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Breast lump removal

Overgrowth of tissue in the breast can cause breast lumps. Where lumps are filled with fluid they are known as cysts. Surgery is needed to remove small breast lumps that don't go away on their own or cysts that keep coming back. The operation is known as a lumpectomy or wide local excision.

It is routinely performed under general anaesthetic as a day case or with just one night's stay in hospital.

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.  

Your specialist or hospital will give you some information about when and how to check into hospital.

Before you come into hospital, you may be asked to:

  • Have a bath or shower on the day of your admission,
  • Remove any make-up, nail varnish and bulky or sharp jewellery. Rings and earrings that you'd prefer not to remove can usually be covered with adhesive tape,
  • Follow the fasting instructions given in your admission confirmation letter. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow a few sips of water until two hours before.

When you arrive at the hospital, a nurse will explain how you will be cared for during your stay, and will perform some simple tests such as checking your pulse and blood pressure, and testing your urine.

Your surgeon and anaesthetist will also visit you. The surgeon may use a pen to mark the breast to be treated. This is a good time to ask any outstanding questions about your treatment.

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

Consent

Before going to the theatre, you will be given a consent form to sign. By doing this, you confirm that you understand what the procedure involves, including the benefits and risks, and give your permission for it to go ahead.

You will be taken from your room on a bed or trolley to the anaesthetic room where you'll be put off to sleep.

A cut slightly bigger than the lump is made over or near the lump, allowing it to be removed completely. In some cases, a margin of healthy tissue around the lump may also be removed. The cut is then closed up with very fine stitches. The operation usually takes between 45 and 60 minutes.

The lump is sent to a laboratory for testing (biopsy).

After your operation

You will be taken from the operating theatre to a recovery room, where you will come round from the anaesthetic under close supervision. After this, you will return to your room, where a nurse will make you comfortable. He or she will assess the operation sites and monitor your blood pressure and pulse at regular intervals.

Back on the ward

You will have tubes running out of small holes in the skin near the operation site. These drain fluid and blood into a bag beside your bed. You will also find a drip in your arm to keep you hydrated. This will be removed when you've started drinking enough fluid.

You will normally have a small dressing over the operation site. You will need to rest until the effects of the general anaesthetic have passed. If you are sore, you may require painkillers. These can usually be taken every four to six hours. Please discuss pain relief with your nurse, surgeon or anaesthetist.

When you feel ready, begin to drink and eat, starting with clear fluids such as water or apple juice.

Going home

If your operation has been planned as a day case, you will be able to go home once you have made a full recovery from the anaesthetic. However, you will need to arrange for someone to drive you home and stay with you for the first 24 hours.

If you stay overnight after your operation, you may leave your room by the next morning. Before you are discharged, your nurse will advise you about caring for the healing scar, bathing, diet and exercise. He or she will give you a contact telephone number for the hospital, in case you need to ask for any further advice, and will make an appointment for you to have any stitches removed as an outpatient.

Another appointment will be made with your surgeon to discuss the biopsy results and any further treatment required.

After your return home

If you need them, continue taking painkillers as advised by the hospital. A general anaesthetic can temporarily affect your co-ordination and reasoning skills, so you should avoid driving, drinking alcohol, making any vital decisions or signing legal documents for 24 hours afterwards.

You should be able to resume driving when you feel confident that you could perform an emergency stop without discomfort.

You will need to take it easy and should expect to tire easily at first. You should be able to return to light activities the day after your operation, and should try to use the arm on the side of the operation to prevent it from getting stiff.

Where possible, avoid using aerosol deodorants, perfume and talcum powder, as these can irritate the wound area.

Use a supportive bra without underwires. You may also be advised to wear a bra at night for a week. If you play sport, you should wear a supportive sports bra for at least a month after your operation.

Breast lump removal is generally a safe procedure. For most people, the benefits are much greater than any disadvantages. However, like all surgery, there are some risks. These can be divided into the risk of side-effects and the risk of complications.

Side-effects

These are the unwanted, but mostly mild and temporary, effects of a successful procedure. Examples of side-effects include feeling sick as a result of the general anaesthetic or painkillers. Bruising and some swelling are common after breast lump removal. The skin around the operation site can change colour, and sometimes a lump will appear under the scar – both of these should disappear within six weeks.

Your arm and shoulder may also feel sore and stiff, particularly if the lump was removed from the upper, outer part of the breast. You may feel "pins and needles" or numbness in the underarm skin because nerves here can be irritated or damaged during the operation. This is usually temporary. If it is severe, contact the hospital for further advice.

Complications

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

The main complication specific to breast lump removal is infection, which can usually be treated with antibiotics. Signs of infection include bleeding, redness, high temperature, increasing pain, discharge or hardness in the breast.

Sometimes fluid can accumulate at the site of the operation under the arm (known as seroma), which can feel uncomfortable and push your arm away from your side. If this occurs, you should contact the hospital as you may need to have the fluid drained.

The chance of complications depends on the exact type of operation you are having and other factors such as your general health. Please ask your surgeon to explain how these risks apply to you.

 

American Cancer Society
Benign breast conditions
http://www.cancer.org/docroot/CRI/content/CRI_2_6X_Benign_Breast_Conditions_59.asp?sitearea=

National Cancer Institute
http://www.cancer.gov/cancerinfo/understanding-breast-changes/page5

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