Wide Local Excision (Lumpectomy)
What is a wide local excision (WLE)?
A wide local excision aims to remove a cancer with a small margin of surrounding normal breast tissue. It is also known as breast conservation surgery. This is almost always followed by radiotherapy. The most important thing is to adequately remove the cancer but Dr Graham will aim to make the scar as neat and hidden as possible. Dr Graham will leave some small titanium clips within the breast to allow the radiation doctors to plan their treatment. These clips are inert, harmless and are MRI compatible.
What are the benefits of breast conservation surgery for breast cancer (compared to mastectomy)?
Most of your breast is left in place with an attempt to keep as much of your natural shape as possible
Your appearance will not be changed as much as it would be following a mastectomy
Research demonstrates that women who have breast conservation surgery have higher satisfaction rates with their surgery when compared to women who have a mastectomy (even with breast reconstruction)
Breast conserving surgery is associated with at least equivalent survival to mastectomy and perhaps even improved survival in some studies
What are the disadvantages of breast conservation surgery for breast cancer (compared to mastectomy)?
Your breast will look and feel different after treatment. How different it looks and feels will depend on the size and location of the cancer, the size and shape of your breast and the treatments you have in addition to surgery.
Radiotherapy is almost always recommended after breast conservation surgery.
Yearly mammogram and ultrasound of both breasts will be required for ongoing cancer surveillance after treatment.
The cancer can come back in the breast, the risk of this is low but some women find that this possibility causes them concern
How long is the operation and what is the recovery like?
The length of the operation and the duration you will stay will depend on whether you are having any other procedures. For most patients the operation takes around 1 hour. Patients who have a wide local excision alone can usually go home on the same day provided they feel well and have someone at home with them. A waterproof dressing will be placed on your wound. You will be able to do most things for yourself immediately after the operation and are encouraged to do so.
What are the complications of a WLE?
All operations have potential side effects and complications. Fortunately, these are uncommon and surgery usually proceeds without any problems. Dr Graham will the risks and possible complications with you in detail at your consultation.
These complications include but are not limited to pain, bleeding, infection, numbness or decreased sensation, seroma (a collection of fluid in the breast), cosmetic changes and the need for further surgery. All the tissue that is removed is carefully looked at under the microscope by a pathologist. Sometimes there are microscopic cancer cells that we cannot see or feel extending from the tumour towards the cut edge of the tissue that is removed. If this is the case, another operation will be required to take further tissue to obtain a wider cancer-free margin. We will only find out if you need further surgery once the pathologists look closely at the lesion under a microscope. This takes around a week and Dr Graham will tell you when she sees you at your follow-up appointment.
Dr Graham advocates the National Law and Australian Health Practitioner Regulation Agency (AHPRA) guidelines that any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.