What is Lumpectomy

Lumpectomy sometimes called a partial mastectomy, is surgery to remove a cancerous tumor or mass (the lump) from a breast. It is a form of “breast conserving” or “breast preservation” surgery. This means that the cancerous tissue is removed but the breast remains intact.

During a lumpectomy, the portion of the breast that contains the tumor is removed. Some normal tissue around the lump may be taken out to make sure that all of the tumor has been removed. Lymph nodes under your arm may also be removed and tested to find out if the cancer has spread. Lymph nodes are part of the body’s disease-fighting system (immune system), and are usually the first place where breast cancer spreads.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Infection.
• Allergic reaction to medicines.
• Pain, swelling, weakness, or numbness in the arm on the side of your surgery.
• Temporary swelling.
• Change in the shape of the breast, particularly if a large portion is removed.
• Scar tissue that forms at the surgical site and feels hard to the touch.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

• Follow instructions from your health care provider about eating and drinking, which may include:
  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• Ask your health care provider how your surgical site will be marked or identified.
• You may be screened for extra fluid around the lymph nodes (lymphedema).
• Plan to have someone take you home from the hospital or clinic.
• On the day of surgery, your health care provider will use a mammogram or ultrasound to locate and mark the tumor in your breast. These markings on your breast will show where the incision will be made.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Your health care provider will use a kind of electric scalpel that uses heat to minimize bleeding (electrocautery knife). A curved incision that follows the natural curve of your breast will be made. This type of incision will allow for minimal scarring and better healing.
• The tumor will be removed along with some of the surrounding tissue. This will be sent to the lab for testing. Your health care provider may also remove lymph nodes at this time if needed.
• If the tumor is close to the muscles over your chest, some muscle tissue may also be removed.
• A small drain tube may be inserted into your breast area or armpit to collect fluid that may build up after surgery. This tube will be connected to a suction bulb on the outside of your body to remove the fluid.
• The incision will be closed with stitches (sutures).
• A bandage (dressing) may be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You will be given medicine for pain as needed.
• Your IV will be removed when you are able to eat and drink by mouth.
• You will be encouraged to get up and walk as soon as you can. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• You may have a drain tube in place for 2–3 days to prevent a collection of blood (hematoma) from developing in the breast. You will be given instructions about caring for the drain before you go home.
• A pressure bandage may be applied for 1–2 days to prevent bleeding or swelling. Your pressure bandage may look like a thick piece of fabric or an elastic wrap. Ask your health care provider how to care for your bandage at home.
• You may be given a tight sleeve to wear over your arm on the side of your surgery. You should wear this sleeve as told by your health care provider.
• Do not drive for 24 hours if you were given a sedative during your procedure.

Summary

• A lumpectomy, sometimes called a partial mastectomy, is surgery to remove a cancerous tumor or mass (the lump) from a breast.
• During a lumpectomy, the portion of the breast that contains the tumor is removed. Some normal tissue around the lump may be taken out to make sure that all of the tumor has been removed. Lymph nodes under your arm may also be removed and tested to find out if the cancer has spread.
• You may have a drain tube in place for 2–3 days to prevent a collection of blood (hematoma) from developing in the breast. You will be given instructions about caring for the drain before you go home.
• Plan to have someone take you home from the hospital or clinic.

Lumpectomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Breast swelling.
• Breast tenderness.
• Stiffness in your arm or shoulder.
• A change in the shape and feel of your breast.
• Scar tissue that feels hard to the touch in the area where the lump was removed.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Take your antibiotic medicine as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Keep your dressing clean and dry.
• If you were sent home with a surgical drain in place, follow instructions from your health care provider about emptying it.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Be careful to avoid any activities that could cause an injury to your arm on the side of your surgery.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe. Avoid lifting with the arm that is on the side of your surgery.
• Do not carry heavy objects on your shoulder on the side of your surgery.
• After your drain is removed, you should perform exercises to keep your arm from getting stiff and swollen. Talk with your health care provider about which exercises are safe for you.

General instructions

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Wear a supportive bra as told by your health care provider.
• Raise (elevate) your arm above the level of your heart while you are sitting or lying down.
• Do not wear tight jewelry on your arm, wrist, or fingers on the side of your surgery.
• Keep all follow-up visits as told by your health care provider. This is important.
  • You may need to be screened for extra fluid around the lymph nodes (lymphedema). Follow instructions from your health care provider about how often you should be checked.
• If you had any lymph nodes removed during your procedure, be sure to tell all of your health care providers. This is important information to share before you are involved in certain procedures, such as having blood tests or having your blood pressure taken.

Contact a health care provider if:

• You develop a rash.
• You have a fever.
• Your pain medicine is not working.
• Your swelling, weakness, or numbness in your arm has not improved after a few weeks.
• You have new swelling in your breast or arm.
• You have redness, swelling, or pain in your incision area.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.

Get help right away if:

• You have very bad pain in your breast or arm.
• You have chest pain.
• You have difficulty breathing.

Summary

• After the procedure, it is common to have breast tenderness, swelling, and stiffness in your arm and shoulder.
• Follow instructions from your health care provider about how to take care of your incision.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe. Avoid lifting with the arm that is on the side of your surgery.
• If you had any lymph nodes removed during your procedure, be sure to tell all of your health care providers. This is important information to share before you are involved in certain procedures, such as having blood tests or having your blood pressure taken.