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.
Once You're Sure It's Cancer
Once your cancer diagnosis is confirmed, experts say the next step is
frequently a breast MRI -- one of the very latest diagnostic advances for
breast cancer. The goal here is to help determine the extent of the disease --
an important factor when planning treatment.
Lehman says that for up to 15% of women the findings on a presurgical MRI
result in a change of treatment plan. Additionally, she says in about 5% of
women who have an MRI doctors discover cancer in the opposite breast, even
though they had a negative mammogram and a negative clinical exam.
"Both these findings show that the MRI can be effective in not only choosing
a better treatment for the cancers we do find, but also in helping to find and
treat cancers we would otherwise miss entirely," says Starr.
So if MRI is that good, shouldn't every woman have one -- maybe even instead
of a mammogram? Experts say that unless you are at very high risk for
developing breast cancer, the answer is "no."
"What the MRI achieves in sensitivity, it loses in specificity, so we can't
always readily identify what we are seeing," says Sumkin. Moreover, he says
that although an MRI is sensitive, there are things it can't visualize, such as
breast abnormalities that a mammogram -- or sometimes an ultrasound -- can
In short, if used as a screening tool, experts say the level of unnecessary
biopsies -- not to mention patient anxiety -- would soar.
The best approach, say doctors, is to use all the diagnostic options
appropriately, and at the right time for the right woman.
Says Lehman: "There is no one perfect screening tool. In fact, what's really
new is the recognition that there are a collection of tools that need to be
used appropriately in conjunction with each other if a woman is to achieve the
best diagnosis of palpable abnormalities, the best diagnosis of extensive
disease, and ultimately, the best evaluation of response to therapy. And they
all work together."