Breast Lump Removal

QUICK ANSWER

Breast lump removal, or excision, is a small planned operation to take a lump out of the breast so it can be examined under a microscope. It is usually done as a day procedure, under local or general anaesthesia, and most people go home the same day.

Being told a lump should come out is unsettling, even after you have been told it is not cancer. Breast lump removal is a planned operation: the lump comes out with a small margin of tissue, and the laboratory then confirms exactly what it was. At Melanie Seah Breast Specialist in Singapore, Dr Melanie Seah, a Consultant Breast Surgeon, removes benign lumps such as fibroadenomas, and lumps that a scan and a needle sample have not settled between them. This page covers when removal is the right call, what the day involves, recovery, and what the results mean.

What is breast lump removal?

Breast lump removal, also called excision or excision biopsy, is an operation to take a lump out of the breast through a small incision. The lump is removed together with a thin margin of surrounding tissue and sent to a laboratory, where a pathologist examines it and confirms what it was.

Most lumps removed this way turn out to be benign. According to the National Cancer Centre Singapore, only about one in ten breast lumps is cancerous — the rest are fibroadenomas, cysts, fatty lumps and other harmless changes. Removal is often about certainty, or about a lump that has become a nuisance, rather than about cancer.

Which page you want depends on the lump. This page is about a lump you or your doctor can feel. If a change was found only on a scan and cannot be felt, it is located with a fine wire first — see hookwire localisation and excision. If the question is only what the lump is, and not yet whether it should come out, a breast biopsy takes a sample with a needle and leaves the lump in place.

Should the lump be removed, or can it be watched?

Not every benign lump has to come out. A small, stable fibroadenoma that a scan and a needle sample both agree on can often be monitored instead, while a lump that is growing, painful, uncertain on tests, or suspected of being a phyllodes tumour is usually removed. The table sets out the common situations.

SITUATIONUSUAL APPROACHWHY
Lump that is growing or has changedUsually removedGrowth is the finding that most often changes the assessment, whatever the earlier tests said.
Scan and needle sample do not agreeRemovedExcision examines the whole lump rather than a sample of it, which settles the question.
Phyllodes tumour suspectedRemoved with a marginImaging and even a core needle biopsy may not separate it from a fibroadenoma reliably.
Lump that is painful or bothersomeRemoved if you wishDiscomfort and anxiety are legitimate reasons, discussed rather than assumed.

The decision belongs to you as much as to the surgeon. At Melanie Seah Breast Specialist in Singapore, Dr Melanie Seah, a Consultant Breast Surgeon, goes through what the scan and the needle sample showed, what removal would settle, and what monitoring would involve if you would rather wait.

breast-lump

How is a breast lump removed?

Through a small incision, usually as a day procedure. The whole visit takes a few hours; the operation itself is generally under an hour.

  • The lump is examined and marked on the skin, with you awake, before anything begins.
  • Anaesthetic is given — local for a small superficial lump, general for a deeper or larger one.
  • An incision is made in a position chosen to keep the eventual scar as discreet as possible.
  • The lump is removed with a thin margin of surrounding tissue and sent for laboratory examination.
  • The wound is closed, often with dissolvable stitches, and dressed.
  • You rest in recovery and go home the same day, with someone to accompany you if you had a general anaesthetic.
after-surgery

What is recovery like after breast lump removal?

Most people are back to ordinary routines within a few days. There is some soreness, bruising and swelling around the wound at first, and it settles steadily.

  • Mild pain and tenderness for the first few days, usually managed with simple painkillers
  • Bruising and swelling that fade over one to two weeks
  • Desk work and light activity generally resumed within a few days
  • Heavy lifting, gym work and vigorous exercise held back until the wound has settled
  • A supportive bra worn day and night for the first week or so, for comfort
  • A review appointment to check the wound and go through the laboratory result

Contact the clinic if the wound becomes hot, increasingly painful, or starts to discharge, or if you develop a fever. Those are the signs worth acting on rather than waiting out.

What happens to the lump after it is removed?

It goes to a laboratory, where a pathologist examines it under a microscope and produces a report on exactly what it was. This is the step that turns a probable diagnosis into a confirmed one, and it is the main reason many lumps are removed at all.

A needle biopsy samples part of a lump; excision examines all of it. That difference matters when the earlier tests disagreed, when a lump has grown, or when a phyllodes tumour is a possibility — situations where a sample can be misleading and the whole specimen cannot.

The report is discussed at a follow-up appointment rather than sent to you cold. Dr Melanie Seah goes through what the pathologist found, whether the lump was removed completely, and whether anything further is needed — which, for a benign lump, is usually nothing beyond routine breast screening.

Frequently Asked Questions

Yes, but a small one, and its position is planned before anything is cut. Any operation that removes tissue through the skin leaves a scar, so the question is where it sits and how visible it stays. Where the anatomy allows, the incision is placed along a natural line — the edge of the areola, the crease under the breast, or a skin crease — so the mature scar follows a boundary the eye already expects. Fresh scars look red or pink and firm, then fade and flatten over months rather than weeks. Keeping the scar out of direct sun during that first year helps it settle paler. Dr Melanie Seah discusses incision placement with you before the operation, so you know in advance where the scar will be.

The lump that was removed does not usually come back, but a new one can form elsewhere. Excision takes the lump out with a margin of surrounding tissue, so recurrence at the same site is uncommon for a benign lump that has been completely removed. What is more common is a separate new lump in either breast, particularly in women who have had a fibroadenoma before, because the tendency to form them is not removed with the lump. That is why a new lump after previous surgery is assessed on its own merits rather than assumed to be a recurrence. According to the National Cancer Centre Singapore, having a simple fibroadenoma does not in itself raise the risk of breast cancer. Any new lump should still be examined..

In most cases no, particularly when the lump sits away from the nipple. Milk is produced across the whole breast and drains through many separate ducts, so removing a small area of tissue usually leaves the system able to work. The risk is higher when an incision is made at the edge of the areola on a lump close to the nipple, because more ducts converge there and some may be divided. If you are planning a pregnancy or hope to breastfeed in future, say so before the operation rather than after — it can influence where the incision is placed and which approach is chosen. Raise it at the consultation with Dr Melanie Seah so it is factored into the plan.

Usually not noticeably, because the volume of tissue taken is small relative to the breast. Most benign lumps removed in this way are a few centimetres or less, and the space closes as the tissue settles and heals. A visible change is more likely when the lump is large relative to a small breast, or sits close to the surface where a dip can show. Where that is a possibility, it is discussed before the operation rather than discovered afterwards, and the surgical approach can be adjusted to limit it. Swelling and firmness in the first weeks make the breast feel different from how it will eventually look, so the final shape is best judged several months on.

Been told a lump should come out?

Speak with Dr Melanie Seah, Consultant Breast Surgeon in Singapore, about whether removal is needed, what the day involves, and what the results would tell you.



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