Lumpectomy - A Breast-Conserving Procedure
The goal of a lumpectomy is to remove just the tumor and a small margin of tissue. Your surgeon’s task will be to locate the lump itself, and a margin of tissue, which surrounds the lump. Sometimes a wire localization procedure is used to help mark the position of the lump. A surgeon will work by feel, and use information that is included in your mammogram or ultrasound report. My surgeon remarked that “cancer is very hard, sort of like a raw carrot” and that he guided his scalpel just outside of that hard area, to be sure that he had removed the whole tumor. Your surgeon may mention that getting “clear margins” around the tumor is important, and that is why a bit more than just the cancer must be removed. Since a tumor typically has bumpy ("spiculated") surfaces that may be trying to branch out and spread, the surgeon will try to ensure that when the tumor is removed, no bits of the bumps or spikes of the tumor are left in the breast tissue, which could cause a recurrence of cancer.
Here is a more detailed description of what you can expect during a lumpectomy.
Preparing for Radiation Treatments
After a lump has been removed, if you will need radiation, your surgeon may place a radiation catheter device, sometimes called a balloon catheter, into the lumpectomy cavity. This device allows your radiologist to give you brachytherapy, a method of radiation that is delivered from inside your breast, instead of external beam radiation.
New Shape, New Texture
Depending on how much tissue is removed, you may or may not need a prosthesis, or extra padding, in a bra after you’ve recovered from a lumpectomy. Your body will generate some scar tissue in the surgery area, which may fill in the place where the lump was. This will change the texture of your breast somewhat, and this area will show up on future mammograms as different from the undisturbed breast tissue. You will have a scar on the skin where your incision was made, but with good care, this will fade into a small line that is just a bit lighter that the surrounding skin. Ask your surgeon or family doctor how you can take the best care of the incision and promote healing.
Larger tumors may require a quadrantectomy, a type of partial mastectomy.
American Cancer Society. Detailed Guide: Breast Cancer. Surgery for Breast Cancer. Revised: 09/13/2007.