What is Wide Local Excision?
Wide local excision is the surgical removal of a tumour, mass or suspicious tissue along with a surrounding margin of normal tissue. It may be performed to remove a lump or mass from the breast and is referred to as a lumpectomy.
Indications for Wide Local Excision
Breast cancer generally begins in the lobules or ducts of the breast but can also occur in the fatty and fibrous tissues. If left untreated, the tumour cells may invade the lymph nodes of the underarm and then spread to other body parts.
The procedure is performed under general anaesthesia and usually takes 30 to 60 minutes. The mass is excised and sent to the laboratory where its margins are observed and should ideally be free of cancer cells. Cancer cells in the margin indicate that the tumour has not been completely removed and repeat surgery may need to be performed. In addition to a wide local excision, the axillary area (armpit) may also be operated on at the same time to see if cancer has spread to this region. At the end of the procedure, a plastic tube may be left in place to drain blood and fluid from the operative site and is usually removed in 2-3 days.
Following the procedure, you may have some soreness for which pain medications are prescribed. A well-fitted, comfortable bra must be worn for support. Exercises are recommended to avoid stiffness of the shoulder and back muscles. Your doctor may suggest a course of radiotherapy or chemotherapy to destroy any unseen cancer cells.
Some wide local excisions do not significantly alter the appearance of the breast while others may cause some dimpling or a change in size depending on the size and position of the mass. The scar produced is usually small.
Risks and Complications
As with any surgical procedure, a wide local excision may be associated with certain complications such as bleeding, swelling, infection or nerve injury.