What is breast-conserving surgery (lumpectomy)?

Breast-conserving surgery (lumpectomy) removes the cancer and just enough tissue to get all the cancer. The goal is to keep the breast looking as normal as possible after the surgery while reducing the chances of the cancer coming back.

The size and location of tumors differs from one person to another, so the amount of tissue removed during surgery also differs.

Some of the lymph nodes under the arm may also be removed during breast-conserving surgery. This is done with a separate incision. If cancer is found in those lymph nodes, more lymph nodes may be removed.

Most people who have breast-conserving surgery also have radiation therapy. You may also have chemotherapy, hormone therapy, or both.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. You may want to sleep on the side that has not been operated on. A woman may want to use a pillow to support the affected breast while lying on her side.
• Avoid strenuous activities, such as biking, jogging, weightlifting, or aerobic exercise, for 1 month or until your doctor says it is okay. This may include housework, such as washing windows, especially if you have to use the arm next to the affected breast.
• Most people can return to their normal activities within 2 weeks.
• Try to walk each day. Start out by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• For 1 to 2 weeks, avoid lifting anything over 10 to 15 pounds or that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
• You may drive when you are no longer taking pain medicine and can use your arm without pain. Talk to your doctor about when to start driving, especially if you are having radiation treatments.
• You will probably be able to go back to work or your normal routine in 1 to 3 weeks. It may be longer, depending on the type of work you do and whether you are having radiation or chemotherapy.
• You may shower 24 to 48 hours after surgery, if your doctor okays it. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • Your doctor may have given you a medicine to numb the area inside and around your cut (incision). The numbness will last from 6 to 12 hours. If you went home right after the surgery, you may want to take pain medicine before this wears off.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.

Incision care

• If you have strips of tape on the cut the doctor made (incision), leave the tape on for a week or until it falls off.
• When you can shower, wash the area daily with warm, soapy water and pat it dry.

For early-stage breast cancer, breast-conserving surgery with radiation therapy has the same survival rate as mastectomy.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Complications of breast-conserving surgery are unusual. But they may include infection, bleeding, poor wound healing, or a reaction to the anesthesia used in surgery. Blood or clear fluid may also collect in the wound and need to be drained. You may have breast pain and feelings of pulling, pinching, tingling, or numbness.

Compared to women who have a mastectomy, women who have breast-conserving surgery have a slightly higher chance of the cancer returning.

After your surgery, you will be taken to a recovery room. A nurse will be able to help with any nausea, pain, or anxiety you might have.

Most people go home the day of the surgery. Your doctor or nurse will give you instructions on pain control and caring for your incision. In most cases, you can take a shower on the day after surgery. If you like, you can wear a bra if it is comfortable. Some doctors recommend wearing a bra day and night for a few days for support.

Most people are able to get back to normal activity within a few days. But be sure to wait for your doctor to tell you when you can start with more strenuous physical activity. This will depend on the extent of the surgery and on other treatment you might be having.

If you are going to have radiation therapy, it won't start until your incision heals. This usually takes 4 to 6 weeks.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.
• Bring a comfortable, supportive bra with you. You will need to wear this all the time, even during the night, for the first week after surgery.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors. If your doctor can't feel the lump, a needle can be put in the suspicious area. This may be done during a mammogram just before surgery. The needle will guide your doctor.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The surgery will take about 1 hour or longer, depending on the size of the lump.

Breast-conserving surgery is done in early-stage breast cancer to remove the cancer and just enough tissue to make sure that all the cancer is removed.