Wide local excision

This is a form of breast-conserving surgery. The operation is performed in order to remove breast cancer and a rim of surrounding breast tissue preserving the remaining breast. The procedure is performed under a general anaesthetic. A surgical cut is made over the tumour and the tumour with some healthy breast tissue is removed. Some metal clips are left in the area where the cancer has been removed so that it can be seen in future mammograms. The skin is then closed with self-dissolving sutures. The operation is sometimes combined with partial removal (sentinel lymph node biopsy) of the lymph nodes in your armpit.

The healthy breast tissue around the cancer is tested under the microscope. If there is no evidence of cancer in the healthy tissue the risk of the cancer coming back is less. In up to one in five patients cancer may be found in the surrounding tissue and a second operation may be needed to remove further tissue with any residual cancer from the breast. After breast-conserving surgery you will usually be offered radiotherapy to kill any remaining cancer cells. The combination of wide local excision and radiotherapy for breast cancer produces similar results to mastectomy in relation to cancer control and survival.

Prior to the procedure

No special procedure is required prior to this operation. Smoking cessation is important if you are a smoker as it helps reduce the risk of wound complications.

Recovery

After the procedure you will wake up in a hospital room. After wide local excision you may go home on the same day or spend one night in hospital. You are typically expected to go home once you are eating and drinking and are able to manage the pain. It normally takes about three to six weeks to fully recover and return back to work but it varies from person to person and depends on their general health and the nature of their work. Once at home it is important to get adequate rest and perform shoulder exercises to reduce the risk of getting a stiff shoulder. For the first four weeks you should avoid any heavy lifting or repetitive movements (ironing, vacuuming), avoid swimming or playing sport, avoid driving until you are confident.

Risks of the procedure

Wide local excision is in general a very safe procedure. Complications common to all surgical procedures include risk of wound infection (2%), bleeding/bruising (1%), blood clots, heart problems, pneumonia and anaesthetic risks. The complications specific to this operation include short term pain, a scar or dimpling of the breast over the area that the lump has been removed, a fluid collection called seroma and skin numbness over the wound.