Lumpectomy; Wide local excision; Excisional Biopsy
Breast lump removal is a surgical procedure to remove a lump in the breast.
A breast lump may be a solid mass or a fluid-filled cyst. Lumps most commonly occur in women, but can occur in men as well. Mammography and ultrasound are two imaging techniques used to evaluate breast lumps, but many people will need to have a tissue sample taken to determine if a suspicious lump is cancerous.
Tissue from a solid mass can be removed by needle biopsy - a procedure in which a needle is placed into the lump to sample the tissue to check for cancer cells. When 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 cyst, a needle and syringe are used to drain fluid. If the cystic fluid is clear or green in color, 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, it is typically surgically removed.
Only a small portion of all breast lumps are malignant, but the risk increases with age.
If you find a lump in your breast, you should seek medical attention.
Your doctor will do a clinical breast exam and possibly order the following tests:
- An X-ray of the breast called a mammogram
- An ultrasound of the breast to determine whether the lump is a fluid-filled cyst or a solid mass
- A mammogram and an ultrasound
Based on these exams, the doctor may decide no further tests or treatment are needed. If no further tests are needed, the doctor will recommend regular checkups to detect any changes in the lump.
In some cases, the doctor may want to perform a needle biopsy or a lumpectomy to determine whether cancer is present.
If cancer is found, more tests will be required to tell the doctor whether the cancer has spread within the breast, to the lymph nodes in the armpit, or to other parts of the body. This is called staging and helps determine the treatment plan.
Treatment depends on the type and stage of cancer and the patient’s age, menopausal status, and overall health. If the entire lump was not removed in the biopsy, further surgery to remove it and surrounding tissue may be necessary.
Radiation therapy or chemotherapy may be needed.
The treatment of breast cancer in its earliest stages is much more likely to be successful than in more advanced stages. Routine mammography, clinical breast examination, and breast self-examination all play a role in early detection.
The risks of any surgery are bleeding, infection, and injury to nearby tissues. Some postoperative pain and soreness are to be expected and can be effectively treated with medication.
The risks of local anesthesia are minimal, though there is the possibility of an adverse reaction. With general anesthesia, the risk of breathing and heart problems, as well as reaction to medication, is greater. But for a woman who is in otherwise good health, the risk of a serious complication due to general anesthesia is less than 1%.
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.
Expectations after surgery
The outcome of a lumpectomy depends on the type of lump found. If the lump is benign, the outcome is usually without complications. If the lump is cancerous, the outcome depends on the type and extent of the tumor’s spread.
Depending on the circumstances, a lumpectomy followed by radiation therapy to the breast yields the same long-term survival as a mastectomy. After mastectomy, some women choose to have a surgical reconstruction of the breast.
Lumpectomy typically does not require breast reconstruction.
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.
by Arthur A. Poghosian, M.D.
All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.