19302 Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy

Name of the Procedure:

Partial Mastectomy (e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy) with Axillary Lymphadenectomy

Summary

A partial mastectomy involves the surgical removal of a portion of breast tissue, typically containing cancer. It includes an axillary lymphadenectomy, where lymph nodes from the underarm area are also removed to check for the spread of cancer.

Purpose

This procedure addresses breast cancer confined to a specific area of the breast. The goal is to remove the cancerous tissue while preserving as much of the breast as possible and to assess whether cancer has spread to the lymph nodes.

Indications

• A diagnosed breast cancer tumor that is localized and can be removed without a full mastectomy.
• Patients with early-stage breast cancer.
• Patients who prefer breast-conserving surgery over a full mastectomy.

Preparation

• Fast for at least 8 hours before the surgery.
• Discontinue certain medications as advised by the doctor, such as blood thinners.
• Undergo preoperative imaging studies like mammography or MRI.
• Preoperative blood tests and possibly an EKG.

Procedure Description

• Under general anesthesia, an incision is made in the breast.
• The surgeon removes the cancerous tissue along with a margin of healthy tissue.
• An axillary incision is made to remove lymph nodes for biopsy.
• The incisions are closed with sutures, and a drainage tube may be placed.
• The removed tissue is sent to the lab for further examination.

Duration

The procedure typically takes about 2-4 hours.

Setting

The surgery is performed in a hospital or surgical center.

Personnel

• Breast surgeon
• Surgical team including nurses and technologists
• Anesthesiologist

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Seroma (fluid accumulation)
• Lymphedema (swelling due to lymph node removal)
• Numbness or changes in breast sensation
• Scarring

Benefits

• Removes cancerous tissue effectively while preserving breast appearance.
• Helps determine if cancer has spread to the lymph nodes, guiding further treatment.
• Lower invasiveness compared to a full mastectomy.

Recovery

• Hospital stay of 1-2 days may be required.
• Pain management with medication.
• Incision care and potential use of drains.
• Avoid heavy lifting and strenuous activities for about 4-6 weeks.
• Follow-up appointments for suture removal and to discuss pathology results.
• Radiation therapy may be needed after surgery.

Alternatives

• Total mastectomy: complete removal of the breast; higher chance of complete cancer removal but more invasive.
• Chemotherapy or radiation therapy without surgery: non-surgical options, typically used in combination with surgery.
• Hormone therapy: for hormone receptor-positive breast cancers.

Patient Experience

• General anesthesia means the patient is asleep and feels no pain during the procedure.
• Mild to moderate pain and discomfort post-surgery, managed with pain medications.
• Breast tenderness, swelling, and bruising are common.
• Emotional support and counseling may be beneficial for coping with changes in body image.