Breast lumps don’t normally go away on their own and excising them when they are small ensures a smaller incision. Excising, aspirating, or biopsying a breast mass allows your medical team to figure out what kind of mass it is and what treatment, if any, is required. Sometimes the doctor is sure the lump has fibrocystic changes and if there are many small lumps, the doctor may simply continue to monitor them by making appointments every two to three months to check them. These lumps can disappear on their own but may need to be removed if they change in size. If the lump is a cyst, the doctor may simply drain it. A breast lump is a mass that develops in the breast. Breast lumps are commonly found in one breast but can appear in both. Some may be too small or too deep to be felt from the outside and may appear in imaging studies like mammograms and/or ultrasound. Others may be detectable from the outside during self-examination or a physical examination by a doctor. Breast lumps can be found at all ages. Girls who are beginning puberty will experience breast changes due to hormonal changes. Breasts will grow as the milk-producing glands and ducts develop. This process can make the breasts feel “lumpier.” These lumps will settle as she enters adulthood. Breast lumps can also be found in boys, especially during the teenage years, also due to hormonal changes. They too tend to disappear on their own. There are many types of breast lumps. The most common ones include: -Fibrocystic changes account for 40% of all breast lumps. -Fibroadenoma makes up 7-10% of breast lumps. -Other benign lumps (13-20% of breast lumps) include cysts (fluid-filled sacs), lipomas (fat masses), phyllodes, hyperplasia, and adenosis. -Malignant growths make up 10% of breast lumps. Sometimes a patient may think they feel a lump in their breasts that the doctor is not able to find from the physical examination or imaging studies. This occurs in 30% of women who think they feel a lump.
A breast lump excision is performed to prevent a cancerous tumor from spreading to other parts of your body. Whether a doctor can perform a lumpectomy depends on the size and stage of the tumor and certain patient characteristics such as the size of your breast. Many doctors prefer this method over a mastectomy. A lumpectomy is less invasive that the entire removal of the breast. In a lumpectomy, your doctor takes a part of the breast, which leaves much of your breast’s appearance and sensations intact. This allows for better breast symmetry. But you may need radiation or chemotherapy following a lumpectomy to ensure all cancer cells have been destroyed.
-A lumpectomy is a more minor surgery than a mastectomy, requires no hospital stay, has a smaller chance of complications, and is quicker to recover from. Women generally report having a better body image after a lumpectomy than a mastectomy—even among those who have reconstructive plastic surgery after breast removal.
-Although survival rates of women who have a lumpectomy versus a mastectomy are the same, breast cancer recurs more often in those with the less-aggressive surgery. It’s usually treatable with additional surgery, which is why survival rates are the same. About 20% of women will need additional surgery after having a lumpectomy. Most will have another lumpectomy to remove more cancer cells; a very small percentage go on to have a mastectomy and remove all the breast tissue.
Breast lump removal is done as an outpatient surgery most of the time. You will be given general anesthesia (you will be asleep, but pain free) or local anesthesia (you are awake, but sedated and pain free). The procedure takes about 1 hour. The surgeon makes a small cut on your breast. The cancer and some of the normal breast tissue around it is removed. A pathologist examines a sample of the removed tissue to make sure all the cancer has been taken out. When no cancer cells are found near the edges of the removed tissue, it is called a clear margin. Your surgeon may also remove some or all of the lymph nodes in your armpit to see if the cancer has spread to them. Sometimes, small metal clips will be placed inside the breast to mark the area of tissue removal. This makes the area easy to see on future mammograms. It also helps guide radiation therapy, when needed. The surgeon will close your skin with stitches or staples. These may dissolve or need to be removed later. Rarely, a drain tube may be placed to remove extra fluid. Your doctor will send the lump to the pathologist for more testing.
Try to maintain good health. If you have any medical conditions, please discuss them with your doctor to assess your risk of complications with surgery. Eat nutritious food, especially easily digestible protein like fish and soy, and foods high in iron, such as milk, egg yolk, and leafy green vegetables. Eat fruit and vegetables to prevent constipation. Get enough sleep. Meditation can help if you have difficulty sleeping. Exercise to strengthen the muscles, lungs, and heart, such as walking 30 to 40 minutes a day. Maintain a normal body weight. Obesity can put you at risk of complications, such as from the general anesthesia. Being underweight can put you at risk of excessive bleeding. Stop smoking and drinking alcohol. Please let your doctor know about all medication that you are taking as some, such as aspirin, will need to be stopped before the procedure. Think positive to reduce stress and maintain good immune health.
Recovery will depend on the type of procedure. The surgeon will give detailed instructions on how and when a person should have a follow-up appointment for further care. The doctor may give the individual a prescription for some pain medication and instructions about caring for the dressing and follow-up appointments. Sometimes, the drainage tube remains in place until the follow-up appointment. Depending on the extent of the procedure, aftercare may include: resting taking sponge-baths instead of showers while stitches are still in place wearing a support bra or sports bra arm exercises that the surgeon may recommend People should look out for increasing pain, swelling, redness, and other signs of infection. If they notice these, they should contact your doctor. There may be some itching and sensitivity as the nerves grow back after surgery. This may go away in time, or a person may become used to the different feeling. After removing the breast tissue, the surgeon will send it 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 the results mean and what will happen next.
As with all surgeries, a lumpectomy involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery. The general risks of surgery include: -Anesthesia reaction, such as an allergic reaction and problems with breathing -Bleeding, which can lead to shock -Blood clot -Infection Complications of a lumpectomy are uncommon but include: -Damage to nearby organs, such as the lymph nodes and lungs -Differences in breast sizes after a lump is removed -Numbness of the affected breast that may or may not go away -Opening or infection of the external incision
What are the travel recommendations that comes with this procedure?
If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure. Travelers to Thailand should plan to stay in the country for at least two weeks or for the entire duration of treatment. If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel. During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).
What are the causes of breast lumps?
-Breast cancer -Breast cysts (fluid-filled sacs in breast tissue that are usually benign) -Fibroadenoma (a solid, benign mass most common in young women) -Fibrocystic breasts (lumpy or rope-like breast tissue) -Galactocele (a milk-filled cyst that's usually harmless) -Injury or trauma to the breast -Intraductal papilloma (a benign, wart-like growth in a milk duct) -Lipoma (a slow-growing, doughy mass that's usually harmless) -Mastitis (an infection in breast tissue that most commonly affects women who are breast-feeding)
What are the advantages and disadvantages of lumpectomies and mastectomies? Which one should I get?
Advantages of lumpectomies: -aims to keep most of the breast tissue -is less of a change to your body than a mastectomy -has a recovery time of a few weeks
Disadvantage of lumpectomies: -your breast might be misshapen or dimpled or unequal to the other one -you will need radiotherapy to the breast for about 3 weeks (some people may also need radiotherapy after a mastectomy) -radiotherapy can make you tired for a few months -if the cancer comes back some time later, you won't be able to have radiotherapy again and would need a mastectomy -you may have more surgery if the margins are not clear
Advantages of mastectomies: -you might feel more confident your cancer won't come back -you usually won't need radiotherapy after the surgery -you can have radiotherapy to the area if your cancer comes back in the future
Disadvantages of mastectomies: -you have permanent removal of your breast -if you have breast reconstruction the surgery takes longer and it can take some months to recover -you usually have 1or 2 smaller operations after a reconstruction (to match the reconstruction to your other breast as much as possible) -if you don't have reconstruction you might need to wear an external breast shape (prosthesis)