a step-by-step guide of what to do when you find a lump or change
1. I’VE FOUND A BREAST LUMP. NOW WHAT?
First of all, do not panic. Most lumps are not cancerous. They are actually very common, especially in premenopausal women. They usually go away by the end of the menstrual cycle, but do not ignore any change in your breast, either. The best advice is to see your doctor.
2. WHAT WILL MY DOCTOR DO?
Your doctor should begin by asking about your personal and family medical history. He or she will ask you about what you are feeling or seeing. Show exactly where you noticed the lump or other change in your breast. A doctor can tell a lot about a lump from its size, texture and the way it moves within the breast. Benign (not cancerous) lumps often feel different than cancerous lumps.
3. WHAT ABOUT A DIAGNOSTIC MAMMOGRAM OR ULTRASOUND?
A mammogram is an X-ray of the breast. A diagnostic mammogram is used to examine lumps or changes in the breast, and includes more views of the breast than a screening mammogram. Ultrasound is another way of looking inside the breast by using sound waves instead of X-rays. It can help tell the difference between normal and abnormal breast lumps. Ultrasound, which can show the dif ference between a liquid-f illed cyst and a solid mass, is often used in addition to a mammogram.
4. CAN FLUID BE REMOVED?
Sometimes an abnormal lump is a liquid- f illed sac called a cyst. Doctors can collapse these cysts by inser ting a ver y thin needle and drawing out the f luid. This is called a cyst aspiration and can be done in a doctor’s office. It is generally not painful because the breast is numb. Cysts rarely contain cancer cells. If the cyst does not collapse all the way, or if the fluid in the cyst contains blood, the doctor may examine the cells and f luid from the cyst with a microscope. Based on what is found, your doctor may order a follow-up mammogram, ultrasound or biopsy.
5. WHAT ABOUT MRI?
Magnetic resonance imaging (MRI) uses a large magnet and radio waves to create an image of the breast. In dense breasts, use of MRI can sometimes detect cancers that are not seen on mammograms. MRI is often used with mammography for screening women at a high risk of breast cancer. These tests give one of three results:
• The breast change is nothing to worry about; return to regular clinical breast exams, and yearly mammograms if you are older than 40;
• The abnormal tissue is probably not cancer, but return for a re-check in four to six months, or see a surgeon for a second opinion; or
• A biopsy is needed to tell whether the breast change is cancer.
6. WILL I NEED A BIOPSY?
If the breast lump turns out to be a solid lump, a procedure called a biopsy might be needed to remove a small portion of tissue. The tissue is examined under a microscope to see if the lump is cancerous. A needle biopsy will usually tell your doctor whether you have cancer. However, there is a small chance that the biopsy needle could miss the suspicious area or that more tissue is needed. If any doubt remains, a surgical biopsy may be needed to determine if cancer cells are present. If the lump is found to be a benign tumor or cyst, then it is not cancer.
7. WHAT HAPPENS NEXT?
If it is not cancer, you may have a benign breast condition. While benign breast conditions are not cancer, some may increase the risk of breast cancer. Your doctor may recommend additional follow-up and advise you to have a mammogram every year or perhaps more often (if you are 40 or older), and have regular clinical breast exams. If you do have breast cancer, your doctor will talk with you about your treatment choices.