You Found a Breast Lump: What Happens Now?

You wake up feeling fine. You grab your morning coffee -- and maybe a doughnut -- and head for the shower. But not more than five minutes pass when suddenly you get a shock.

What's different? You find a lump in your breast. And even though studies show up to 80% of all breast lumps are harmless, you still feel threatened and want to know you'll be OK.

Fortunately, that's a lot easier now, thanks to advances in diagnostics -- a variety of options that pull together not only the specifics of your breast lump, but also look to your personal and family history, your age, even the results of a previous mammogram, to ensure you have the quickest and most accurate diagnosis possible.

"One of the real advances we are seeing in breast diagnostics is this trend toward individualized care. It's no longer a one-size-fits-all mentality. When it comes to diagnosing and treating breast abnormalities, it's a little bit different for every woman," says Cheryl Perkins, MD, scientific advisor for the Susan G. Komen Breast Cancer Foundation.

Advances in diagnostics include new uses for ultrasound, the advent of digital mammography, the increased use of magnetic resonance imaging (MRI), and the development of newer and more complete biopsy techniques. Experts say these methods are allowing doctors to get better at reducing patient anxiety and the need for unnecessary surgery -- while helping to find and eliminate more breast cancers than ever.

Call Your Doctor First

But what does this all mean on the morning you discover your lump? And what do you do first? Experts say the journey should always begin with a call to your primary care doctor.

"Some really exciting things are going on in the diagnosis of breast cancer," says Constance Lehman, MD, PhD. Lehman is principal investigator of the American College of Radiology Imaging Network (ACRIN) Breast MRI Trial, and director of breast imaging at the University of Washington Medical Center in Seattle.

"But still," says Lehman, "the most important thing to do when you find a lump, or see or feel any breast irregularity, is to call your personal physician and have it evaluated. And don't schedule a mammogram or try to see a surgeon on your own."

One reason is that for many women -- particularly young women -- the next step won't be a mammogram at all, but an ultrasound exam; it's a painless, radiation-free way of determining if the lump is a mass or a harmless, fluid-filled cyst.

"If it's a cyst, testing stops here; there is nothing to fear," says Lehman.

Moreover, if a mammogram does become necessary, and particularly if it's been a year or more since your last one, Lehman says an ordinary screening mammogram won't do.

"It takes only four pictures, two of each breast. A diagnostic mammogram uses the same equipment and technique but focuses intently on the area of concern, compressing tissue and magnifying the images so that we can get a much more detailed look," says Lehman.

With the advent of digital mammography -- which, much like your digital camera, uses electronic imaging rather than film -- pictures can be computer-manipulated, making them even cleaner, clearer, and some say easier to read.

"In the area of screening, but particularly in diagnosis of breast abnormalities, digital is one of the exciting and very promising new technologies," says Perkins.