Lumpetomy

Lumpectomy is a surgical procedure where a lump or abnormal portion of breast tissue is removed while sparing most of the surrounding healthy tissue. Commonly utilized in the treatment of breast cancer, a lumpectomy is a form of breast-conserving surgery. Compared to mastectomy, which involves the removal of the entire breast, lumpectomy is less invasive and retains the overall appearance and shape of the breast, making it a popular option for many women.

Partial mastectomy

Lumpectomy illustration

Lumpectomy, Partial or segmental mastectomy, extracted from Understanding breast cancer treatment - a guide for patients (1998)

Indications

Lumpectomies are typically recommended for:

• Early-stage breast cancer.
• Tumors that are less than 4 cm or about 25% of the breast.
• Patients opting for radiation therapy post-surgery.
• In some cases, for larger tumors after chemotherapy has reduced the size.

Procedure

The process involves:

• Local or general anesthesia, depending on the tumor's size and location.
• A small incision in the breast, typically around the tumor's edge.
• Removal of the tumor along with a margin of healthy tissue.
• Pathological examination of the margins to ensure no cancer cells remain.

Advantages over Mastectomy

Lumpectomy offers several advantages:

• Conservation of the breast's natural appearance.
• Faster recovery and less pain post-surgery.
• Preservation of breast sensation.
• Reduced psychological trauma associated with losing a breast.

Risks and Complications

• Infection or bleeding at the surgical site.
• Scarring or changes in breast shape.
• Incomplete removal of cancer cells, necessitating another surgery.
• Possibility of radiation therapy post-surgery.

Post-Surgical Care

• Regular follow-up with mammograms.
• Radiation therapy to kill any remaining cancer cells.
• Physical therapy to maintain arm movement.
• Awareness of changes or lumps in the breast.

Comparisons with Other Treatments

Mastectomy involves removing the entire breast and is often chosen for larger tumors or if the patient wishes to avoid radiation therapy. Breast-conserving surgery is a category that includes lumpectomy and refers to surgeries that remove cancer but not the entire breast.

References

• Fisher, B., Anderson, S., Bryant, J., Margolese, R. G., Deutsch, M., Fisher, E. R., ... & Wolmark, N. (2002). Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. *New England Journal of Medicine*, 347(16), 1233-1241.
• Veronesi, U., Cascinelli, N., Mariani, L., Greco, M., Saccozzi, R., Luini, A., ... & Salvadori, B. (2002). Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. *New England Journal of Medicine*, 347(16), 1227-1232.
• Moran, M. S., Schnitt, S. J., Giuliano, A. E., Harris, J. R., Khan, S. A., Horton, J., ... & Morrow, M. (2014). Society of Surgical Oncology–American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. *Journal of Clinical Oncology*, 32(14), 1507.