For many women in Oro Valley who have just been diagnosed with early-stage breast cancer, the first surgical question is whether the whole breast has to be removed. Often it does not. A lumpectomy removes the cancer with a rim of healthy tissue around it, and when it is paired with radiation, long-term survival for the right candidate is the same as after mastectomy. Dr. Michele Ley, MD, FACS, has been a breast surgical oncologist in Tucson since 2006, and patients from Oro Valley travel into Tucson to plan their surgery with her at her office near Tucson Medical Center.
Breast Conservation Without the Jargon
You will hear several names for the same operation: lumpectomy, partial mastectomy, and breast-conserving surgery. All three describe removing the tumor while leaving the rest of the breast in place. “Breast conservation” usually refers to the full course of treatment, which is the surgery followed by radiation. Lumpectomy at Tucson Breast Health Specialists is planned around two goals at once: clear margins, meaning no cancer cells at the edge of the removed tissue, and a breast that still looks like your own.
The second goal is where oncoplastic breast surgery comes in. Oncoplastic techniques borrow from plastic surgery to reshape the remaining tissue after the tumor is removed, so the breast keeps its contour rather than showing a hollow where the cancer was. Dr. Ley uses these techniques as part of the cancer operation itself, not as a separate cosmetic procedure later.
When Keeping the Breast Is on the Table
Breast conservation tends to suit patients whose cancer is confined to one area of the breast, whose tumor is relatively small, whose disease is early-stage, and whose health allows them to complete radiation afterward.
It is usually not the recommended path when there are several tumors in the same breast, when the tumor is large, when the cancer has reached the skin or chest wall, or when cancer has returned after an earlier lumpectomy. Patients who carry a BRCA1, BRCA2, or other inherited mutation have additional factors to weigh, and genetic testing results can shape which surgery makes sense.
Dr. Ley reviews your imaging and pathology with you before recommending either path, and she lays out the options rather than handing you a single answer. If you are still weighing the choice, the practice’s guide to choosing between lumpectomy and mastectomy sets out the trade-offs side by side.
From Oro Valley to Recovery: The Lumpectomy Timeline
The consultation
The process starts with a visit to go over your diagnosis. Dr. Ley reviews your mammogram, ultrasound or MRI, and biopsy pathology with you, asks about your personal and family history, and explains which surgical options fit your situation. Many patients find it helps to bring a family member or friend to take notes, since a lot of information is covered in one sitting. You should leave with a clear picture of what surgery would involve, and with time to decide.
Marking the tumor
Before surgery, the tumor’s location has to be marked so it can be found precisely in the operating room. Often a small metal clip is placed during the original biopsy. Some patients instead have a tiny SAVI SCOUT reflector placed in the breast at a separate visit before the operation.
Surgery day
The operation takes place at a hospital or surgery center. You will receive either general anesthesia or moderate sedation combined with a local anesthetic, and in most cases you go home the same day. During the procedure, Dr. Ley removes the tumor with a margin of healthy tissue and closes the incision using plastic-surgery techniques.
The lymph nodes
Many patients also have a sentinel lymph node biopsy during the same operation, in which one or more of the first lymph nodes draining the breast are removed and sent to pathology. If cancer is found in those nodes, a further operation called an axillary lymph node dissection may be needed. The practice’s page on lymph node surgery explains both procedures in more detail.
Removing lymph nodes carries some risk of lymphedema, a swelling of the arm or chest that can develop after surgery. The practice provides guidance on recognizing and managing lymphedema, including self-lymphatic massage, so you know what to watch for.
The first couple of weeks
Most patients take one to two weeks off work. Those with physically demanding jobs, or who also had lymph nodes removed, may need longer. You will go home with post-operative instructions that cover garments, gentle exercises, and when to pick up your normal routine.
Radiation and the rest of the plan
Once the final pathology report is back, the next steps come into focus. For most lumpectomy patients that means radiation, and Dr. Ley coordinates with radiation oncology and medical oncology colleagues so the handoff is organized for you rather than left for you to arrange.
A Surgeon Who Has Sat in the Patient’s Chair
Dr. Ley earned her medical degree at St. Louis University School of Medicine, completed her general surgery residency at the University of Arizona, and trained in breast surgical oncology through a fellowship at the University of California, San Francisco. She is board-certified in general surgery, a Fellow of the American College of Surgeons, and a member of the American Society of Breast Surgeons since 2004. She has also served as medical director for breast programs at the University of Arizona and Tucson Medical Center.
She is a breast cancer survivor as well, diagnosed through high-risk screening because of her family history. Her patients’ reviews return to the same point again and again: she explains everything and makes room for every question. Read Dr. Ley’s full background.
Questions Oro Valley Patients Bring to the First Visit
Does choosing lumpectomy affect long-term survival?
For patients who are good candidates, long-term survival after lumpectomy with radiation is the same as after mastectomy. Survival depends more on the type of cancer than on which operation is chosen.
Can removing the tumor spread the cancer?
Breast cancer surgery, including lumpectomy, is not known to spread cancer. The tumor is taken out together with a margin of healthy tissue so that the edges are clear.
What should I have ready before my first appointment?
The practice sees patients with a surgical breast diagnosis and asks for breast imaging done within the last three months. Having your imaging reports and biopsy results available lets Dr. Ley go through them with you at the visit.
Will my breast look different afterward?
Some change in size or shape is possible, depending on how large the tumor is and where it sits. Oncoplastic techniques are designed to limit that change, and Dr. Ley will talk you through what to expect for your particular case before surgery.
Starting Your Plan With Dr. Ley
If you live in Oro Valley and have been diagnosed with breast cancer or DCIS, the next step is a consultation to review your imaging and pathology and decide on surgery together. Send a message through the contact form, or call the office to book a time.
