Does breast cancer require the entire breast to be removed? Let's learn about Lumpectomy surgery!

We all know the fear and shock that comes to mind when we hear the words "breast cancer." The biggest question that comes to mind is, "Will I have to have my entire breast removed?" Many people are very afraid of this. However, not all breast cancers require a mastectomy. Today, we are talking about a special surgery that can help you in such a situation, preserving the breast and removing only the cancer. That is the `Lumpectomy` surgery.

Simply put, what is Lumpectomy?

A lumpectomy is a surgical procedure that removes only the cancerous tumor and a small amount of healthy tissue around it, leaving your breast intact. This is also called a partial mastectomy. The goal is to remove all of the cancer while preserving the appearance and function of your breast as much as possible. This is why it is also called "breast-conserving surgery."

Radiation therapy is often given after a lumpectomy to reduce the risk of cancer coming back.

Sometimes this surgery is done to check whether a lump in the breast is cancerous or not. But most often it is done as a treatment for cancer.

Are there different types of this surgery?

Yes, there are several different methods that the doctor will decide on depending on your situation. Let's see what they are.

Who is suitable for lumpectomy surgery?

Your doctor will decide whether this surgery is right for you. Typically, you may be recommended this surgery in the following situations:

• If the cancer is limited to one area of ​​your breast .
• If the cancer is not too big compared to the size of your breast.
• If the doctor feels that the amount of tissue remaining after removing the tumor is sufficient to reconstruct the breast.
• If you are in good health to complete the radiation therapy required after surgery.

Who would be better off not having this surgery?

In some cases, a mastectomy, which removes the entire breast, may be more appropriate than a lumpectomy.

Your doctor may not recommend this surgery if you have the following reasons:

• If there are multiple cancerous tumors in the same breast .
• If the tumor is very large compared to the size of the breast.
• If the cancer has spread to the skin of the breast or the chest wall .
• If you have a type of cancer that spreads quickly (such as inflammatory breast cancer).
• If you have a high risk of cancer recurrence due to a family history of cancer or genetic factors (such as `BRCA` gene mutations).
• If you have previously had a lumpectomy and radiation therapy, and the cancer has recurred .

Also, this surgery is not suitable if there are risks associated with radiation therapy. Examples:

• If you have previously received radiation treatment to the same breast .
• If you are at risk of complications from radiation therapy due to skin conditions such as `Scleroderma` or `Sjögren's syndrome`.
• If you are pregnant (but sometimes surgery can be done in the last three months of pregnancy and radiation therapy can be given after the baby is born).

What happens during the surgery?

Let's take a step-by-step look at what happens on the day of surgery.

1. Marking the location of the tumor: First, a radiologist uses an ultrasound or mammogram to locate the exact location of the tumor within the breast. Then, a small wire or chip is inserted into the area to make it easier for the surgeon to reach.

2. Anesthesia: You will be given medication to make you feel no pain. Most often, you will be given general anesthesia, which will put you completely asleep. Sometimes, you will be given medication to numb only the area being operated on and make you feel a little sleepy.

3. Removing the tumor: The surgeon uses the previously made mark to remove the cancerous tumor and a thin layer of healthy tissue around it.

4. Marking: A few small metal clips (marker clips) are placed where the tumor was. This is important so that the radiation oncologist knows exactly where to target the radiation when giving radiation therapy later.

5. Suturing: Finally, the skin is sewn back together. Usually, dissolvable stitches are used for this. So there is no need to come back to cut them again.

The importance of removing leg veins (Sentinel Node Biopsy)

During a lumpectomy, one or more lymph nodes in your armpit closest to your cancer are removed and sent to a lab for testing. This is called a Sentinel Node Biopsy (SNB). These nodes are the first to be tested if cancer cells have spread. If cancer cells are found in these nodes, it means that the cancer has spread beyond the tumor. You may need additional treatment.

What happens after the surgery?

After surgery, your future treatment will be determined based on the pathology report of the removed tumor and the surrounding tissue.

• Best result: No cancer cells in the tumor and no cancer cells in the healthy tissue removed around the tumor (negative margin).
• "Positive Margin" result: If there are cancer cells in the area of ​​healthy tissue that was removed, another surgery may be needed to remove all remaining cancer cells.
• Cancer cells in the testicles: If cancer cells are found in the testicles, you may need additional treatment or tests .
• Special characteristics of cancer cells: Some cancer cells are helped to grow by hormones (such as estrogen). In that case, you may need to start hormone therapy .

Your doctor will explain all of this to you.

Benefits and possible risks of surgery

Main advantages

The biggest advantage of this is that you get to preserve your breast while removing the cancer. It can preserve its appearance, its feel, and everything in between.

Lumpectomy used to be done only in the early stages of cancer. However, recent research has shown that in most cases, there is no significant difference in survival outcomes between lumpectomy and radiation therapy, and mastectomy, which removes the entire breast . Therefore, it is now recommended as the first treatment for many types of cancer.

Possible risks (Complications)

Like any surgery, this one may have some minor risks.

• Infection at the suture site.
• Fluid accumulation at the surgical site (Seroma).
• Blood collection `(Hematoma)`.
• Scarring due to radiation treatment.
• Swelling in the arm or armpit (Lymphedema).
• Pain in the surgical area (reduces in a few weeks).

When you need to call the doctor urgently

If you notice any signs of infection during your recovery, it could be serious. So be aware of these symptoms. If you have any of these , tell your doctor right away .

• Redness and swelling of the operated breast.
• Feeling warm when touching the skin.
• A thick, milky fluid (pus) oozes from the wound.
• Fever, chills, sweating .
• Increased fluid accumulation around or within the breast.
• The pain is increasing after the surgery.

Lumpectomy, breast cancer, breast conserving surgery, mastectomy, cancer tumor