Definition During a breast lump removal, a worrisome lump or mass in the breast is taken out. It is then examined for signs of cancer by a pathologist.
Who is a candidate for the procedure? The thought of finding a lump in the breast is frightening for most women. Anyone, male or female, young or old, who notices a new or changing lump in the breast, wall of the chest or armpit, should see her or his doctor. If the doctor thinks the lump may not be normal, it should be checked for cancer.
It is not unusual to find breast lumps. Many men, women, and children have normal lumps and bumps that are not a problem. These can just be watched for changes if the individual and the doctor agree that is the best approach.
Some lumps are merely fluid-filled cysts. When the fluid inside them is drained with a needle, the lump collapses. A biopsy is done on almost all lumps in women over the age of 20, and in those who have a family or personal history of breast cancer.
How is the procedure performed? The procedure can be done several ways, depending on what the lump is like.
If the lump is fluid-filled, a simple needle aspiration in the office is often all that is needed. The skin above the lump is cleansed and then numbed with a local anaesthetic. The lump is pierced with a needle and the fluid is drawn off. Usually, this fluid is sent to a pathologist to examine for cancerous cells. In most cases the lump goes away in a few days after swelling caused by the procedure disappears.
If the lump is harder and feels more solid than a cyst, it is usually removed completely in an operating room or an office equipped for minor surgery. The person having the procedure can choose one type of anaesthetic or a combination. A local anaesthetic can be injected to numb the area of the operation. A general anaesthetic puts the person to sleep.
While the person is still awake the location of the lump is confirmed. Some surgeons mark the spot on the skin with a pen. Then general anaesthesia is given or a local anaesthetic is injected into the area. The skin above the lump is cleansed and the area is opened. The lump is separated from normal tissue and removed for the pathologist to examine. The incision is then closed with stitches or tapes. A dressing is put over the wound and the person is awakened. Usually a person can go home as soon as he or she has some fluids and is feeling fine.
What happens right after the procedure? The surgeon usually tells the individual how to care for the wound. If not, the person should ask the nurse before going home. The partner or friend who comes to take the person home should listen to the instructions too. The after-effects of anaesthesia and surgery often make remembering hard and driving dangerous. Written instructions are very helpful.
What happens later at home? After the procedure the breast will be tender for a short while, usually less than 3 days. Putting ice bags on the area on the day of the operation and cutting back on activity will help. A person can expect to be tired from the surgery, even if a local anaesthetic is used. Women should wear a bra at all times, even when sleeping, to support the breast and reduce pain for the first 3 to 5 days.
What are the potential complications after the procedure? Few problems occur after breast lump removal.
Some people have a bit of bleeding around the incision. If the dressing must be changed more than twice, the person should call the surgeon.
The skin under the incision can look very bruised for a few days after the operation. If it is bruised, swollen, and tender, call the surgeon.
The surgeon tries to make the cavity left behind when the lump is removed as small as possible. That's because the body does not tolerate empty spaces well. It tends to fill in the space, often with fluid or blood. The tissue around the space where the lump was removed may weep, filling the cavity with thin, watery fluid. This is usually absorbed by the body and is generally nothing to worry about.
The site becomes infected in less than 5% of cases. Infection is suspected if the breast becomes more tender after the third day following the biopsy, if there is redness or pus around the incision, or if a fever develops.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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