Our Summary

This study is about improving the process of breast-conserving surgery, a treatment for breast cancer that aims to remove the cancer and some of the normal tissue around it, while preserving as much of the breast as possible. In particular, the researchers focused on the issue of estimating how much tissue will need to be removed in the surgery, called a lumpectomy.

The researchers collected data from 410 patients who had this type of surgery between 2018 and 2020. They found that the amount of tissue that had to be removed could be predicted based on three factors: the patient’s body mass index (a measure of body fat based on height and weight), the size of the patient’s breast, and the size of the tumor as seen in pre-surgery images.

Based on these findings, the researchers developed a tool that can predict the size of the lumpectomy. This tool, which is available as a web-based application, can be used by surgeons to better plan the surgery, and to give their patients a more accurate idea of what to expect. This could be particularly useful in oncoplastic reconstructive surgery, a type of surgery that combines cancer removal and plastic surgery to achieve the best possible aesthetic results.

FAQs

  1. What is the aim of breast-conserving surgery?
  2. What factors can predict the amount of tissue to be removed in a lumpectomy?
  3. What is the purpose of the tool developed by the researchers?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumpectomy is to discuss with their surgeon about using this predictive tool to better plan the surgery and have a more accurate idea of the amount of tissue that will need to be removed. This can help improve the surgical outcome and potentially reduce the need for additional surgeries. It’s important for patients to have open communication with their healthcare team and ask any questions or concerns they may have about the procedure.

Suitable For

Patients who are typically recommended lumpectomy are those with early-stage breast cancer, where the tumor is small and localized. Lumpectomy is often recommended for patients who have smaller tumors, as well as those who have tumors that are not located close to the chest wall or nipple. Additionally, patients who have larger breasts and a lower body mass index may also be good candidates for lumpectomy, as it may be easier to achieve good cosmetic results in these patients. Ultimately, the decision to undergo lumpectomy is made on a case-by-case basis, taking into account factors such as the size and location of the tumor, the patient’s overall health, and their personal preferences.

Timeline

Before lumpectomy:

  1. Patient is diagnosed with breast cancer through a biopsy or imaging tests.
  2. Patient discusses treatment options with their healthcare team, including lumpectomy.
  3. Patient undergoes pre-surgery imaging tests to determine the size and location of the tumor.
  4. Surgeon uses the new predictive tool to estimate the amount of tissue that will need to be removed during the lumpectomy.

After lumpectomy:

  1. Patient undergoes the lumpectomy surgery, which typically takes a few hours and is performed under general anesthesia.
  2. Patient may experience some pain and discomfort following the surgery, which can be managed with pain medication.
  3. Patient may have drains placed at the surgical site to help remove excess fluid and reduce swelling.
  4. Patient recovers in the hospital for a day or two before being discharged home.
  5. Patient follows up with their healthcare team for post-operative care, including monitoring for any signs of infection or complications.
  6. Patient may undergo additional treatments such as radiation therapy or chemotherapy to further treat the cancer.
  7. Patient may be referred for oncoplastic reconstructive surgery to improve the cosmetic appearance of the breast following the lumpectomy.

What to Ask Your Doctor

  1. How much tissue will need to be removed in my lumpectomy surgery?
  2. Can you explain how the size of the lumpectomy is determined based on factors such as my body mass index, breast size, and tumor size?
  3. Will the lumpectomy affect the appearance of my breast?
  4. Are there any risks or complications associated with a lumpectomy surgery?
  5. How long is the recovery time following a lumpectomy?
  6. Will I need additional treatments, such as radiation therapy, after the lumpectomy?
  7. Are there any alternative treatment options to consider besides a lumpectomy?
  8. How often will I need follow-up appointments or tests after the lumpectomy surgery?
  9. What can I do to help optimize the success of the lumpectomy and my overall recovery?
  10. Can you refer me to a plastic surgeon for oncoplastic reconstructive surgery if needed?

Reference

Authors: Makineli S, Strijbis R, Tsehaie J, Schellekens PPA, Moman MR, Veenendaal LM, Ferdinandus PI, Witkamp AJ, Richir MC, Maarse W. Journal: Plast Reconstr Surg. 2024 Sep 1;154(3):503-510. doi: 10.1097/PRS.0000000000011085. Epub 2023 Sep 26. PMID: 37749793