Our Summary

This research paper is about a study conducted to see whether taking antibiotics before surgery to remove a breast lump (known as a wire-localized lumpectomy) can help prevent infections at the surgical site. The study also aimed to find out what factors increase the risk of these infections. The researchers compared patients who were given antibiotics before surgery with those who weren’t. The results showed that there was no significant difference in infection rates between the two groups. The only factor that increased the risk of infection was obesity. All infections were treated with antibiotics and one patient needed their wound reopened. The study concludes that it’s safe not to give antibiotics before this type of surgery. This could lower the cost of treatment and avoid unnecessary side effects from the antibiotics.

FAQs

  1. Does taking antibiotics before a wire-localized lumpectomy help prevent infections at the surgical site?
  2. What factors increase the risk of infections after a wire-localized lumectomy?
  3. Is it safe not to give antibiotics before a wire-localized lumpectomy?

Doctor’s Tip

A doctor might tell a patient undergoing a lumpectomy to carefully follow post-operative care instructions, including keeping the surgical site clean and dry, avoiding strenuous activities that could strain the incision site, and watching for signs of infection such as redness, swelling, or discharge. They may also recommend regular follow-up appointments to monitor healing progress and address any concerns. Additionally, the doctor may advise the patient to maintain a healthy weight to reduce the risk of infection and promote overall healing.

Suitable For

Patients who are typically recommended lumpectomy are those with early-stage breast cancer or benign breast conditions such as fibroadenomas or atypical hyperplasia. Lumpectomy is often recommended for patients who have small tumors that can be easily removed while preserving the appearance of the breast. Patients with larger tumors may also be candidates for lumpectomy if they undergo neoadjuvant therapy (chemotherapy or hormone therapy before surgery) to shrink the tumor.

Additionally, patients who have multiple tumors in the same breast, have a history of previous radiation therapy to the breast, or have a genetic predisposition to breast cancer (such as BRCA gene mutations) may also be recommended lumpectomy. Lumpectomy may not be recommended for patients with large tumors that cannot be easily removed while preserving the appearance of the breast, tumors located in multiple areas of the breast that cannot be completely removed with one surgery, or patients who are unable or unwilling to undergo radiation therapy after surgery.

Timeline

Before lumpectomy:

  1. Patient undergoes diagnostic tests such as mammogram, ultrasound, and biopsy to confirm the presence of a breast lump.
  2. Patient consults with a surgeon to discuss treatment options, including lumpectomy.
  3. Patient may undergo additional imaging tests to help guide the surgeon during the procedure, such as wire localization or MRI.
  4. Patient may be instructed to stop taking certain medications, such as blood thinners, before surgery.
  5. Patient may be instructed to fast before surgery and to arrange for transportation home after the procedure.

After lumpectomy:

  1. Patient is monitored in the recovery room immediately following surgery.
  2. Patient may experience some pain, swelling, and bruising in the days following the procedure.
  3. Patient will be given instructions on how to care for the surgical site, including keeping it clean and dry.
  4. Patient may be prescribed pain medication to manage any discomfort.
  5. Patient will have follow-up appointments with the surgeon to monitor healing and discuss any further treatment, such as radiation therapy or chemotherapy.
  6. Patient may undergo additional imaging tests, such as mammograms, to ensure that the tumor was completely removed.
  7. Patient may be referred to a physical therapist or counselor to help with recovery and emotional support.
  8. Patient will be educated on the signs of infection to watch for and how to properly care for the surgical site to prevent complications.

What to Ask Your Doctor

  1. Is a lumpectomy the best treatment option for my breast lump?
  2. What are the potential risks and complications associated with a lumpectomy?
  3. How long is the recovery period after a lumpectomy?
  4. Will I need any additional treatments (such as radiation therapy) after the lumpectomy?
  5. How will the lumpectomy affect the appearance and feel of my breast?
  6. Are there any alternative treatment options to consider?
  7. What can I do to prepare for the surgery and optimize the outcome?
  8. What is the likelihood of developing an infection at the surgical site, and what steps can be taken to minimize this risk?
  9. How will any potential infections be treated if they occur?
  10. Are there any specific factors in my medical history or lifestyle that may impact the success of the lumpectomy procedure?

Reference

Authors: Giguère GB, Poirier B, Provencher L, Boudreau D, Leblanc D, Poirier É, Hogue JC, Morin C, Desbiens C. Journal: Ann Surg Oncol. 2022 Apr;29(4):2202-2208. doi: 10.1245/s10434-021-11031-9. Epub 2021 Nov 25. PMID: 34825283