Breast lump removal

About breast lump removal

Breast lumps are common and most are not cancerous (known as benign breast lumps). Breast lump removal may be recommended if you have one of the following types of benign breast lump.

  • Fibroadenoma – this is when your breast tissue becomes thickened.
  • Intraductal papilloma – this is a wart-like lump that develops in a duct just behind your nipple.

Your surgeon may refer to these kinds of lump as simple breast lumps. He or she will be able to advise you about whether you will need to have your lump surgically removed.

What are the alternatives to breast lump removal?

If you have been diagnosed with a benign breast lump, your surgeon may suggest an alternative, such as vacuum-assisted core biopsy (VACB) to remove the lump. For more information on VACB, see breast lump investigation.

If you have been diagnosed with a cancerous breast lump, your treatment will be different. Depending on the size and position of your breast lump, your surgeon may suggest either a lumpectomy or a mastectomy.

Preparing for breast lump removal

Your surgeon will explain how to prepare for your operation. For example, if you smoke you may be asked to stop as smoking increases your risk of getting a chest or wound infection, which can slow your recovery.

Breast lump removal is usually done under general anaesthesia, so you will be asleep during the operation. You will be asked to follow fasting instructions, which means not eating or drinking, typically for about six hours beforehand. However, it's important to follow your surgeon's advice.

You may be recommended to bring in a soft, supportive bra to wear after surgery. Your surgeon or nurse will advise you about the most suitable type of bra.

You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anticlotting medicine called heparin as well as, or instead of, wearing compression stockings. Your nurse may also check your heart rate and blood pressure, and test your urine.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during breast lump removal?

The operation generally takes between 15 minutes and one hour depending on the technique used.

Your surgeon will make a small cut in your skin, over or near to the lump. He will then cut the lump away. Often this doesn’t require any other breast tissue to be removed but occasionally a small bit of normal tissue needs to be taken out as well. Your surgeon will advise you about this prior to your operation.

Your surgeon will close the cut with fine stitches and sometimes put tissue glue and/or a small dressing over the wound. The lump is sent to a laboratory for testing.

What to expect afterwards

You may need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

If you are going home on the same day as your operation, you will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours after your operation.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon’s advice.

The length of time your dissolvable stitches will take to disappear depends on what type you have. However, for this procedure, they should usually disappear in about seven to 10 days.

Your nurse will give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment.

Recovering from a breast lump removal

It usually takes about one to two days to make a full recovery from a simple breast lump removal but this varies between individuals, so it's important to follow your surgeon's advice.

Most people are comfortable to go back to work after one to two days but you may wish to avoid contact sports for some weeks. Don't drive until you feel confident that you could perform an emergency stop without discomfort. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon’s advice.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

What are the risks?

As with every procedure, there are some risks associated with breast lump removal. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. For example, you may have:

  • bruising and some swelling – this should improve as your wound heals
  • scarring – you will have a scar but this should gradually fade

Complications

Complications are problems that occur during or after the operation. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding, or developing a blood clot, usually in a vein in your leg (deep vein thrombosis, DVT). Specific complications of breast lump removal include:

  • a wound infection
  • an unevenness in the size and shape of your breast
  • a temporary build up of fluid under your wound (called a seroma)

Speak to your surgeon for further information.

Will my breast look different after breast lump removal?

Answer

Your breast may look slightly different after having a breast lump removed. You will also have a scar from surgery, though this will fade and become less noticeable over time. Your surgeon will do everything possible to make sure any change to your breast shape or scarring is as minimal as possible.

Explanation

Usually, there are few noticeable changes to your breast after a breast lump removal. Any change in your breast size or shape will be minimal and shouldn't affect your bra size. Most women don't need to have breast reconstruction unless the lump is very large.

Talk to your surgeon or nurse about how your breast will look after you have had your surgery.

You will have a small scar after surgery. This usually fades gradually and becomes less noticeable. If you have dark skin, or fair, freckled skin, your scars may take longer to settle. Speak to your doctor if you have any concerns.

I’ve been advised to have a lumpectomy - what does this involve?

Answer

A lumpectomy is an operation to remove a cancerous lump in your breast and some of the tissue around it. Your surgeon will try to keep the appearance of your breast as similar as possible to how it was before.

Explanation

If you have a cancerous lump in your breast, or if there is any doubt about whether a lump in your breast is cancer, you may be advised to have a lumpectomy. This procedure is also called a wide local excision, or breast conserving or breast preserving surgery because it aims to leave as much healthy tissue as possible. This is compared with a mastectomy in which your entire breast is removed.

You may have a lumpectomy done under local or general anaesthesia depending on a number of things, such as the size of your breast lump. Your surgeon will remove the cancer and also some healthy tissue from around it. This is to try to reduce the risk of the cancer coming back or of leaving any cancerous cells behind. You may also have some lymph nodes removed from your armpit, This may be if your surgeon is concerned that the cancer may have spread to them or if there is a risk that it might.

Your surgeon may be able to reshape or reconstruct your breast during your operation, to avoid an obvious indentation. This will depend on the size of your breast, the position of the lump being removed and your breast tissue.

The tissue that has been removed will be sent to a laboratory for testing. This is to check that there is an area of healthy cells around the cancer – known as a ‘clear margin’. If the results of this show that there are no cancer cells, you probably won’t need any further surgery, but if the margin isn’t clear, you may need another operation.

Another procedure that is carried out much less commonly is a quadrantectomy, which involves removing about a quarter of your breast. The difference in appearance between your breasts will be more noticeable after a quadrantectomy. However, your surgeon may be able to reconstruct your breast during the procedure to improve the cosmetic appearance.

If your lump is cancerous, you will be advised to have radiotherapy after a lumpectomy or quadrantectomy. This is to prevent new cancers growing within your remaining breast tissue. There is evidence to show that if you have early breast cancer, a lumpectomy followed by radiotherapy is as effective at treating it as a mastectomy.

Any type of surgery to remove a breast lump will leave a scar and may affect the cosmetic appearance of your breast. This will probably be quite small if you have a lumpectomy. Talk to your surgeon about what to expect about the appearance of your breast after any type of surgery. You may wish to consider surgery to reconstruct the breast that was treated or to reduce the size of your other one.

Will having a breast lump removed affect my ability to breastfeed?

Answer

It’s possible that your ability to breastfeed may be affected after having a breast lump removal.

Explanation

Having any type of invasive breast surgery has the potential to damage ducts or nerves in your treated breast and this can affect your ability to produce breast milk. How much of an impact surgery has on breastfeeding will depend on the size and location of the lump and how much surgery you need to have. However, you should be able to breastfeed without any difficulty on your untreated breast.

For more information about breastfeeding after breast lump removal, speak to your surgeon.