Finding a breast lump can be frightening, but it does not mean an automatic diagnosis of breast cancer.
There are several reasons why someone may need to have a lump removed from their breast. This surgery is known as a lumpectomy.
This article will look at the reasons for the surgery and what patients can expect before, during, and after the procedure.
Contents of this article:
Who needs a breast lump removal?
It is recommended to visit a healthcare professional if a lump is present in the breast.
There are several reasons why a lumpectomy might be performed.
The outlook after surgery depends on several factors. These include the type of lump that is found, and if it is cancer, how advanced the cancer is.
Causes of breast lumps
There are different causes for lumps in the breast. Not all of them are cancer.
- Cysts: Harmless growths in the breast tissue. They tend to occur with hormonal changes, such as with the start of a menstrual period. Cysts are usually filled with fluid that can be drained with a needle. It is possible for cysts to reoccur after the fluid has been drained.
- Fibrosis: A thickening of the tissue within the breast. It is usually harmless.
- Benign tumors: Solid growths that are not cancerous or dangerous. They can be uncomfortable, and they can sometimes cause leakage from the nipples, depending on their location. The only way to determine if a tumor is cancerous or benign is by looking at the cells that make up the tumor under a microscope.
It is important to see a doctor to find out which type of lump is present in the breast. Early treatment can then be started if needed.
A doctor will likely order image testing to see the lump and surrounding tissue. Examples include mammogram, ultrasound, or MRI. Someone at low risk for breast cancer may be asked to monitor the lump and to return periodically to check on it.
Sometimes the doctor will want to do a biopsy. This involves removing a small amount of the lump, in order to diagnose the cause. The only way to definitively diagnose breast cancer or other conditions is to perform a biopsy.
There are several different types of biopsies:
- Fine needle aspiration biopsy: A small needle is inserted into the lump and a few cells are removed to be studied.
- Core needle biopsy: A slightly larger needle is used to remove three to six small cylinders of tissue from the abnormal breast tissue. The samples are then looked at under a microscope.
- Surgical biopsy: A surgeon makes a cut into the breast to remove either a small amount of the abnormal tissue or the entire lump. Removing the entire lump is known as an excisional biopsy.
An excisional biopsy is also known as a breast lump removal or a lumpectomy. This procedure removes only the abnormal tissue and a small amount of surrounding tissue from the breast. It leaves the rest of the breast intact.
Types of surgical procedures
Several types of surgical procedure can be performed to remove a breast lump, or in some cases, the entire breast.
It is important for patients to discuss with the surgeon which procedure is most appropriate. This will depend on the size and location of the tumor, breast size, whether the cancer has spread, and the wishes of the patient.
A lumpectomy is known as a breast-conserving procedure, because most of the breast tissue stays in place. If the doctor suspects cancer, the surgeon will remove lymph nodes that are close to the breast tumor to look for evidence that the cancer has spread.
When performed to treat a cancerous tumor, it is very important to ensure that all of the cancer cells have been completely removed. The surgeon will take a small amount of tissue that surrounds the tumor, known as the border, for examination under a microscope.
If there are no cancer cells in the border, it is said to have a healthy or clear margin. If there are cancer cells in the border, further surgery may be necessary to remove the rest of the cancer.
Another type of breast-saving surgery, though less common, is a quadranectomy. Around a fourth of the breast, including the tumor, is removed. Reconstructive surgery to replace the removed tissue may be an option after having a quadranectomy.
Complete removal of the breast, nipple, and all of the breast tissue is known as a mastectomy. A radical mastectomy also removes the muscles that make up the chest wall. Reconstructive surgery to create a new breast can be performed either at the same time or at a later date.
Preparing for surgery
A lumpectomy is usually performed as an outpatient procedure, either in the hospital or an outpatient surgical center. The procedure is carried out under general anesthesia and the patient goes home after a brief recovery period.
Before surgery, doctors may recommend that some blood-thinning medications are stopped.
A mastectomy is usually performed in the hospital, because the procedure and recovery are more complex.
If the lump is difficult to locate within the breast tissue, a radiologist may need to place a marker in the lump and a thin guidewire leading from the outside of the breast down into the lump. This makes it easier for the surgeon to find the lump during surgery.
Before surgery, certain medications may need to be stopped to reduce the risk of bleeding. These include aspirin or other blood-thinning medications. It is also important not to eat or drink at least 8 to 12 hours before surgery, and to make arrangements for a ride home.
Patients having these procedures will meet with the surgeon a few days to a week beforehand to discuss any additional instructions that may be necessary.
Risks during surgery
As with all surgical procedures, breast lump removal surgeries carry some risks.
These risks may include:
- Scar tissue
- Change in appearance of the breast.
What to expect after surgery
Recovery will depend on the type of breast lump removal procedure that was performed. The surgeon will give detailed instructions for how and when to follow up for further care.
The tissue removed during the surgery will be sent to a pathologist who will examine it under a microscope to confirm the diagnosis. The doctor will share this information after receiving the results. They will discuss what they mean, and what will happen next.
While it can be frightening to find a lump in the breast, it is important to realize that there can be many different causes other than cancer. Seeing a doctor promptly for testing is crucial to making an accurate diagnosis and starting early treatment if needed.