Axillary lumpectomy: clarifying surgery for an armpit lump

An underarm lump may be a lymph node, a skin cyst, fatty tissue, accessory breast tissue or another lesion. Some breast cancers and lymphomas present with enlarged axillary nodes, but an armpit lump alone does not establish either diagnosis.

The surgeon may plan to remove one discrete mass for diagnosis, excise a lymph node, sample selected nodes or perform a wider axillary node operation. These procedures differ in incision, tissue removed and risks, so the consent form should use the precise procedure name.

Removed tissue is examined by a pathologist. The report identifies the tissue type and any abnormal cells, and may include tests that guide further care. Imaging or a needle biopsy is often used before surgery when it can answer the clinical question with less tissue disruption.

Before consenting, ask the surgeon to mark the target and explain whether the goal is diagnosis, symptom relief or cancer treatment. Mention medicines that affect bleeding, allergies, previous breast or underarm surgery, arm swelling and any limitation in shoulder movement.

Afterward, follow wound and drain instructions, take pain medicine as prescribed and perform only the arm exercises recommended by the team. Observe the hand and arm for swelling or tightness. Keep the pathology appointment even if the wound feels well, because the result determines whether more care is needed.

Contact the surgical team urgently for fever, spreading redness, increasing warmth, pus, worsening pain, a rapidly enlarging swelling, persistent bleeding, a drain that suddenly stops while swelling increases, or new marked swelling of the arm or hand.

Seek emergency help for breathing difficulty, facial or throat swelling, fainting, severe chest pain, or heavy bleeding that does not stop with firm pressure. Before surgery, a hard, enlarging or persistent underarm lump also warrants clinical assessment rather than attempted squeezing or home removal.

Ask what structure the lump appears to arise from, whether imaging or needle biopsy should come first, exactly how much tissue will be removed, how the procedure could affect sensation and lymph drainage, when pathology will be discussed, and who to contact about wound or arm symptoms.