McKesson Clinical Reference Systems: Women's Health Advisor 2002.2

What is a lumpectomy and axillary lymph node excision?

A lumpectomy is a procedure in which the doctor surgically removes a cancerous lump from a woman's breast. Axillary lymph node excision is removal of the lymph nodes under the armpit. This procedure is a treatment for breast cancer.

When is it used?

This procedure is usually done when you have found a lump in your breast and a biopsy has shown it is cancerous.

As an alternative you could:

• Have the whole breast removed (a mastectomy).
• Try chemotherapy or radiation therapy or have a combination of the therapies. (Usually these treatments are started after the cancerous lump has been removed. Chemotherapy may be started before surgery to shrink a large tumor.)

You should ask your doctor about these choices.

How do I prepare for a lumpectomy?

Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow instructions provided by your doctor. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight or the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a general anesthetic. A general anesthetic relaxes your muscles, puts you to sleep, and prevents you from feeling pain.

The doctor makes a small cut and removes the lump and nearby breast tissue. The doctor may then use the first cut or make a second cut over the lymph nodes in your armpit to remove the nodes.

The cut(s) will be closed with stitches. A drain may be left in the cut in your armpit for a few days.

What happens after the procedure?

You may go home that day or stay in the hospital for 1 or 2 days. Your doctor may suggest you start treatment with radiation or chemotherapy after you have healed from the surgery.

Ask your doctor what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

You may have the cancer removed without losing your breast.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• You may have infection and bleeding from the cut.
• A lumpy scar, called a keloid, might form.
• If one of the lymph nodes lies close to a nerve, that nerve may be hurt when the node is taken out. As a result, the underside of your arm may be numb after the surgery.
• Depending on the size of the lump that was taken out and the size of your breast, the shape of your breast may change.
• Your nipple may point another way and your breasts may not match as well as before the surgery.
• The cancer may not be completely removed. In this case you will need more surgery.
• The cancer may recur, although radiation therapy can reduce the risk of recurrence.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.
• You have bleeding or weeping from the wound.
• You have a lot of pain.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.