Breast Lumpectomy

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Evolution of Breast Lumpectomy

Throughout history and to this day, surgery has had a major role in the treatment of breast cancer. In the late 19th century, the standard surgery for breast cancer was the radical mastectomy. This surgical procedure removed the breast, chest muscle, and all surrounding lymph nodes (small lumps of immune tissue).

By the mid 20th century, the standard surgery shifted towards the modified radical mastectomy, which did not remove the chest muscle. Some patients did not tolerate the psychological and social implications of losing their breast. Others developed severe swelling of the arm as a result of the removal of lymph nodes. Because of these drawbacks, breast cancer surgery shifted towards a breast conserving approach towards the end of the 20th century.

Early recognition through increased use of mammogram screening contributed to this shift since tumors were often recognized earlier at a smaller size. In most cases, breast conserving surgery, or lumpectomy, involves removal of the tumor and a small rim of surrounding tissue, while keeping the healthy breast tissue in place. Lumpectomy often involves post-operative radiation and may involve sampling of the lymph nodes that drain the breast.

Whether or not a patient is eligible for breast conserving surgery often depends on multiple factors to include tumor characteristics and patient preference. Sometimes, if a surgeon is not able to confidently feel the area that needs to be removed, new technologies are used to help localize the area of cancer or DCIS.

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