Breast lump removal

Definition

Breast lump removal is surgery to remove a lump that may be breast cancer. Tissue around the lump is also removed. This surgery is called a lumpectomy.

When a noncancerous tumor such as a fibroadenoma of the breast is removed, it is often called an excisional breast biopsy, instead of a lumpectomy.

Alternative Names

Lumpectomy; Wide local excision; Breast conservation surgery; Breast-sparing surgery; Partial mastectomy; Segmental resection; Tylectomy

Description

Sometimes, the health care provider cannot feel the lump when examining you. However, it can be seen on imaging results. In this case, a wire localization will be done before the surgery.

Breast lump removal is done as an outpatient surgery most of the time. You will be given general anesthesia (you will be asleep, but pain-free) or local anesthesia (you are awake, but sedated and pain-free). The procedure takes about 1 hour.

The surgeon makes a small cut on your breast. The cancer and some of the normal breast tissue around it is removed. A pathologist examines a sample of the removed tissue to make sure all the cancer has been taken out.

Sometimes, small metal clips will be placed inside the breast to mark the area of tissue removal. This makes the area easy to see on future mammograms. It also helps guide radiation therapy, when needed.

The surgeon will close your skin with stitches. These may dissolve or need to be removed later. Rarely, a drain tube may be placed to remove extra fluid. Your doctor will send the lump to a laboratory for more testing.

Why the Procedure Is Performed

Surgery to remove a breast cancer is most often the first step in treatment.

The choice of which surgery is best for you can be difficult. It may be hard to know whether lumpectomy or mastectomy (removal of the entire breast) is best. You and the providers who are treating your breast cancer will decide together. In general:

You and your provider should consider:

Risks

Risks for any surgery are:

The appearance of your breast may change after surgery. You may notice dimpling, a scar, or a difference in shape between your breasts. Also, the area of the breast around the incision may be numb.

You may need another procedure to remove more breast tissue if tests show the cancer is too close to the edge of the tissue already removed.

Before the Procedure

Always tell your provider:

During the days before your surgery:

On the day of surgery:

After the Procedure

The recovery period is very short for a simple lumpectomy. Many women have little pain, but if you do feel pain, you can take pain medicine, such as acetaminophen.

Your skin should heal in about a month. You will need to take care of the surgical cut area. Change dressings as your provider tells you to. Watch for signs of infection when you get home (such as redness, swelling, or drainage from the incision).

You may need to empty a fluid drain a few times a day for 1 to 2 weeks. Your provider will remove the drain later.

Most women can go back to their usual activities in a week or so. Avoid heavy lifting, jogging, or activities that cause pain in the surgical area for 1 to 2 weeks.

Outlook (Prognosis)

The outcome of a lumpectomy for breast cancer depends mostly on the size of the cancer. It also depends on its spread to lymph nodes underneath your arm.

A lumpectomy for breast cancer is most often followed by radiation therapy and other treatments such as chemotherapy, hormone therapy, or both.

You may not need a breast reconstruction after lumpectomy.

References

American Cancer Society. Breast-conserving surgery (lumpectomy). Cancer.org website. Updated September 29, 2016. www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-treating-breast-conserving-surgery. Accessed December 16, 2016.

Bevers TB, Brown PH, Maresso KC, Hawk ET. Cancer prevention, screening, and early detection. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 23.

Hunt KK, Mittendorf EA. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 34.

The American Society of Breast Surgeons. Performance and practice guidelines for breast-conserving surgery/partial mastectomy. Breastsurgeons.org website. Updated February 22, 2015. www.breastsurgeons.org/new_layout/about/statements/PDF_Statements/PerformancePracticeGuidelines_Breast-ConservingSurgery-PartialMastectomy.pdf. Accessed December 16, 2016.

Wolff AC, Domchek SM, Davidson NE, Sacchini V, McCormick B. Cancer of the breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 91.



Review Date: 11/11/2016
Reviewed By: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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