You Found a Breast Lump: What Happens Now?
It’s every woman’s worst fear: finding a lump in your breast. Before you panic, get advice from experts on the next steps to take.
Call Your Doctor First continued...
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,
"If it's a cyst, testing stops here; there is nothing to fear," says
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
"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.
Is It Cancer? How to Know for Sure
Once it's established that your lump is not a cyst, the next step is to rule
out other noncancerous lesions, such as fibroadenoma (benign tumor) or
intraductal papilloma (small, wart-like growth in a milk duct).
This is frequently accomplished by testing the suspicious area for the
presence of cancer cells.
For many years, this routinely meant surgery -- which, when cancer wasn't
found, became a harshly unnecessary procedure.
Today, however, the advent of minimally invasive biopsy is changing the way
breast cancer is
diagnosed. It began with the development of ultrasound guided core needle
biopsy -- an in-office procedure that can diagnose cancer.
"Using the real-time ultrasound image as a guide we insert a slender needle
into the breast and suck out a small sampling of cells which we test for
cancer," says Jules Sumkin, DO, professor of radiology and chief of radiology
at Magee Women's Hospital in Pittsburgh.
In the event that the lesions can't be seen on ultrasound -- which Sumkin
says occurs about a third of the time -- a similar procedure known as a
"stereotactic needle biopsy" uses a mammogram to guide the procedure.
"In this instance we insert the needle and then scan the breast with the
mammography equipment to ensure accuracy," says Sumkin.