A partial mastectomy, also called a lumpectomy or breast-conserving surgery, involves removing a cancerous tumor and a surrounding margin of healthy breast tissue. This procedure eliminates the malignancy while preserving the majority of the breast structure. The amount of tissue removed depends directly on the tumor’s size and location. Understanding the physical changes following this procedure helps manage expectations regarding the treated breast’s appearance as it heals.
The Immediate Post-Operative Appearance
The breast shows acute, temporary changes immediately following the procedure and throughout the initial weeks of recovery. Bruising and swelling are normal in the surgical area, resulting from tissue manipulation and the body’s healing response. Swelling may affect the chest wall, shoulder, and arm on the operated side, typically lessening within six to eight weeks after surgery.
A surgical dressing covers the incision, which may have sutures that dissolve or require removal after seven to ten days. A thin surgical drain may be placed beneath the skin to prevent fluid accumulation, though this is less common for smaller excisions. The drain is usually removed within the first few weeks. Tenderness and a temporary sensation of tightness or pulling around the incision and armpit are common and diminish as recovery progresses.
Long-Term Physical Changes and Scarring
The final appearance of the breast stabilizes once the healing process is complete, which typically takes six to twelve months. A permanent scar will be present; its size and position depend on the extent of tissue removed. Surgeons often plan incision placement to be discreet, sometimes locating it around the edge of the areola or within the natural fold beneath the breast.
Over time, the scar matures, flattening and fading from an initial raised, reddish appearance to a pale white or silver line. The most noticeable long-term difference is the volume loss where tissue was removed. This loss can result in an indentation, slight dimpling, or a flattened area in the breast’s shape. If a significant volume was excised, the treated breast may appear noticeably smaller than the other, creating asymmetry.
The nipple and areola complex generally remain intact, as the procedure conserves the breast. However, if the tumor was close to the nipple, patients may experience subtle changes in sensation. The formation of firm, internal scar tissue is also possible and contributes to the final shape and feel of the breast.
Factors Influencing the Final Aesthetic Result
The final cosmetic result following a partial mastectomy varies significantly, depending on surgical decisions and subsequent treatments. The ratio between the volume of tissue removed and the overall size of the breast is a primary predictor of the final shape. Removing a small tumor from a larger breast typically results in minimal contour change. Conversely, removing the same volume from a small breast leads to a more noticeable change in shape and size. Excising more than 20% of the preoperative breast volume significantly increases the likelihood of a less satisfactory aesthetic outcome.
Surgical technique also plays a substantial role in minimizing aesthetic changes. Oncoplastic surgery integrates plastic surgery principles with cancer removal, allowing the surgeon to reshape the remaining breast tissue to fill the space left by the tumor removal. These techniques, which include volume displacement or volume replacement, maintain symmetry and reduce indentation. This planning helps create a better final contour, particularly when a larger portion of tissue must be removed.
Radiation therapy often follows a partial mastectomy to reduce the risk of cancer recurrence. The effects of radiation are a major determinant of the long-term appearance and texture of the breast. Months or even years after treatment concludes, the treated breast may become firmer and harder due to fibrosis, which is the formation of dense connective tissue. Radiation can also cause the breast to shrink slightly over time, potentially increasing the size difference between the treated and untreated breasts.
Other Long-Term Radiation Effects
Other long-term changes include subtle darkening or lightening of the skin in the treated area. The appearance of tiny, visible red or purple blood vessels, known as telangiectasia, may also occur.