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Breast lump removal
Definition
Breast lump removal is surgery to remove a lump in the breast.
Alternative Names
Lumpectomy; Wide local excision; Excisional biopsyDescription
Tissue from a solid breast mass can be removed by needle biopsy. This procedure places a needle into the lump to take out a piece of tissue. The tissue is then checked for cancer cells.
If the entire lump is surgically removed, the procedure is called a lumpectomy. For a lumpectomy, general or local anesthesia with or without sedatives is used. Once the area is pain-free, an incision is made and the lump is removed, as is the surrounding rim of normal breast tissue. The lump is then sent to a laboratory for examination.
For a fluid-filled lump (cyst), a needle and syringe are used to drain fluid. If the fluid is clear or green and not bloody, and the cyst disappears completely when drained, nothing further needs to be done. If the fluid is bloody, it is sent to the laboratory for analysis. If there is still a lump after the cyst fluid is drained, or if the lump disappears but returns later, surgery is usually done to remove it.
Why the Procedure is Performed
Lumpectomy is performed to either diagnose or treat an abnormal spot in the breast.
If a needle biopsy or a lumpectomy shows that the lump is cancerous, more tests will be required to determine whether the cancer has spread. Often lymph nodes in the axilla (armpit) are removed and tested. This is called staging. Staging of a tumor helps your health care provider plan your treatment.
Treatment depends on the type and stage of cancer, your age, menopausal status, and overall health. If the entire lump was not removed in the biopsy, you may need surgery to remove the rest of the lump and some surrounding tissue.
Radiation therapy or chemotherapy may be needed.
Risks
You may have pain and soreness after the procedure.
Since a lumpectomy removes a portion of the breast, there may also be a change in the breast's appearance. Dimpling, a noticeable scar, or asymmetry of the two breasts may occur, depending on the size and location of the lump and the size of the breast.
There is a chance that some microscopic pieces of the lump may be left behind, which would need to be removed with another operation.
Risks for any surgery include the following:
- Bleeding
- Infection
Risks for any anesthesia include the following:
- Reactions to medications
- Breathing problems, pneumonia
- Heart problems
For a woman who is in otherwise good health, the risk of a serious complication due to general anesthesia is less than 1%.
Outlook (Prognosis)
The outcome of a lumpectomy depends on the type of lump found and whether or not it is cancerous.
A lumpectomy followed by radiation therapy to the breast usually results in the same long-term survival as a mastectomy, depending on the type and extent of breast cancer.
After mastectomy, some women choose to have a surgical reconstruction of the breast. Lumpectomy typically does not require breast reconstruction.
Recovery
The recovery period is very short for a simple lumpectomy. Most women are able to resume their usual activities in a week or so.
When cancer is found, follow-up treatment will be scheduled.
References
Iglehart JK, Smith BL. Diseases of the Breast. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery, 18th ed. St. Louis, M0: WB Saunders; 2008: chap. 34.
Reviewed By: Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
