Breast Surgery Archive Questions

Below are Dr. Robert Buras’s answers to Breast Surgery questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 5 of 5.

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Q : 1 11/04/2009	I have to have a breast biopsy. In the meantime, I have results of my ultrasound: a lobulated circumscribed tri-lobed hypoechoic mass measuring approx 1cm with some increased vascularity and acoustical shadowing. Does this suggest a benign or malignant mass? The ultrasound is just a picture. Only the pathology will be able to tell you if it is benign or malignant. I presume you will have an ultrasound-guided core needle biopsy. The results should be ready in 2-3 days. If there are any abnormal cells detected, then the lump should be removed with an operation.
Q : 2 11/02/2009	What is the safest and best way to remove a benign breast lump? Is smoking one cause of a breast lump? What else would cause it? If a breast lump is relatively small, it may be possible to entirely remove it with a core biopsy instrument under ultrasound guidance. If it is palpable, it will probably require an operation. It is not known why they develop. They are probably not related to smoking. The pathology report from the specimen will indicate whether it is benign or malignant.
Q : 3 06/21/2009	I was diagnosed with breast cancer via a biopsy and I am planning to have a lumpectomy. Would a plastic surgeon be available at the same time to perform a breast reduction? I have been considering having a reduction due to severe neck and shoulder pain. This is certainly an option which you can discuss with your surgeon. We arrange for this type of joint surgery (two surgeons) regularly, assuming there are no significant added risks in performing the additional surgery.
Q : 4 05/02/2009	My OB detected a cyst and referred me to a specialist. I had both a mammogram and ultrasound. The radiologist said it was a benign tumor, hard, 3.5 cm and recommended surgery instead of biopsy. Why is she not performing a biopsy so that the tissue can be analyzed and checked for cancer? What are the chances that after the surgery, they may discover that it is indeed breast cancer? There are some inconsistencies in your question. It sounds like your doctor detected a "mass" not a cyst. A cyst is filled with fluid, not generally "hard" and not usually referred to as a "tumor." A radiologist cannot tell you definitively if a solid (not cystic) mass is benign, they can only describe characteristics which might suggest that it is benign or malignant. A needle biopsy can prove that a mass is malignant, but cannot prove that a mass is benign. Thus, a needle biopsy (fine-needle or core) is used more often when a mass is highly suspicious for cancer. If the mass appears to be benign and you have no significant risk factors for breast cancer, then proceeding directly to a surgical excision of the mass makes the most sense.
Q : 5 02/18/2009	My daughter is scheduled for ultrasound-guided breast biopsy at a community hospital. Because of the size of the mass, we have been advised that she should have it removed even if it is benign. She has no health insurance. Wouldn't it be more cost effective to skip the biopsy and just have surgery? Is there any assistance through your hospital for such cases? I would need to review the imaging findings with our radiologists here before we could determine what the best approach for diagnosis is. Patients here at the University of Maryland either go on medical assistance or through the Baltimore City Cancer Program depending on where they live, which I believe would cover the costs for a biopsy. Surgery, of course, has its risks, so I generally recommend surgery for indeterminate lesions after biopsy, or if there is discordance between imaging and biopsy results. Please feel free to contact our breast program coordinator, Yolanda Sumter, at 410-328-7855 if you have additional questions.

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