So… you’ve discovered a breast lump. Now what? Step one: breathe! Remember, breast lump does not equal breast cancer! Step two: empower yourself with knowledge and action. Here are answers to questions you might have if you find a lump.
1. I found a lump. What do I do? First step - don’t panic! Remember that breast lumps are quite common - especially in premenopausal women. Most breast lumps are not cancer - but there are steps to take when you do find a lump.
2. What could it be? It could be many things - not all cancer is lumpy and not all lumps are cancer. Cysts are a common cause of lumps especially in premenopausal women. There are some benign, non-cancerous conditions that may present as a lump including fibroadenomas (a benign tumor common in premenopausal women) and lymph nodes. Some women also have fibrocystic breast tissue, leaving an impression of lumpiness that may be normal for them. Sometimes this lumpiness will change during the menstrual cycle - if it persists, it should be further evaluated.
3. What does cancer feel like? Many cancers will not be felt on physical exam of the breast. If a breast cancer can be felt on physical exam of the breast, it may be a hard lump that feels fixed in position. Sometimes the lump has a gritty texture.
4. What should I do next? Call your doctor and make an appointment. A new breast symptom (anything from pain to a physical change to breast discharge or leakage) should start will an evaluation by your doctor.
5. What will my doctor do? Your primary care doctor will start by reviewing your personal and family history. Your healthcare provider will do a careful examination of your breasts, targeting evaluation to the area of concern. If there is a discrete lump, your doctor will evaluate things like size, texture (rubbery or hard, etc) and how the lump moves in the breast tissue. Based on the results of these evaluations, you may be sent for further evaluation with imaging. If imaging is not done as the physical exam is normal, re-evaluate the area in a month. Still bothering you? Ask for imaging evaluation.
6. What will my radiologist do? Imaging evaluation for a breast lump will depend on your age. If under 30, the evaluation may begin (and may end) with breast ultrasound. If you are over 30, the evaluation will likely start with a diagnostic mammogram. The lump may be marked on your skin with a marker that can be seen on the mammogram. Extra mammmographic views may be done as needed. An ultrasound may also be done, as it is excellent in distinguishing between fluid-filled cysts and solid masses. Comparing your current study to other imaging tests of your breast is important in assessing for change. After the evaluation is complete, the radiologist will provide you and your doctor with a report. This will categorize your findings into normal; benign (like a cyst or other benign finding); probably benign meaning we think it is most likely a nothing, but requires short term (often 6 month) follow-up studies to be sure; or there is a finding that will need biopsy. Even if you are sent for a biopsy, it is still likely that the results will not be cancer - so hang in there!
Hopefully, this information will help ease some of your anxiety should you come across a lump in your breast. Remember, the most important thing is to empower yourself and take action!
Image credit: don’t-panic-iPad by Kevin Sonney (via Flickr) Copyright Creative Commons Attribution-NonCommercial-NoDerivs 2.0 Generic (CC BY-NC-ND 2.0)
Originally published 1/9/14 on mammographykc.com.