تعريف
Lumpectomy is the removal of part of the breast.
Lumpectomy may be combined with a procedure to sample lymph nodes in the area (axillary dissection or sentinel node biopsy).
أسباب هذا الإجراء
This procedure is done to treat breast cancer.
المضاعفات المحتملة
Complications are rare, but no procedure is completely free of risk. If you are planning to have a lumpectomy, your سيقوم الطبيب بمراجعة القائمة من المضاعفات المحتملة، والتي قد تشمل:
- Accumulation of blood in the wound
- Accumulation of clear fluid in the wound
- العدوى
- Numbness of the nipple or underarm skin
- Change in the size and/or shape of the breast
- Blood clots
- رد فعل للتخدير
بعض العوامل التي قد تزيد من خطر المضاعفات تشمل:
- السمنة
- سوء التغذية
- التدخين
- Recent or long-term illness
- استخدام بعض الأدوية
- Characteristics of the tumor to be removed
ما يمكن توقعه
قبل الإجراء
طبيبك سوف المرجح أن تفعل ما يلي:
- اختبار بدني
- Mammogram —this test uses radiation to take a picture of the breasts.
- Fine needle biopsy of the breast
- اختبارات الدم والبول
- Wire-localization procedure—if the tumor was visible on mammogram, but is not able to be felt, the doctor will use a wire to mark the tumor.
التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
- الأسبرين أو غيره من العقاقير المضادة للالتهابات
- سيولة الدم, مثل كلوبيدوجريل (بلافيكس) أو الوارفارين (الكومادين)
Do not eat or drink anything for 8-12 hours before surgery, unless your doctor tells you otherwise.
التخدير
General anesthesia is most often used. You will be asleep.
الوصف الداخلي
A small cut will be made in the breast. The tumor will be cut out, along with some of the surrounding tissue. Another incision near the armpit may be made so that lymph nodes can be removed. The nipple and areola will not be removed. Plastic tubes for drainage may be inserted. The incisions will be closed with stitches.
مباشرة بعد الإجراء
Removed tissue will be examined. The findings may determine if any further surgery is needed.
كم من الوقت سيستغرق ؟
حوالي 1-3 ساعات
هل سيكون هناك ألم؟
Anesthesia prevents pain during the procedure. There is usually relatively little pain after a lumpectomy. There may be temporary unpleasant sensations, including numbness and a pinching or pulling feeling in the underarm area. Patients who have lymph node biopsies generally have more discomfort. If needed, you may be prescribed pain medicine.
الرعاية ما بعد الجراحة
- Keep the surgical area clean and dry.
- اسأل طبيبك حول, عندما هي آمنة للاستحمام, السباحة, أو نقع في الماء.
- You may have one or more tubes to drain blood and fluids while you heal. Empty the drains, measure the fluid, and report any problems.
- If tubes were placed, they will be removed in the doctor’s office 1-2 days later.
- Avoid vigorous activity for about four weeks, or as directed by your doctor.
- Try not to lift anything heavier than five pounds for about a week or longer if directed by your doctor.
- Wear a well-fitting, very supportive bra 24 hours a day for the first week.
If you do develop complications from lymph node surgery, you will need to take some special precautions:
- لا يتم أخذ ضغط الدم أو سحب الدم أو الحقن في هذا الذراع.
- ارتدِ القفازات عند غسل الأطباق وتنظيف المنزل وأعمال الفناء.
- لا ترتدي أي شيء ضيق على هذا الذراع ، بما في ذلك الأكمام المرنة.
- Do not carry heavy packages, purses, suitcases, grocery bags, etc. with that arm.
- Keep the skin of that arm well-moisturized with a lanolin-containing product.
- Use an electric shaver if you wish to shave your armpits.
- If you had lymph nodes in your armpit removed during سرطان الثدي surgery, participating in a physical therapy program may help to prevent lymphedema.
The breast may change in size or shape after lumpectomy. There may be local skin discoloration from dye used to localize lymph nodes for biopsy. The dye may also discolor your urine for a short time after surgery. You will be asked to see your doctor for a follow-up appointment within 7-14 days after the surgery.
The surgery is usually followed by an appropriate course of radiation therapy and, in some cases, chemotherapy.
استدعاء الطبيب
بعد وصوله الى المنزل ، اتصل بطبيبك إذا كان أي من الحالات التالية:
- علامات الإصابة, بما في ذلك حمى وقشعريرة
- احمرار أو تورم أو ألم متزايد أو نزيف مفرط أو إفرازات من موقع الشق
- If you have drains, report any problems that your doctor has discussed with you
- Oozing or discharge from nipples on either breast
- A lump, redness, or swelling in either breast
- If lymph nodes were removed: redness, warmth, swelling, stiffness, or hardness in the arm or hand
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery or that persist for more than two days after discharge from the hospital
- ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
- السعال، ضيق التنفس، أو ألم في الصدر
- اكتئاب
- أعراض جديدة غير مبررة
إذا كنت تعتقد أن لديك حالة طارئة ، فاتصل بالمساعدة الطبية على الفور.