A lumpectomy is surgery to remove a lump caused by cancer from your breast. When the lump is removed from your breast, you may also have lymph nodes removed to see if the cancer has spread.
Lymph nodes are the size of a pea, and are found throughout your body. The lymph system consists of lymph nodes that store blood cells (lymphocytes) to fight infection and vessels that carry fluid, nutrients, and wastes between your body and your bloodstream. Many types of cancer spread through the lymph system. Removing nearby lymph nodes can limit how far the cancer can spread.
When is it used?
This procedure is a treatment for breast cancer. As an alternative you could:
Have your whole breast removed (a mastectomy)
Have the lumps frozen (cryosurgery), treated with targeted drug therapy or radiation, or removed with a laser
Choose not to have treatment
Ask your healthcare provider about your choices for treatment and the risks. Also, it is helpful to have a family member or friend listen to the choices with you.
How do I prepare for this procedure?
Plan for your care and find someone to give you a ride home after the procedure.
Tell your provider if you have had kidney problems or an allergy to chemicals, such as contrast dye. Contrast dye is used for some scans.
You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Tell your healthcare provider about all medicines and supplements that you take. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
Follow any other instructions your healthcare provider gives you.
Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do.
What happens during the procedure?
You will be given general anesthesia to keep you from feeling pain during the procedure. General anesthesia relaxes your muscles and you will be asleep. The surgeon makes a small cut and removes the lump and surrounding breast tissue. You may have one of two procedures to remove lymph nodes:
Sentinel lymph node biopsy (SLNB). If you have SLNB, a blue dye is injected around the area of the lump. The dye finds the first lymph nodes to which cancer cells are likely to spread from a tumor. Then a small cut is made in your armpit and the nodes containing the dye are removed. These nodes are checked for cancer.
Axillary lymph node dissection (ALND). If you have ALND, the lymph nodes under your armpit are removed through another cut in the armpit. A drain will be left in the cut in your armpit for a few days.
What happens after the procedure?
You may go home that day or stay in the hospital overnight. Ask your healthcare provider:
How and when you will hear your test results
How long it will take to recover
What activities you should avoid, including how much weight you can lift and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. It is helpful to have a family member or friend with you on the first visit after surgery, when you discuss test results.
If no cancer is found in the lymph nodes and removal of the cancer is complete, your provider may still recommend chemotherapy or radiation therapy.
If cancer is found in the lymph nodes, then you will usually be advised to schedule more surgery to remove the remaining lymph nodes in the armpit before you have chemotherapy or radiation therapy.
What are the risks of this procedure?
Your healthcare provider will explain the procedure and any risks. Some possible risks include:
Anesthesia has some risks. Discuss these risks with your healthcare provider.
You may have infection, bleeding, or blood clots.
You may have an allergic reaction to the dye used to find the sentinel lymph nodes.
A lumpy scar, called a keloid, may develop. Tell your provider if you have other scars that have healed this way.
After axillary lymph node dissection, the underside of your arm will probably be numb due to the loss of nerves to the skin.
You may develop arm swelling, called lymphedema. Removal of the lymph nodes under your armpit can change the way the lymph fluid drains from the arm. Lymphedema can happen right after surgery or months to years later. A mild injury, such as from a blood test, a blood pressure cuff that is too tight, or an infection in the arm can cause lymphedema or make it worse. Ask your provider how you can help avoid this problem.
Depending on the size of the lump that was taken out and the size of your breast, the shape of your breast may change.
Your nipple may point another way and your breasts may not match as well as before the surgery.
Lab tests may show that the cancer was not completely removed. If this happens, you may need more surgery.
Every procedure or treatment has risks. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.
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Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-05-29 Last reviewed: 2013-12-02
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
http://www.nccn.org. NCCN Clinical Practice Guidelines in Oncology-Breast cancer,v.2.2011. BINV-2 Locoregional treatment of clinical stage I, IIA, or IIB disease or T3, N1, M0. BINV-D Surgical Axillary Staging, StageI, IIA and IIB. Accessed 01/23/12.
Neumager L, Neterission S, McMasters K. Canadian Association of General Surgeons and American College of Surgeons Evidence Based Reviews in Surgery. ASCO recommended guidelines for sentinel lymph node biopsy for early stage breast cancer. Can J Surg 2007 December; 50(6): 482-484.
Lymon GH, Giuliano AE, Somerfield MR et al. American Society of Clinical Oncology guidelines, recommendations for sentinel lymph node biopsy in early stage breast cancer. J Clin Oncol 2005; 23(30): 7703-20.