A pathologist checks the tissue removed during breast surgery. It takes about 1-2 weeks to do a complete check of the tissue.
The pathologist looks at the tissue under a microscope. They determine whether the entire tumor was removed by checking to see if the margins (the rim of tissue around the tumor) contain cancer cells.
Clean margins (also called uninvolved margins or negative margins) contain only normal tissue on their outer edges. This means there are no cancer cells at the margins.
In some cases, more surgery is needed to get clean margins.
Learn more about assessing tumor margins.
Assessing lymph nodes (Has cancer spread to the lymph nodes?)
If breast cancer spreads, the axillary lymph nodes (lymph nodes in the underarm area) are the first place it’s likely to go.
During a lumpectomy for invasive breast cancer, some axillary lymph nodes are removed to check for cancer cells. Often, there’s a separate incision (cut) in the underarm area (below where your underarm hair grows) to remove these nodes.
The presence or absence of cancer in the axillary nodes affects cancer stage, treatment and the chances for survival.
Learn more about assessing axillary lymph nodes.
Length of hospital stay
Usually, you can go home the same day as the surgery.
However, the length of the hospital stay after a lumpectomy depends on whether axillary lymph nodes are removed.
Discuss the expected length of your stay with your surgeon and insurance company.
Sentinel lymph node biopsy
If you have a sentinel lymph node biopsy or you don’t have axillary lymph nodes removed, you’ll likely go home the same day as your surgery.
Axillary lymph node dissection
If you have an axillary lymph node dissection, you usually go home the same day. In rare cases, people need to stay overnight in the hospital.
A surgical drain (tube) may be placed in the underarm area to collect fluid. This drain stays in for a week to 10 days after surgery.
Learn more about sentinel lymph node biopsy and axillary lymph node dissection.
What to expect after a lumpectomy
Pain and numbness
After a lumpectomy, you’ll likely:
- Have some soreness in your chest, underarm and shoulder
- Feel a healing ridge (a firm ridge below the scar while it heals)
- Have numbness along the surgical incision (scar)
If axillary lymph nodes are removed during surgery, you may also have some numbness and a burning feeling under and behind your arm. Placing a small pillow below your underarm may make you more comfortable.
Pain related to surgery may be treated with mild pain relievers or if the pain is more severe, prescription medication.
Learn about the management of surgery-related pain.
Limited range of motion in the shoulder area
If you had a sentinel lymph node biopsy to remove axillary lymph nodes during surgery, you may have short-term problems with your range of motion in your shoulder area (the ability to move the shoulder easily). These problems may last longer after an axillary lymph node dissection than after a sentinel node biopsy.
If you had an axillary lymph node dissection, your health care provider may recommend special exercises to improve your range of motion. They may also refer you to a physical therapist if needed.
Risk of lymphedema
If axillary lymph nodes are removed during surgery, there’s a risk of lymphedema.
Lymphedema is a condition where fluid builds up in the arm and/or hand, causing it to swell. Today, lymphedema isn’t very common. If it does occur, it usually develops within 3 years of having axillary lymph nodes removed [5-6].
Learn more about lymphedema.
Cosmetic issues
Women may choose a lumpectomy over a mastectomy to keep their breast and have it look (as much as possible) like it did before surgery.
However, a lumpectomy may change the look and feel (sensation) of the breast. Because some tissue is removed, the breast may become smaller. There will also be some numbness and a scar. Ask your health care provider about products that might help reduce the appearance of the scar.
Radiation therapy (usually given after a lumpectomy) can also affect the look of the breast. It may:
- Make the breast smaller or larger
- Change the texture of the breast
- Make the breast feel firmer
- Make the skin where the breast was treated have mild tanning or red discoloration
The look and feel of your breast will continue to change during the first 1-2 years after surgery and radiation therapy.
When a mastectomy may be a better option
Sometimes, things like the location and size of the tumor make it unlikely a woman will be happy with the look of her breast after a lumpectomy. In these cases, a mastectomy (with or without breast reconstruction) may be the better option.
Breast reconstruction after a lumpectomy
While not common, some women have breast reconstruction (either at the time of the lumpectomy or later) to maintain a more natural appearance of the breast, or to match the size and shape of the other breast.
These surgeries are complex, so it’s best to meet with a plastic surgeon to discuss your options.
Emotional health after a lumpectomy
After a lumpectomy, you may feel a buildup of emotions. You may have been anxious leading up to surgery. And, after surgery, you may feel a sense of relief, or you may be worried about what happens next. This is normal.
Make sure you take time to recover both emotionally and physically. You may want to have family and friends available for support.
Learn more about social support.
Transportation, lodging, childcare and eldercare assistance
You may not live near the hospital where you’ll have your surgery. It’s OK to ask for help.
There may be resources available if you need a ride to and from surgery or help with childcare or eldercare. Family and friends often want to help but don’t know how. These are great ways for them to get involved.
There may be some programs that help with local or long-distance transportation and lodging (if you need a place to stay overnight).
There may also be programs to help you with childcare or eldercare costs.
Learn more about transportation, lodging, childcare and eldercare assistance programs.
Susan G. Komen® Support Resources |
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Updated 04/08/24
