Breast lump removal

Definition

Breast lump removal is surgery to remove a breast cancer along with some surrounding tissue from the breast. It is called a lumpectomy.

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

This article covers lumpectomy that is done to remove breast cancer. Other reasons to perform a lumpectomy include:

Alternative Names

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

Description

If the breast cancer can be seen on imaging tests but the doctor cannot feel it when examining you, a wire localization will be done before the surgery.

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

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

Sometimes, small metal clips will be placed inside the breast to mark the area of removal so it can be seen on future mammograms and to help guide radiation therapy when needed. The surgeon will close the skin with stitches. These may dissolve or need to be removed later. 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 is best. You and the health care providers who are treating your breast cancer will decide together.

You and your doctor 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 the two breasts. You may also have numbness in the breast area.

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 doctor or nurse:

During the days before the surgery:

On the day of the surgery:

After the Procedure

The recovery period is very short for a simple lumpectomy. You should have little pain. If you do feel pain, you can take pain medicine, such as acetaminophen (Tylenol).

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

You may need to empty a fluid drain a few times a day for 1 to 2 weeks. Your doctor 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 and if it has spread to lymph nodes underneath your arm.

A lumpectomy for breast cancer is usually followed by radiation therapy and additional treatment such as chemotherapy, hormone therapy, or both.

Women usually do not need breast reconstruction after lumpectomy.

References

National Comprehensive Cancer Network. Breast cancer, v1.2014. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. 2013.

Hunt KK, Green MC, Buchholz TA. Diseases of the breast. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery, 19th ed. St. Louis, Mo: WB Saunders; 2012:chap 36.

Wolff AC, Domchek S, 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 Churchill Livingstone; 2013:chap 91.

Cuzick J, DeCensi A, Arun B, Brown PH, Castiglione M, Dunn B, et al. Preventive therapy for breast cancer: a consensus statement. Lancet Oncol. 2011. 12:496-503.

Heisey RE, McCready Dr. Office management of a palpable breast lump with aspiration. CMAJ. 2010;182:693-696.