Lumpectomy: Indications, Procedure & Recovery

A lumpectomy, also called a breast lump excision, is a surgical procedure to remove an abnormal lump from the breast. It may be recommended to diagnose or treat breast cancer, or to remove benign growths such as fibroadenomas.

This is typically a simple and quick operation performed through a small incision near the lump. It can be done under local anesthesia, although general anesthesia may be used when the lump is large or when multiple lumps need to be removed.

The procedure is usually carried out by a breast specialist and aims to remove the abnormal tissue while preserving as much healthy breast tissue as possible, helping maintain the breast’s natural shape and appearance.

When a lumpectomy is recommended

Breast lump removal surgery may be recommended for:

• Small, localized breast cancer in an early stage.

• Breast nodules classified as BI-RADS 3 or 4.

• A single invasive breast cancer smaller than 5 cm.

• Ductal carcinoma in situ.

• Benign lumps, such as fibroadenomas.

• Lumps measuring 3 to 5 cm that continue to grow.

It may also be recommended if the fine-needle aspiration (FNA) biopsy results are inconclusive.

Does a benign breast lump need to be removed?

Not every benign breast lump needs to be removed. The need for surgery depends on factors such as the type of lump, symptoms, size, growth over time, and any associated risk.

The most common benign breast lumps are fibroadenomas and cysts, which usually are not dangerous and often do not require surgery.

According to the American Cancer Society, many fibroadenomas do not need to be removed and can often be monitored without treatment when the diagnosis is clear and the lump is not growing or causing problems.

When the lump is small, stable, and does not cause pain, follow-up with periodic imaging tests is often enough.

However, surgery may be recommended if the lump grows quickly, causes discomfort or pain, or creates cosmetic or emotional concerns.

How to prepare

To prepare for a lumpectomy, it is important to discuss any questions with your doctor, including what to expect before, during, and after the procedure.

You should also complete any tests requested by your doctor, such as an X-ray or mammogram, and let them know if you have allergies or any other health conditions.

You should also tell your doctor about all medications you are taking, since you may need to stop anticoagulants a few days before surgery.

On the day of surgery, you should fast for 8 hours, as instructed by your doctor.

Lumpectomy surgery

A lumpectomy is performed by a breast specialist in the hospital using local anesthesia with or without sedation, or general anesthesia.

To perform the surgery, the doctor generally follows these steps:

1. Administers anesthesia, either general or local with intravenous sedation.

2. Cleans the skin of the breast to reduce infection risk.

3. Makes an incision along the edge of the areola or directly over the lump.

4. Removes the lump and, according to the National Cancer Institute’s definition of breast‑conserving surgery, also removes a small margin of healthy tissue around the tumor while preserving the rest of the breast.

5. Closes the incision with stitches.

6. Applies a sterile dressing and wraps the area for protection.

The breast lump that is removed is sent to the lab for analysis, and the results should be reviewed by the breast specialist.

In some cases, the doctor may place a drain in the breast to remove excess blood or fluid that could interfere with healing.

Recovery time

Recovery after surgery can vary depending on how complex the procedure is, but it is common to stay in the hospital for 12 to 24 hours before going home, especially because of the effects of anesthesia.

Aftercare instructions

Some recommendations for recovery after breast lump surgery include:

• Taking pain medication as prescribed by your doctor.
• Wearing a surgical bra continuously to provide proper support.
• Resting and avoiding physical exertion or lifting your arms for about 7 to 14 days.
• Performing arm exercises (when advised by your doctor) to help prevent stiffness in the arm and shoulder on the side of the surgery.
• Keeping the surgical area covered when showering, especially during the first few days after the procedure.

In most cases, the doctor removes the dressings during a follow-up visit about one to two weeks after surgery.

Possible risks

Breast lump removal surgery is generally very safe. However, like any surgery, it can lead to complications such as pain, bleeding, infection, scarring, or changes in breast sensation, such as numbness.

It is important to contact your surgeon or go to the nearest emergency room if you notice signs of infection, such as redness, severe pain, swelling, or pus draining from the incision site.

As with any surgery that uses anesthesia, an allergic reaction to the anesthetic may also occur.