Breast Lump Surgery in Ankara, Turkey

Breast lump surgery is a surgical procedure performed to remove benign or malignant masses detected in the breast tissue. Early interventions contribute to reducing cancer risk and protecting breast health.

Breast lump removal surgery is usually performed under local or general anesthesia. The surgical technique is determined according to the size, location, and structure of the mass. In this way, both a diagnostic examination can be performed and the progression of diseased tissue can be prevented.

Aesthetic preservation is an important element in breast surgery. Care is taken to preserve the shape of the breast while removing the mass. Especially in young women, minimally invasive methods are preferred to ensure rapid psychological and physical recovery after the operation.

The post-operative follow-up process is shaped according to the pathology results. If a malignant mass is detected, additional treatments come into consideration, while in benign masses, regular check-ups are usually sufficient. In this process, patient education and lifestyle recommendations are also important.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Breast Lump Surgery in Ankara, to get information about Breast Lump Surgery prices, the process, and the hospital where Breast Lump Surgery is performed.

What Is a Breast Lump?

A breast lump is defined as a hardness, nodule, or swelling felt in the breast tissue. These lumps can be benign or malignant. While they can occur due to reasons such as fibrocystic changes, cysts, and fibroadenomas, sometimes they can also be the first sign of breast cancer. Every new or changing lump should be evaluated by a specialist doctor.

What Are the Symptoms of a Breast Lump?

A breast lump is most often noticed as a nodule that can be felt by hand. However, some symptoms may indicate the presence of a lump and its potential risk. When the following symptoms are observed, medical evaluation is important:

• A round or irregularly shaped lump felt in the breast
• Tenderness, pain, or tightness in the area of the lump
• Skin dimpling, color change, or thickening
• A change in the shape of the nipple or discharge
• Swelling or hardness in the armpit along with the lump
• A general feeling of fullness or heaviness in the breast

Is There a Difference Between a Lump in the Right and Left Breast?

Lumps that occur in the right and left breast are not medically different; evaluation is based on the structure, size, margins, and other accompanying symptoms rather than which side of the breast the lump is on. However, some studies have reported that lump formation is observed more frequently in the left breast. A lump felt in either breast should be evaluated with the same seriousness and absolutely requires specialist examination.

What Causes a Breast Lump?

Breast lump formation can be due to many causes, ranging from hormonal changes to benign tumors and, rarely, malignant formations. The most common causes include:

• Hormonal fluctuations: during the menstrual cycle, puberty, pregnancy, or menopause
• Fibrocystic changes: benign changes in breast tissue accompanied by hardness and pain
• Cysts: fluid-filled, usually harmless formations
• Fibroadenoma: mobile, benign lumps commonly seen in young women
• Mastitis or abscesses: infection-related inflammations, usually developing during breastfeeding
• Breast cancer: irregular, hard, usually painless lumps that grow over time

Every lump should be evaluated by a doctor.

What Is Breast Lump Surgery?

When a lump is detected in a breast, the surgical options are quite diverse, and these options are shaped entirely according to the nature and size of the lump and your personal situation. Our aim is always to provide the most effective oncologic treatment while preserving your body integrity and aesthetic appearance at the highest level. There are fundamental surgical methods that are performed, and each serves a different purpose.

The main types of these surgeries are:

• Lumpectomy (Breast-Conserving Surgery)
• Mastectomy (Removal of the Entire Breast)
• Oncoplastic Surgery
• Excisional Biopsy

Lumpectomy aims to remove not the entire breast but only the cancerous mass and a small amount of healthy tissue surrounding it. The greatest advantage of this method is that it preserves the natural form of the breast as much as possible. It is frequently preferred in early-stage breast cancers and is almost always completed with radiotherapy (radiation therapy) afterward. The most important point to remember is that with the right patient selection, lumpectomy and mastectomy yield exactly the same results in terms of survival success. In other words, preserving the breast does not mean compromising treatment.

Mastectomy is the removal of the entire breast tissue. This method becomes a necessity in cases where the tumor is very large relative to the breast, there are multiple tumor foci in different regions of the breast, or the patient cannot receive radiotherapy. Mastectomy also has advanced different types within itself, especially in line with aesthetic concerns and breast reconstruction plans. For example, thanks to skin-sparing or nipple-sparing mastectomy techniques, it is possible to achieve much more natural and satisfactory reconstruction results in the same operation.

Oncoplastic Surgery is a highly advanced approach that combines the principles of cancer surgery and plastic surgery. The philosophy here is to remove the cancerous tissue safely while achieving the best possible aesthetic appearance of the breast. It is a great solution, especially to prevent the collapse or deformity that may occur in the breast after lumpectomy. Sometimes the technique of a breast reduction or lift surgery is used to remove the tumor. Thus, both the cancer is treated and the breasts gain a more symmetrical and aesthetic appearance. This approach now allows breast-conserving surgery even in larger tumors that previously would have required mastectomy.

Excisional Biopsy is the complete removal of the lump for diagnostic purposes. Today, since our diagnostic rate is very high thanks to core needle biopsies, we use this method less frequently. It is generally used in rare cases where the needle biopsy result is suspicious or where imaging findings such as mammography do not match the biopsy result, to confirm the diagnosis.

In Which Cases Is Breast Lump Surgery Performed?

A decision for breast lump surgery is never made based on a single finding. This decision emerges at the end of the process we call the “triple assessment,” based on a detailed examination by the physician, imaging methods such as mammography and ultrasound, and most importantly, the pathological examination of the sample taken from the lump by needle biopsy. Whether surgery is necessary depends on the character of the lump.

Situations Requiring Surgery for Benign Lumps

Most benign lumps are harmless and only need to be monitored. However, in some cases, surgically removing them is the most appropriate course. These situations are:

• Causing complaints such as pain or tenderness
• Gradually increasing in size
• Creating a visible distortion in the shape of the breast
• Needle biopsy results being suspicious or insufficient
• Imaging findings and biopsy results not matching
• Being a special type such as a “phyllodes tumor”
• Causing intense anxiety and stress in the person

Situations Requiring Surgery for Malignant Lumps (Cancer)

When breast cancer is diagnosed, it forms the basis of surgical treatment. The choice of surgery is personalized entirely according to the stage of the disease, the biological characteristics of the tumor, and the patient’s expectations. There are main situations where surgery is necessary and factors affecting the choice:

• Preserving the breast in early-stage tumors (Lumpectomy)
• Multiple tumors in different regions of the breast (Mastectomy)
• The tumor being very large relative to the breast size (Mastectomy)
• A diagnosis of inflammatory breast cancer
• Having previously received radiotherapy to the same breast
• The patient’s personal preference for mastectomy

Situations Requiring Surgery for High-Risk Lesions

Sometimes, the needle biopsy result is not “cancer,” but it comes as a “high-risk” lesion that carries the potential to transform into cancer or to harbor an occult cancer alongside it. The presence of these lesions usually requires the complete removal of that area. Some diagnoses that lead to this situation are:

• Atypical Ductal Hyperplasia (ADH)
• Lobular Carcinoma in situ (LCIS)
• Radial Scar
• Atypical Papillary Lesion

What Are the Risks of Breast Lump Surgery?

As with any surgical intervention, breast surgeries also have potential risks. A large portion of these risks are rare and have been minimized thanks to today’s modern surgical techniques and anesthesia methods. Still, it is important to be aware of every possibility.

The general risks that can be seen in any surgery are:

• Reactions related to anesthesia
• Blood collection in the surgical area (Hematoma)
• Wound infection
• Unwanted scarring (Scar tissue)
• Blood clot formation (Deep vein thrombosis)

Situations that may be encountered after breast-specific surgery are somewhat different.

• Fluid accumulation in the surgical cavity (Seroma)
• Change in breast shape or size
• Asymmetry
• Loss of sensation in the breast skin or nipple
• Tumor extending to the incision margin (Positive surgical margin)
• Swelling of the arm (Lymphedema)

Among these risks, the most important issue that should be emphasized is lymphedema. Lymphedema is the chronic condition in which lymph fluid accumulates in the arm and causes swelling after an intervention on the axillary lymph nodes. The magnitude of the risk is directly related to the extent of the procedure performed in the armpit. While the risk of lymphedema is below 7% after Sentinel Lymph Node Biopsy (SLNB), in which only a few “sentinel” lymph nodes are removed, this risk can rise to around 30% after Axillary Lymph Node Dissection (ALND), in which most of the lymph nodes in the armpit are removed. For this reason, one of the most fundamental goals in modern breast surgery is to avoid performing ALND unnecessarily in order to protect the patient from the risk of lymphedema.

How Is Breast Lump Surgery Performed?

Breast lump surgery is like a journey, and every step is planned with great care. This process includes pre-operative preparation, the operation itself, and the post-operative recovery period.

Pre-Operative Preparation: This stage is vital for the success of the operation. First, the diagnosis of the lump is confirmed with a needle biopsy. If the lump cannot be felt on examination and is only seen on mammography, a marking must be done so that the surgeon can find this tiny target during surgery. In the past, this was done with a wire placed into the breast on the morning of surgery. However, this method was both uncomfortable for the patient and difficult to plan.

Now we use much more modern and comfortable wireless localization methods. In this method, days before surgery, a radiology specialist places a tiny “chip,” about the size of a grain of rice, inside the lump. This is like a GPS device for the surgeon. During the operation, the location of this chip is found with millimetric precision using a special hand-held detector, and only the targeted tissue is removed. These modern methods increase patient comfort, make planning easier, and allow the surgeon to make the incision in the most aesthetically appropriate place.

The main wireless markers used.

• Radioactive seed
• Magnetic seed
• Radar reflector

The Operation: The surgery is performed under general anesthesia, meaning while you are completely asleep. If a lumpectomy is to be performed, the surgeon makes an incision in the most aesthetically appropriate place, and removes the marked or palpable lump along with a small amount of healthy tissue around it. An X-ray of the removed specimen is taken immediately to confirm that the target has been removed. Tiny metal clips are placed in the surgical cavity so that, if radiotherapy is planned later, the radiation can be focused on the correct area. If a mastectomy is performed, the entire breast tissue is removed while preserving the chest muscles underneath.

One of the most critical stages of the operation is evaluating the status of the axillary lymph nodes. To determine whether cancer cells have spread throughout the body, a sample must be taken from these nodes. If there is no suspicious finding in the armpit in the pre-operative tests, the standard method is Sentinel Lymph Node Biopsy. During surgery, a radioactive substance and blue dye given to the breast mark the “sentinel” lymph node that the tumor drains to first. The surgeon finds and removes only these 1–3 sentinel nodes. If these nodes are clean, there is no need to touch the others. This is a revolutionary technique that protects the patient from an unnecessarily extensive surgery and the risk of lymphedema. If it is already known that there is cancer in the axillary lymph nodes, then most of the nodes are cleared with Axillary Lymph Node Dissection.

Post-Operative Process After Breast Lump Surgery

The period after the surgery is an adaptation process in which the body recovers, healing begins, and you gradually return to normal life. This process may vary from person to person depending on the extent of the surgery.

If you have undergone a smaller procedure such as lumpectomy, you can usually go home the same day. In larger surgeries such as mastectomy or reconstruction, you may need to stay in the hospital for 1–2 days. Post-operative pain is controlled very well with modern pain management methods. The aim is for you to be as comfortable as possible and to start moving early.

After mastectomy or surgeries in which the axillary lymph nodes are cleared, thin tubes called “drains” are placed to remove fluid that accumulates in the surgical area. You go home with these drains, and you are given detailed instructions on how to care for them. When the daily amount of fluid decreases, the drains are usually removed easily during an outpatient visit, generally within 1–2 weeks.

Wound care is quite simple. You are usually allowed to shower 1–2 days after surgery. The special tapes on your wound will fall off on their own after a while. One of the most important issues in this process is shoulder and arm movement. To prevent stiffness and limitation of movement in the shoulder joint (“frozen shoulder”), you are shown specific exercises. Starting these exercises shortly after surgery helps your arm functions return to normal as soon as possible. However, you should avoid heavy lifting and strenuous movements with the operated arm for about a month.

All tissues removed during surgery are sent to the pathology laboratory for detailed examination. This final report, which includes all the characteristics of the tumor, whether the surgical margins are clear, and the status of the lymph nodes, is usually ready within 7–10 days. This report is the most important document that will determine your treatment roadmap from this point forward. Depending on the result, a multidisciplinary team will decide whether additional chemotherapy, radiotherapy, hormone therapy, or targeted smart drugs are required.

What Those Who Have Undergone Breast Lump Surgery Should Pay Attention to

In the post-operative period, there are some important points you should pay attention to in order to support your recovery process both physically and emotionally and to protect your health in the long term. This is a team effort, and it is very valuable that you take an active role in this process.

When Should You Call Your Doctor?

While some symptoms are considered normal during recovery, others may indicate a problem. In the following situations, it is important to contact your doctor without delay.

• Fever exceeding 38°C
• Increasing and spreading redness at the surgical wound
• Marked increase in warmth or severe pain at the wound site
• Purulent or foul-smelling discharge from the wound
• A sudden, large, and painful swelling in the surgical area
• Shortness of breath or chest pain

The Most Important Long-Term Issue: Protection From Lymphedema

If you have had a surgical intervention in your armpit, you need to protect that arm against the risk of lymphedema for the rest of your life. This includes simple but highly effective precautions that should be adopted as a lifestyle:

• Not having blood pressure measured
• Not having blood drawn
• Not getting vaccines or injections
• Not having IV fluids administered
• Protecting the skin from all kinds of cuts, scratches, and burns
• Not cutting the cuticles during a manicure
• Taking precautions against insect bites
• Not wearing tight clothing or jewelry that constricts the arm
• Avoiding excessively hot environments (sauna, thermal baths)
• Maintaining an ideal body weight

Remember, breast cancer treatment is a journey, and surgery is an important stop on this journey. In this process, you should be kind to yourself and give your body and mind time to heal. Keeping up with your regular check-ups and adopting healthy lifestyle habits will be your best protection in the long term.