A partial mastectomy is a common surgical procedure for individuals diagnosed with breast cancer. This operation aims to remove cancerous tissue while preserving a significant portion of the breast, offering an alternative to more extensive surgeries.
Understanding Partial Mastectomy
A partial mastectomy, also referred to as a lumpectomy or breast-conserving surgery, involves removing the breast tumor and a surrounding margin of healthy tissue. The goal is to excise all cancerous cells while leaving most of the breast intact, helping to maintain its natural appearance and shape.
A partial mastectomy differs significantly from a total mastectomy, which involves the complete removal of the entire breast, including all breast tissue, the nipple, and the areola. In contrast, a partial mastectomy targets the cancerous area, removing only a segment of the breast. This difference in tissue removal is central to understanding the “partial” aspect of the procedure.
The removed tissue, including the tumor and healthy margin, is sent to a pathologist for examination. This confirms clear margins, meaning no cancer cells are found at the edges, which is important for reducing recurrence risk. If cancer cells are detected at the margins, a second surgery, known as a re-excision, may be necessary to achieve clear margins.
Who Is a Candidate and Why
Candidacy for a partial mastectomy is determined by breast cancer characteristics and the patient’s overall health. This procedure is recommended for individuals with early-stage breast cancer, particularly when the tumor is small, often less than 3 to 5 centimeters. Tumor location and confinement to a single area also influence eligibility.
The tumor’s size relative to breast size is an important consideration, ensuring enough breast tissue remains for a cosmetically acceptable outcome. The absence of scattered cancer cells (multifocal or multicentric disease) is also important. Patient preference plays a role in choosing this option to preserve breast appearance and body image.
The patient’s ability and willingness to undergo subsequent radiation therapy are important. Radiation therapy follows a partial mastectomy to destroy any remaining cancer cells and reduce local recurrence risk. Certain medical conditions or prior radiation treatments can make a partial mastectomy with radiation unsuitable.
The Surgical Procedure
Before a partial mastectomy, patients undergo pre-operative preparation, which may include imaging like mammograms or ultrasounds to locate the tumor. For non-palpable tumors, a radiologist may insert a thin wire or marker to guide the surgeon. This helps ensure accurate removal of the cancerous tissue.
The surgery is performed under general anesthesia. The surgeon makes an incision, often placed to minimize visible scarring, and removes the tumor along with a small, healthy margin of surrounding tissue. A sentinel lymph node biopsy is often performed during the same operation. This involves removing lymph nodes from the armpit to check for cancer spread, which helps guide further treatment decisions.
After the cancerous tissue and any necessary lymph nodes are removed, the surgeon closes the incision with sutures, aiming to maintain the breast’s natural contour. Patients move to a recovery room where medical staff monitor their vital signs as they awaken from anesthesia. The duration of the surgery ranges from one to two hours, depending on the complexity and whether lymph node removal is involved.
Recovery and Ongoing Care
Following a partial mastectomy, patients can expect a recovery period that generally allows for a return to most normal activities within a few weeks. Pain and discomfort are common initially, managed with prescribed medications. Patients receive instructions on wound care, including how to manage dressings and when it is safe to shower.
Radiation therapy is an important component of ongoing care after a partial mastectomy, which typically begins several weeks post-surgery. This treatment targets the remaining breast tissue to eliminate microscopic cancer cells and significantly reduce the chance of cancer returning. The duration of radiation therapy varies, involving daily sessions over several weeks.
Regular follow-up appointments with the surgical and oncology teams are important for monitoring recovery and detecting recurrence. These appointments include physical examinations and mammograms of the treated breast, starting about six to twelve months after surgery and radiation. Additional treatments, such as chemotherapy or hormone therapy, may be recommended based on the specific characteristics of the cancer.