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Summary

Breast conserving surgery (BCT) removes only the cancerous area and a small amount of surrounding tissue. The breast remains in tact.

How much is removed depends on the size and location of the tumor and other factors.

There are two types of breast conserving surgery: lumpectomy and quadrentectomy. To learn about them, click here. 

As a general matter, a lumpectomy is performed on an out patient basis in a hospital. You go home the same day. With a quadrantectomy, you will typically leave the next day. Any resulting pain is controllable.

For more information see:

NOTE:

  • Check the hospital bill before you leave the hospital, or soon after you get home. A high percentage of hospital bills have mistakes in them. To learn how to check the bill, click here.
  • To learn how to negotiate a hospital bill, click here.

A Lumpectomy Compared To A Quadrantectomy

A lumpectomy 

  • Removes only the breast lump and a surrounding margin of normal tissue. 
  • Surgery is usually performed in a hospital on an out patient basis so you go home the same day.
  • With a lumpectomy, you are left with a scar and sometimes a dimpling of the skin which can be filled in by a plastic surgeon - often at the same time as the lumpectomy.
  • Radiation therapy  is usually given after a lumpectomy. If chemotherapy is to be given as well, radiation is usually delayed until the chemotherapy is completed.

For questions to ask before going home after receiving a lumpectomy, see the document in "To Learn More."

A quadrantectomy 

  • Removes more breast tissue than a lumpectomy. For a quadrantectomy, one-quarter of the breast is removed. 
  • Surgery usually involves a one day stay in a hospital.
  • The breast is generally smaller following this surgery.
  • The breast can be reconstructed - often at the same time as the quadrantectomy surgery. 
  • As a general matter, if the initial surgery is covered by health insurance, so is breast reconstruction.
  • Radiation therapy is usually given after surgery. Radiation therapy may be delayed if chemotherapy is also to be given.

For information about removal of the entire breast, see Mastectomy. 

What To Expect After A Partial Breast Removal

As a general matter, a lumpectomy is performed on an out patient basis in a hospital. You go home the same day. With a quadrantectomy, you will typically leave the next day.

A drain to remove blood and lymph fluid is usually inserted in your armpit during the procedure. The drain removes excess fluid from your system.

The drain is usually removed before you go home. Sometimes the drain stays in longer. In that case, it is generally removed during your follow-up visit with your doctor.

There is generally little pain in the breast area after surgery. You may feel numbness, pinching, or pulling in the underarm area. This is caused by the removal of the sentinel nodes. Some women who have had a partial breast removal may also experience numbness in the chest wall. This generally disappears in a few months.

Let your doctor know how well you do or do not tolerate pain so the doctor can prescribe appropriate medication. Keep in mind that as a general matter, doctors tend to under treat pain. Pain can slow healing. Let the doctor know if you want to be pain free. It is a myth to think that people who are prescribed pain medication will become addicted. (See the document in To Learn More to learn about pain and treatment for pain).

Before leaving the hospital, ask your surgeon what you can and cannot do - preferably in writing. For example, showering, taking a bath, exercise, lifting light or heavier objects. Most doctors will want you to start moving your arm soon after surgery to prevent stiffness. Women are also generally encouraged to return to normal activities as soon as possible after the surgery. 

If the shape of your breast is changed, and you want it to look the same as it does now in clothes, ask when you can start wearing a breast form (prosthesis). Tips about breast forms are in the document of the same name in "To Learn More."

NOTES:

  • You may experience Post-mastectomy Pain Syndrome (PMPS) after a Lumpectomy or quadrantectomy. PMPS is chronic nerve (neuropathic) pain. According to the American Cancer Society, the classic signs of PMPS are chest wall pain and tingling down the arm. Pain may also be felt in the shoulder, scar, arm, or armpit. Other common complaints include numbness, shooting or pricking pain, or unbearable itching. Let your doctor know if you have any of these symptoms. PMPS can be treated with medications that work for nerve pain. 
  • It is not unusual to receive radiation and/or chemotherapy after a lumpectomy. For more information about these treatments, see the documents in To Learn More.




Questions To Ask Before Going Home After A Lumpectomy

The following questions are based on those the American Cancer Society offsite link recommends that you ask before leaving the hospital after a lumpectomy or quadrantectomy *:

How To Take Care Of Your Body
  • How to take care of the wound and bandage
  • How to monitor drainage and take care of the drains 
  • How to know if you have an infection
  • What medicines to take (including pain medicines) and how often
  • When to call your doctor or nurse (and how)
  • Any restrictions on activities
  • What to expect regarding sensations in the breast and arm
  • What to expect regarding feelings about body image
  • What can I do to avoid getting lymphedema
How To Get Back Into Your Life
  • What to eat and what not to eat
  • What activities you should or should not do
  • How soon you can return to work
    • Should return to work be part time? If so, for how long?
    • What limitations should I observe at work, if any. For how long?
    • Will I need an change at work (an accommodation) to allow me to do my work? If so, for how long?
How To Get Used To Your Body After Surgery
  • When to start using your arm
  • How to exercise your arm to keep it from getting stiff
  • How to get in touch with an American Cancer Society Reach to Recovery volunteer. Reach to Recovery is a program in which breast cancer patients can talk by phone or face-to-face with breast cancer survivors.