Breast Procedures
Breast Anatomy
Biopsies
Lumpectomy
Mastectomy
Breast Anatomy
Breasts come in all shapes and sizes. But they all share the same features. You can learn about the parts of your breast (anatomy). This will help you know what you're seeing and feeling when you do a breast self-exam (BSE).
Surgical Breast Biopsy: Types of Biopsies
Wire Localization
Large Core Biopsy
Open Surgical Biopsy
A surgical breast biopsy requires an incision in the skin. This allows your doctor to take a large sample of tissue from the breast. In fact, the whole lump is often removed. The sample is then sent to a lab for study.
If You Need Wire Localization
A lump that can’t be felt may be hard to locate. In such a case, one or more guide wires may be placed in your breast before biopsy surgery. These thin wires help mark the tissue that is to be removed. A mammogram or ultrasound is used to direct the wire’s placement. Then you’re taken to the operating room for surgery. The wire is removed during the biopsy.
Large Core Biopsy
Large core biopsy uses a hollow instrument to remove a tissue sample. A small incision is made in the skin. The hollow instrument is inserted through this incision. A local anesthetic will be used to numb the site. Before the biopsy, a guide wire may be placed to mark the breast mass. Often the entire mass is removed. Large core biopsy takes about an hour to perform. Due to the size of the sample removed, stitches are often needed.
Open Surgical Biopsy
Open surgical biopsy removes a tissue sample through a skin incision. To keep you from feeling pain during the biopsy, you are likely to be given intravenous sedation. This produces a light sleep. Your surgeon then makes one incision in your breast. If possible, this is done in a way that hides the scar. In most cases, all of the lump is removed. The incision is closed with stitches. Some stitches dissolve on their own. Others may need to be removed when the incision heals.
Lumpectomy
Lumpectomy is surgery to remove cancer. It's a breast-conserving surgery, which means your breast remains intact. If you're having a lumpectomy, you'll probably also have radiation therapy.
Before Surgery
A week or more before the procedure, you will have an exam and routine tests. Before surgery:
- Sign any consent forms.
- Tell your healthcare provider about any medications, herbs, or supplements that you are taking.
- Avoid eating or drinking for 8–12 hours before your surgery.
- Arrange for a trusted adult to drive you home after surgery.
- Bring a soft shirt that buttons in front to wear home.
- Talk to the anesthesia care provider. He or she will explain how you will be kept free of pain during surgery.
During Surgery
You may have two incisions. One will be near the tumor site. The other may be under the arm, near the lymph nodes.
Your surgeon will make an incision near the tumor site. The tumor and a surrounding margin of normal tissue will be removed. A second incision may also be made under the arm to remove some of the nearby axillary lymph nodes. These are checked to see if the cancer has spread to them. When the surgery is finished, the incisions will be closed using stitches.
Right After Surgery
You will wake up in the recovery room. You may have an IV (intravenous) line for fluids and medications. Pain medications will be given to you as needed. A nurse will check your temperature, pulse, and blood pressure. You'll likely go home the same day.
When to Call Your Doctor
Call your doctor right away if you have any of the following after surgery:
- Fever of 101°F or higher
- Increased pain, warmth, drainage, swelling, or redness at the incision
- Cough or shortness of breath
- Pain in the chest or calf
- Bleeding that soaks the dressing
Mastectomy
Simple Mastectomy
Modified Radical Mastectomy
Mastectomy is surgery to remove the breast. The most commonly done mastectomies are called simple and modified radical. During these procedures, the chest muscle is not removed. As a result, arm strength remains. Keeping the chest muscle also makes reconstruction easier.
Simple Mastectomy
During a simple mastectomy, the breast tissue (lobules, ducts, and fatty tissue) and a strip of skin containing the nipple are removed. This surgery most often requires a hospital stay. Based on the results of surgery and follow-up tests, further treatment may be needed.
Modified Radical Mastectomy
This type of mastectomy is usually done to treat invasive cancer. During the mastectomy the breast tissue and a strip of skin with the nipple is removed. Some of the axillary lymph nodes are also removed. The removed nodes are tested for cancer. Sometimes a surgical drain is placed to keep fluid from building up. This drain is removed 3–4 days after surgery. Modified radical mastectomy almost always requires a hospital stay. Based on the results of the surgery and follow-up tests, further treatment may also be needed.
Risks and Complications of Mastectomy
- Pain or numbness under the arm
- Bleeding or infection
- Stiffness of the shoulder
- Fluid collection (seroma)
- Long-term swelling of the arm (lymphedema)