Breast surgery - excision biopsy

An excision biopsy of a breast lump involves removing a lump through a small cut. Usually no other breast tissue or lymph nodes (glands) are removed. The tissue will be examined under a microscope to find out if you have cancer.

Your surgeon has recommended an excision biopsy because:

• You want to have the lump removed for cosmetic reasons, or because the lump is causing you pain
• Your surgeon is concerned about the lump and other procedures such as a fine needle aspiration or core needle biopsy have failed to give a definite diagnosis.

Benefits

The surgeon will be able to remove the lump in your breast and confirm, after examining the tissue under a microscope, whether or not you have cancer. If you do have cancer your surgeon will be able to recommend the best treatment for you. If the lump is caused by cancer, early diagnosis and treatment will increase the chances of recovery.

Alternatives

If the lump is probably benign and less than about 2cm (1in) across, it may be possible to remove it using a special needle called a mammotome. However, a mammotome excision is only available in a few specialist centres.

The operation

If your surgeon can’t feel the lump, a breast radiologist (doctor who specialises in breast X-rays and scans) will use a mammogram machine or ultrasound scanner to guide the surgeon to where the lump is. Guidewire may be placed into your breast using a local anaesthetic or, if the lump is close to the skin, a pen will be used to mark the position of the lump.

An excision biopsy is usually performed under a general anaesthetic and takes about 30 minutes. Your surgeon will go through the breast gland and remove the lump. They will usually close the wound with dissolvable stitches. For more information, and if you have any queries about the operation, speak to your consultant. Continue your normal medication unless you are told otherwise.

The following lifestyle changes can help make the operation a success:

• Giving up smoking
• Eating healthily. If overweight, you have a greater chance of developing complications
• Exercising regularly. Your GP can recommend exercises

Possible complications

• Bleeding after surgery. It is common to get bruising of the breast or chest area
• Some pain is common with most operations
• Infection of the surgical wound – this usually settles with antibiotics, but further surgery may be required
• Unsightly scarring of the skin, particularly if the wound gets infected
• Continued lumpiness under the wound. It is normal for the wound to feel lumpy, but this should settle within four to six weeks
• Ongoing pain. The operation may not stop this pain
• Change of feeling in the nipple area, which is rare and should settle on its own

This is not a definitive list and symptoms will vary with each patient. Please ask your consultant for more information.

Recovery

You should be able to go home the same day after the operation. However, your doctor may recommend that you stay a little longer. Remember, you will not be able to drive home after your operation.

Wearing a soft bra that fits comfortably will help to support your breast and reduce any pain, and you should be able to have a bath or shower 24 hours after the operation. Avoid soaking the wound too much for the first five days.

You should be able to return to work after three to seven days and most women return to normal activities within ten days. Ask your GP for advice on gentle exercise.

You’ll be asked to attend a follow-up clinic within three weeks after your operation where results of the biopsy will be discussed and plans of any treatment or follow-up you may need.

Paying for your operation

Excision biopsy costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.

For further information or to book a consultation or treatment, please get in touch with our cancer enquiries team: Call us on 0800 157 7747

Content reviewed: October 2014