Breast Procedures
Biopsies
A breast biopsy is a procedure in which a small sample of breast tissue is removed so it can be tested and evaluated. This is typically recommended after a mammogram or ultrasound has revealed a possible cause for concern, or a breast lump or other unusual change has been detected. There are several types of breast biopsy procedures used to identify and diagnose abnormalities in the cells. The procedure chosen depends upon a number of factors, including the size and location of the breast abnormality. The result of the biopsy will determine next steps and what treatment options to consider. A breast lumpectomy or mastectomy may be recommended if cancer is diagnosed.
Lumpectomies
Also called partial mastectomy, this procedure removes only the part of the breast containing cancer, as well as some surrounding tissues and lymph nodes. This option is usually considered if the cancer is in the early stages.
Mastectomies
This surgery entails the removal of all breast tissue, some nearby tissues and often lymph nodes, in order to treat or prevent cancer. It can be performed on one or both breasts, and in combination with breast reconstruction to restore breast shape. You may also choose to schedule breast reconstruction at a later date or opt against it.
Risks
With a biopsy, there may be some bruising or swelling afterward.
The risks involved with a lumpectomy or mastectomy include:
- Bleeding
- Infection
- Pain
- Swelling
- Tenderness
- Formation of hard scar tissue at the surgical site
Additionally, a lumpectomy may cause a change in breast shape and appearance, especially if a large part of the breast is removed.
A mastectomy has these additional risks as well:
- Swelling (lymphedema) in your arm
- Shoulder pain and stiffness
- Numbness, particularly under your arm, from lymph node removal
- Buildup of blood in the surgical site (hematoma)
Before Surgery
Before your surgery, we will review your medical history and discuss your operation as well as your wishes regarding breast reconstruction.
You will need to refrain from eating or drinking for 8-12 hours prior to your procedure, and arrange for someone to take you home.
What Happens in Surgery?
Lumpectomies and mastectomies are usually performed using general anesthesia.
With a lumpectomy, an incision will be made over the tumor and the tumor will be removed along with some surrounding tissues. Lymph nodes may also be removed in order to analyze them for any abnormalities. The incisions will then be closed with sutures, paying special attention to preserving the appearance of your breast as much as possible.
With a mastectomy, an elliptical incision will be made around your breast, the breast tissue removed, and, depending on your procedure, other parts of the breast may be removed as well. The incision will be closed with sutures. Sometimes, a small plastic tube may be temporarily attached to drain any fluids that accumulate after the surgery.
After Surgery
After a biopsy, ice and anti-inflammatory medication will help with any pain or discomfort.
After your lumpectomy or mastectomy, you’ll be taken to a recovery room where your vital signs will be monitored. Your release from the hospital will depend upon your procedure. For biopsies, and some lumpectomies, a hospital stay is not required, however, a more complicated procedure could entail remaining a day or two in the hospital.
You can expect to have a dressing over your surgery site, and to feel some pain, numbness and a pinching sensation in your underarm area.
You will be given prescriptions for pain medication and possibly antibiotics, as well as thorough at-home instructions, including:
- How to take care of your incision and drains
- How to recognize signs of infection
- When to resume wearing a bra or prosthesis
- What activities you should avoid
A follow-up appointment should be scheduled usually within 7 – 14 days following your procedure.
