What is a lumpectomy and axillary lymph node excision?

A lumpectomy and axillary (armpit) lymph node excision is a procedure in which the doctor surgically removes a lump from a woman's breast and the lymph nodes under her armpit.

Excision means to remove or cut out.

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.

• Choose not to have treatment, with you and your doctor keeping track of the cancer and recognizing the risks of your condition.

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 muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain. The doctor may take an x-ray to find the problem tissue. He or she then makes a small cut and removes the lump and the nearby breast tissue.

The doctor may use the first cut or make a second cut over the lymph nodes in your armpit, divide the nodes from the nearby tissue, and remove them. A drain may be left in the cut in your breast 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. 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.

• There is a risk of infection and bleeding from the cut.

• There is a chance 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 this treatment.

• Based 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 this treatment.

• The cancer may not be completely removed.

• 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.