Lumpectomies

Hello Diane. I know there are research articles on lumpectomies but each of us is unique. I had a lumpectomy and complete level 1 & 2 axilla dissection (lymph nodes removed) on Sept 10/09. My tumour size was 1.7 cm but they were going after about 2 cm plus margins excision because there was a potential satellite lesion on MRI. The morning of surgery they did a needle localization. They freeze you and under mammogram place two needle so they know exactly where to go and what to remove. There is some discomfort but it was not horrible. It did take about 45 minutes. Then they put a cup over the needles (so they do not poke things) and you wait for the surgery. I am not sure if everyone gets this needle localization prior to surgery. I had a small pouch with a wire into the operative area that had a medication like dental freezing to keep the area numb for two days. I am very glad I had this as most of my discomfort was in the arm; I think because of the lymph node surgery. I travelled two days later but took it really easy not lifting anything. Once the little pouch pain wore off they had given me vicodin to take which did not work very well at all. I went and got some 2 mg dilaudid and could take 1-2 of those and this was much more effective for several days. I had a drain for 5 days. A small plastic bulb that you prime by squeezing and they will show you haw that all works. I started gently doing exercises a couple of days after surgery and got more into it after the drains were removed. Again they gave me a list of exercises to do. What was very helpful for me was I went to a physio once; a couple of weeks postop. She was an expert in breast surgeries and pin pointed the 3-4 exercises that would be most helpful for me to do three times a day to get range of motion necessary for radiation. As far as appearance my tumour was the outer aspect of the left breast. There is some discoloration from radiation and it is slightly smaller now but I can still wear the same bras as before. The incision is in the crease of arm, about 4 inches long and can now barely see it. The drain is very important for most people as it drains away the excess fluid from the surgery site. They will show you how to strip the tubing (or show your support person) and I did this at least 2-3 times a day or more often if you are having to empty it more often. This is to keep it from plugging off. Everyone heals differently as well but usually after the drain comes out in 5-7 days you notice quite a difference. Then it is gradual exercises for the next 4-6 weeks. I am still doing exercises to keep range of motion and numb under the arm and the back of the upper arm. As far as to prepare. I had finished chemo before surgery and did not want to deal with any more nausea. Zero tolerance and made a fuss about it with the anesthetist. They gave me about 4 different kinds of meds before and during surgery. I had no nausea and woke up in recovery and ate a light meal no problem. This was very important to me because I had already lost weight with the chemo and I feel miserable if I cannot eat, stomach gets so acidy etc. I will see if I can find some articles about lumpectomies and I am sure there are some in the resources section as well. It would be good if you have a partner or support person stay with you for several days, make sure there are lots of groceries in the house and food prepared so you can take it easy. They will give you written post op directions and if they do not, ask for them. Also some hospitals provide a bra but I took a soft cotton non wire sports bra that fit me quite well and had room to loosen the back notches. They said you need it to support the breast and it also helps with any swelling. If you have a couple of them it is best as I wore them throughout radiation etc as well. This is a very brief over view of my experience and I am sure others will jump in here with tips. Your experience will be unique for you and I would also ask your surgeon or his nurse for some pre operative information; if they have not given that to you yet. Over the next few days if you think of a question write it down and then call them with your list of questions. Every question, no matter how small, is important. The operated breast is slightly perkier now and there is a slight firmness where the lumpectomy is. Right away post op it felt like there was a firm lump there and they told me it was just fluid etc filling in the space. I also could not sleep on my left side for at least 6-8 weeks. I hope this helps Diane. I want to wish you all the best and please any questions ask away. Please let us know how things go along the way. Chemo is a big topic. What kind are you having? There is lots of info posted about this. Let us know if you can find it. I know there will be others that start posting links for you. It can be quite overwhelming so gather your strength and knowledge about the surgery then take it from there. Maybe Steve will post about BRCA testing. 

I had a lumpectomy many years ago. I found it to be a simple procedure. I had already had a surgical biopsy. They just needed to go clean the margins and do a node check.  This was before SN so 13 nodes were removed. I had surgery in the afternoon. I was told I could go home that evening. There was NO Way I could have managed but was ready to go first thing in the morning. They had recut the original surgery site. A "C" shaped scar on the outer side of my breast. There is slight puckering at the scar, which the surgeon said he could fix [ a year later] but I didn't find it worth my time. There isn't much of a scar, now. One would really have to look. I did apply vit. E oil and lavender oil. I was covered in a gauze contraption that supported all nicely. Personally, I couldn't deal with the drains but my dear aunt didn't have a problem with them. I had the drains removed 5 days later. That felt so much better. I sent my aunt home. I went to work 8 days after surgery. I took my pain meds [vicodin] regularly at first. A body not in pain heals faster. Appearance of the breast probably has many variables. Being a c-d breast size the surgery did change much other than my nipple now veers to the right a bit.

Diane66,

Dear HolliBeri,

I had a lumpectomy in October. I didn't have much pain. 5 lymph nodes were taken, so that incision was more painful than the breast. I had no drains put in. My tumor was about 1.6 cm. While that breast is a little smaller now and my nipple doesn't point straight out. I did buy bras without the underwire, because the wire went over my scar from my mammosite radiation scar. Since I had no lymph node involvement my radiation was done the internal method, 5 days-2x days. Hope this helps to hear another opinion. Peggy

Diane,

Diane 66, here the radiation is called mammosite radiation, but I have heard it called other names. I think it is used only if the lymph nodes are all negative. A devise is inserted into the area where the tumor was removed. To me, it reminded me of a kitchen whisk with the catheters coming out, similar to a drain, about the size of a thumb. The radiation source sends seeds into each catheter one at a time. Only took about 10 minutes. It was done twice a day for 5 days. A scan was done before each tx to make sure devise was in place. The devise was inserted in the MD office. Then it was removed immediately after the last radiation tx. Coming out was much less painful than going in. I had no external skin burns or real issues. A lot of fatigue after the 3 day. Then it took about a week to get my energy back. I definitely think this was a good option for me!
Now I am a week past my first chemo tx, and I can easily tell that this will not be as easy.

I'm going in for my lumpectomy next week on 22nd January, 2 cm diameter, Stage 1/2. I guess your op is this week. Good luck - from 4,000 miles away in Wales, I'll be thinking of you Newbie! If you want to keep in touch for a bit to see how we both get along, I'll send you my email address

Jenfromwales,

I want the THANK everyone who has shared with me.