Excisional Biopsy and What to Expect?

sayheysam

I recently found out that a lump in my right breast is ADH. I saw a breast surgeon and we talked about the results, and we decided that a periareolar excisional biopsy is the best way to go to remove this lump and to make sure there's nothing malignant lurking around (which makes me nervous since I'm only 21). I just wanted to know what to expect, if you receive the results of the excisional biopsy right away after surgery, and if my breast will look smaller or deformed? My surgeon said an excisional biopsy won't cause deformation or breast distortion, but I'm quite insecure since I'm small chested, which I know is silly to be worried about since removing anything bad should be my priority.

Georgia1

Hi there and sorry to hear about your situation. And worrying about cosmetic issues is not silly at all. My goodness, if men went through anything like this plastic surgery would be even better as well as free! But the biopsy should not cause any issues; the amount removed should be very small. But do you know the size of the area they will remove? I had to have my husband calculate volume for me since I'm terrible at math, but even with large surgical margins the result of my .7 cm lump being removed was not noticeable.

Best of luck to you.

sayheysam

Thanks for replying ! I'm not sure about the size of the area that's going to be removed, I believe my lump is somewhere between 1-2cm and that's all my doctor is planning to remove (from what I gathered during our consultation). However, you make a good point and I should definitely ask her for specifics when I see her during my pre-op visit. I'm glad to hear that with your lump removal there was no noticeable difference!! I hope I experience the same result.

Anonymous

I have a pretty large scar under my right arm, just to the right of my right breast where the problem was: my 2 c. problem. I told my surgeon to get it all, and he went big, either because he knew I didn't care, or because he simply had to to do his job successfully. The pathology report came back "close, but clear, margins", which was good. I wasn't worried about a scar then and just wanted him to get it all.

I too was small-breasted and I don't think about my scar now; no deformity that I can see. And I figure a bit of deformity is better than having a surgeon leave something in there to cause problems later in life.

Voice your concerns to your surgeon, that's what I would do. They may very well be able to reassure you.

Claire in AZ

Silbar

Sayheysam~~ I would guess that when the scar around the areola heals it is less noticeable than if it was on the actual breast itself. Depending on where the lesion is will determine where the BS cuts. Good luck and keep us posted.

downdog

Sorry that you are having to deal with this at 21. You should ask you surgeon to clarify for you how large the lump is estimated to be (only pathology can determine the actual size), as well as how large a margin she is planning on taking. Most surgeons will want to take a margin with ADH. You need to be clear, so your expectations of the outcome from a cosmetic point of view don't leave you surprised. If you mean A or AA cup by small chested, then depending on the location and the size, plus margin, you could have a dent. For example, a 2 cm mass plus a 1cm wide margin would mean removal of 4cm of tissue, sort of like a small egg. The gap will fill with fluid after surgery, which will be ultimately absorbed by your body. If the mass and margins are smaller, the missing area may not be noticeable, even in a small breast. If it's 2cm with a 1cm margin, I had 2 of these removed for benign growthsand they left a noticeable dent on an A cup breast. I had peri-areolar incisions and the scars were undetectable once they healed. In the event that you do have a dent (called a partial defect, which is an inappropriate term, since they are a full defect to any woman who has one), a plastic surgeon can fat transfer or rearrange your breast tissue to help remedy this. This is reconstruction after a lumpectomy, and will be covered by insurance, in the event you feel you want this and decide to pursue it. Even with 2 peri-areolar incisions on the same breast in different spots, I had no loss of nipple sensation. You should have your pathology results in anywhere from a couple of days to about 10 days, depending on the center where you are having your surgery. Best wishes.

sayheysam

Thankyou all for responding, your replies have been very helpful for me!

Downdog, yeah I am in the A cup category with the lump near my right nipple (above it, it feels like, 12:00 position). I'm definitely going to be asking my surgeon how much she plans to remove and the size of the lump, and whether or not I should expect a dent afterwards. She did tell me during out meeting that this excisional biopsy shouldn't deform my breast in anyway, but I'm not sure if a dent counts as deformation or not (I'm very new to all this). I hate that I didn't think to ask this during my consultation, I tend to just blank out when it comes to medical things and want to get out asap!