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Breast lump removal (lumpectomy)

Published by Bupa's health information team, June 2008.

This factsheet is for women (or men) who are planning to have a breast lump removed, or who would like information about it.

Overgrowth of tissue in the breast can cause breast lumps. Breast lump removal (lumpectomy) may be recommended if the lump is cancerous or if it's causing severe discomfort.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.

About breast lumps
Diagnosis of breast lumps
What are the alternatives?
Preparing for your operation
About the operation
What to expect afterwards
Recovering from breast lump removal
What are the risks?
Further information
Questions and answers
Related topics
Sources

About breast lumps

Breast lumps are very common. Most women will experience one or more breast lumps at some time in their lives. However, the vast majority (at least nine out of 10) are benign and not cancerous. If a lump is filled with fluid, it is known as a cyst. If the lump is a solid growth made up of fibrous and glandular tissue, it is known as a fibroadenoma. Breast lumps can occur in men too, although they are far less common.

Diagnosis of breast lumps

Your surgeon may recommend a breast biopsy to identify if the breast lump is benign or cancerous. If it's cancerous, your surgeon will usually recommend lumpectomy. You may also have some lymph nodes removed from your armpit and you may have other treatments after surgery to help reduce the chance of the cancer coming back, or spreading to other organs.

If your breast lump is harmless no treatment is needed unless the lump is causing severe pain and discomfort.

What are the alternatives?

For cancerous lumps, lumpectomy or local wide excision procedures are usually recommended to help conserve your breast. Depending on the location and size of your breast lump, your surgeon may suggest you have a mastectomy. This is an operation to remove the breast.

For benign lumps, vacuum-assisted core biopsy (VACB) may be done to remove the lump. For more information about VACB see the related Bupa health factsheet, Breast lump investigation.

Preparing for your operation

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.

Lumpectomy is routinely done as a day case under general anaesthesia. This means you will be asleep during the procedure. Alternatively, the operation may be done under local anaesthesia. This completely blocks feeling in the breast lump area and you will stay awake during the operation. You may be offered a sedative with a local anaesthetic to help you relax.

If you are having general anaesthetic, you will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.

Bring in a soft, supportive bra to wear after surgery. Your surgeon will advise you about the most suitable type of bra beforehand.

At the hospital, your nurse may check your heart rate and blood pressure, and test your urine.

Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

You may be asked to wear compression stockings on your legs to help prevent blood clots forming in the veins in your legs.

About the operation

The operation can take up to 60 minutes depending on the size and location of the lump.

A small cut is made in the skin over or near the lump, or in an area where the scar would be less obvious (for example close to the nipple or in the crease under your breast). The lump is cut away. This is called lumpectomy.

Your surgeon may remove the lump and a border of healthy tissue around the lump. This is called wide local excision.

The skin cut is closed with fine stitches. A dressing is usually placed over the wound. The lump (and healthy tissue) is sent to a laboratory for testing.

What to expect afterwards

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

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

You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.

Dissolvable stitches will disappear on their own in seven to 10 days. Non-dissolvable stitches are removed a week after surgery.

Recovering from breast lump removal

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If you are in any doubt about driving always follow your surgeon's advice and please contact your motor insurer so that you are aware of their recommendations.

Don't use aerosol deodorant, perfume or talcum powder on your upper body as these may irritate the healing wound. If you would like more advice, please contact your specialist breast-care nurse. Try to keep the arm on the side of the operation mobile to prevent stiffness.

You should wear a supportive bra, and you may be advised to wear it night and day for the first week or so. Don't lift heavy objects or do any strenuous activity for the first two to three weeks after the operation. When you resume your sporting activities always wear a sports bra.

It usually takes about a week to make a full recovery from lumpectomy, but this varies between individuals, so it's important to follow your surgeon's advice.

If you develop any of the following symptoms contact your GP as you may have developed an infection:

severe pain
high temperature
breast feels unusually hot to touch

What are the risks?

Breast lump removal is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic. Side-effects of lumpectomy include:

bruising and some swelling - this improves as the wound heals
stiff and sore arm and shoulder - this is more common if the lump is removed from the upper part of the breast
numbness or "pins and needles" - nerve damage can result in loss of feeling or tingling
scarring - you will have a scar but this usually fades gradually

Complications

This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, infection, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).

Specific complications of lumpectomy are uncommon, but can include:

an unevenness in size and shape - possibly caused by natural differences highlighted by the surgery
infection - this may need antibiotic treatment
temporarily build up of fluid under the healing wound or the arm (called seroma) - this may need draining

There is a risk the breast lump may re-occur in the future and need further surgery or treatment.

The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.

Further information

Breast Cancer Care
0808 800 6000
www.breastcancercare.org.uk
Breakthrough Breast Cancer
08080 100 200
www.breakthrough.org.uk