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Lumpectomy

Lumpectomy — breast-conserving surgery in which the tumor is removed together with surrounding healthy tissue.

A surgical approach for early-stage breast cancer in which the tumor is removed along with a safe margin of healthy tissue, preserving the breast.

Indication

  • Early-stage (T1-T2) single-focus breast cancer
  • Patients in whom an acceptable cosmetic outcome can be achieved relative to breast size after tumor removal
  • No prior radiotherapy to the same breast
  • Patient preference for breast preservation, with general fitness for radiotherapy
  • Selected cases in which tumor size has decreased after neoadjuvant chemotherapy
  • Periods outside of pregnancy and the absence of contraindications to radiotherapy such as connective tissue disease

Preparation

  • Preoperative evaluation with blood tests, ECG, and chest X-ray if needed
  • Use of blood thinners and hormonal medications is adjusted with physician approval
  • If the tumor is not palpable, wire localization or radioactive marking is planned before the procedure
  • When indicated for sentinel lymph node mapping, a radiopharmaceutical injection is performed
  • Since general anesthesia is planned, fasting for at least 8 hours is required

How it's performed

  1. The procedure is performed under general anesthesia, or in some cases under local anesthesia with sedation
  2. A small incision is made along the skin lines
  3. The tumor is removed together with 1-2 mm of healthy tissue (with the goal of negative surgical margins)
  4. Sentinel lymph node biopsy or, if necessary, axillary dissection may be added in the same session
  5. The removed specimen may be checked with intraoperative X-ray and pathological evaluation
  6. Subcutaneous tissues and skin are closed using aesthetic techniques; a thin drain may be placed

Post-procedure

  • Most patients are discharged the same day or the following day
  • The dressing is kept dry for the first 48 hours; suture care is explained
  • Surgical margin clearance is evaluated with the pathology report; in case of positive margins, re-excision or mastectomy may be required
  • Whole-breast radiotherapy is planned after surgery as the oncologic standard
  • Hormonal therapy, chemotherapy, and targeted treatments are determined according to tumor characteristics; follow-up is performed with regular imaging

Risks

  • Bleeding, hematoma, and seroma formation at the wound site
  • Surgical site infection
  • Asymmetry and contour change of the breast after surgery
  • Need for additional surgery if the surgical margin is positive
  • Skin redness related to radiotherapy and rare long-term tissue firmness

FAQ

Does breast preservation increase the risk of cancer recurrence?

In appropriately selected patients, the combination of lumpectomy and radiotherapy provides long-term survival outcomes comparable to mastectomy.

Is radiotherapy necessary?

The standard approach recommends radiotherapy after breast-conserving surgery; in carefully selected older patients with low-risk disease, individualized decisions may be made.

How much will the appearance of the breast change?

It varies according to the size and location of the tumor and the volume of the breast; oncoplastic techniques may be used to support the cosmetic outcome.

When can I return to work?

For desk-based work, 1-2 weeks is usually sufficient; for jobs requiring heavy physical work, this period may extend to 3-4 weeks.