Segmental breast resection

For certain benign neoplasms and in the early stages of breast cancer, organ-preserving operations are performed. During such an intervention, the surgeon removes the tumor together with a small area of surrounding tissues, preserving the breast.

At the Oxford Medical medical center in Kyiv, operations are performed by experienced breast surgeons and surgical oncologists using expert-class equipment. To learn about possible treatment methods, schedule a consultation with a mammologist by phone or through the online appointment form on the website.

Lumpectomy is a breast-conserving operation during which the surgeon removes the tumor together with a small area of surrounding tissues. Another name for the intervention is sectoral resection of the breast. The extent of removal depends on the size, location, and nature of the neoplasm.

After the operation, the removed tissues are sent for histological examination. It allows the nature of the neoplasm to be established or confirmed and, in the case of cancer, to check whether there are malignant cells at the edges of the removed area.

Sectoral removal of the breast has a number of advantages compared with undergoing a mastectomy. They concern both the course of the surgical intervention and subsequent recovery, as well as the aesthetic result of the operation.

The main advantages of lumpectomy are:

• a smaller incision and less tissue trauma compared with mastectomy;
• preservation of most of the breast tissue;
• faster recovery and return to everyday activities, usually within 1–2 weeks;
• the possibility of preserving the natural shape of the breast with minimal changes in appearance.

According to the National Cancer Institute (NCI), breast-conserving surgery combined with radiation therapy provides the same life expectancy as mastectomy in patients with early-stage breast cancer for whom both methods are suitable.

At the same time, doctors at Oxford Medical explain that the possibility of performing a lumpectomy depends on the size and location of the tumor, the ratio of its size to the volume of the breast, and other oncological indications.

At the same time, most simple cysts and small fibroadenomas do not require surgical removal. If the formation has benign features and does not cause symptoms, the doctor may recommend observation with periodic ultrasound examinations or mammography. If suspicious changes are present, a biopsy is performed, and further management is determined based on its results.

The operation of sectoral resection of the breast is not suitable for all patients. In some cases, breast-conserving surgery does not allow complete removal of malignant tissues or achievement of a satisfactory aesthetic result.

The main contraindications to lumpectomy are:

• large tumors whose size does not allow preservation of a sufficient volume of breast tissue;
• several malignant lesions in different areas of the breast;
• extensive malignant changes, including large areas of suspicious microcalcifications;
• inability to undergo radiation therapy if it is necessary after surgery;
• inability to completely remove the tumor with clear resection margins.

The patient's general health condition, concomitant diseases, and anesthesia risks are considered separately. If lumpectomy is contraindicated, other treatment options, including mastectomy, are considered.

Before lumpectomy, the patient undergoes examinations necessary to clarify the diagnosis, plan the extent of the intervention, and assess her general health condition. The doctor determines the list of examinations depending on the nature of the neoplasm and the presence of concomitant diseases.

Preparation for sectoral resection of the breast includes:

• a consultation with a breast surgeon or surgical oncologist;
• breast ultrasound and/or mammography to determine the size and location of the formation;
• a biopsy, if indicated, to clarify the nature of the neoplasm;
• laboratory blood tests, a coagulation profile, ECG, and other examinations if indicated;
• a consultation with an anesthesiologist to assess anesthesia risks and select the optimal type of anesthesia.

Doctors at Oxford Medical note: examinations help not only to determine the size and location of the neoplasm but also to distinguish it from other breast diseases. For example, an inflammatory infiltrate in mastitis can sometimes resemble a tumor formation.

During the consultation, the use of regular medications should be discussed with the doctor. Particular attention is paid to medications that affect blood clotting: if necessary, the doctor determines whether their administration regimen needs to be changed before surgery.

If the intervention is performed under general anesthesia, it is usually necessary to refrain from eating for 6-8 hours, while clear liquids may be consumed no later than 2 hours before surgery. The anesthesiologist determines the exact restrictions, taking into account the patient's condition.

Lumpectomy is usually performed under general anesthesia. Depending on the size and location of the neoplasm, the intervention lasts approximately 60-90 minutes.

The main stages of lumpectomy are:

• Preparation of the surgical field. After administering anesthesia, the surgeon treats the skin with an antiseptic and determines the incision site.
• Access to the neoplasm. The doctor makes a skin incision, taking into account the location of the tumor and the possibility of preserving the natural shape of the breast.
• Removal of the tumor. The surgeon excises the neoplasm together with an area of surrounding tissues. In the case of a malignant process, the surgeon aims to remove the tumor with a sufficient margin from its borders to reduce the risk of leaving cancer cells behind.
• Assessment of lymph nodes. If indicated, a sentinel lymph node biopsy may be performed at the same time to check for the presence of tumor cells.
• Completion of the operation. The surgeon stops the bleeding, applies sutures and a sterile dressing.

After completion of the intervention, the patient is transferred to the postoperative ward. Medical staff monitor her condition, blood pressure, pulse, and other vital signs until she fully awakens from anesthesia.

After sectoral resection of the breast, the patient usually stays in the hospital until the following day. During the first few days, moderate pain, swelling, bruising, and a feeling of tightness in the area of the suture are possible. These symptoms gradually decrease as the tissues heal.

For recovery after surgery, doctors recommend:

• taking prescribed painkillers and following the dressing change schedule;
• keeping the postoperative wound clean and dry in accordance with the surgeon's recommendations;
• wearing a supportive bra without rigid underwires;
• avoiding lifting heavy objects, intensive exercise, and strain on the chest muscles during the first 1–2 weeks;
• gradually restoring arm mobility on the operated side and everyday activity;
• attending a follow-up examination within the timeframe specified by the surgeon.

Most patients can return to their usual lifestyle within 1–2 weeks, but complete tissue healing usually takes about 2–4 weeks. The duration of recovery depends on the extent of the intervention, the characteristics of healing, and the general state of health.

Complications after lumpectomy occur infrequently; however, as with any surgical intervention, they cannot be completely ruled out. The risk depends on the extent of the operation and the patient's general health condition.

Possible postoperative complications include:

• hematoma — an accumulation of blood in the surgical area that may cause pain and swelling;
• seroma — an accumulation of serous fluid in the surgical area;
• infection of the postoperative wound;
• impaired wound healing, including separation of the sutures;
• changes in the shape of the breast, formation of a noticeable scar, or reduced skin sensitivity in the surgical area.

Doctors at Oxford Medical recommend contacting a surgeon immediately if pain or swelling increases after surgery, pronounced redness or discharge from the wound appears, or body temperature rises. A timely examination helps identify complications and begin the necessary treatment.

The price of sectoral resection of the breast depends on the extent and complexity of the operation. A breast surgeon or surgical oncologist will be able to provide an approximate cost after a consultation and the necessary diagnostic examinations.

Current consultation prices can be viewed here. To schedule an appointment with a doctor, call the contact center or request a callback. You can also use the online appointment form on the website.

The information is for informational purposes only and does not replace a doctor's consultation.

Sources:

• National Cancer Institute
• The American Society of Breast Surgeons
• National Institutes of Health