You Found a Lump in Your Breast. Now What?

Oct 5, 2018


One of the most important things you can do to protect yourself from breast cancer is a monthly breast self-exam. In fact, self-exams can be a life-saver. More than anyone, you are your own best advocate against the disease because you know how your breasts normally look and feel.

“Remember, breast cancer does not usually cause pain,” says Kory Jones, M.D., a breast cancer surgeon with USMD Breast Health Center. “Most often when women find a lump or thickening of the breast that is painless, it’s actually breast cancer. That’s why it’s important to pay attention to any noticeable changes in your breasts.”

Suspicious changes can include:

  • A lump or thickening of the breast
  • A lump under the arm
  • Swelling
  • Skin irritation
  • Dimpling
  • Crusting, scaling or itching of the nipple or areola
  • Redness or pitting of the skin over the breast (like the skin of an orange)
  • Discharge (other than breast milk) or bleeding from the nipple

What should you do if you find a lump?
“If you do detect a lump or any other signs of change during your monthly self-exam, see your healthcare provider as soon as possible,” Dr. Jones urges. “Don’t blow it off. Don’t think a lump is going to go away. Go see your doctor for a clinical breast exam. I promise you, your doctor will be glad you’re having it checked out.”

During a clinical breast exam, your physician will determine if the lump or change should be evaluated in more detail with additional testing, or if it is the result of a non-cancerous condition such as:

Fibrocystic Changes
Lumpiness, thickening or swelling of the breast that is associated with women’s menstrual cycle—particularly for women in their 20s, 30s and 40s.

Cysts
Benign fluid-filled lumps that can range from very tiny to the size of an egg.

Fibroadenomas
Solid, round, rubbery lumps that move under the skin when touched.

Infections
Breasts may become red, warm, tender and lumpy if an infection is present.

Trauma
A blow or bruise to the breast can cause a lump.

Microcalcifications
Tiny deposits of calcium are present in most women’s breasts—especially post-menopausal women. While they can’t be felt, they can bee seen on mammograms. Most of these deposits are harmless, but a small percentage can be precancerous or cancerous.

Your doctor may want a closer look.
If your physician rules out the conditions above, or is unsure about them, additional tests may be recommended to more clearly evaluate the suspicious area, including:

Breast Ultrasound
“This is a painless way to gather more information about your breasts without radiation,” Dr. Jones says. During an ultra-sound exam, a hand-held scanner pressed against the skin emits sound waves that are converted into images. These images are viewed by a radiologist on a computer screen. Because ultrasound is very sensitive, it’s able to detect small cancers very early.

3-D Ultrasound
If you have dense breasts or breast implants, 3-D ultrasound is a good option. “Images are captured from at least three different positions on each breast so we get a view all the way back to the chest wall,” Dr. Jones explains.

3-D Mammography
“Much like a CT scan for the breasts, a 3-D mammogram is also a great way to look at dense breasts because it essentially plots your breast for the radiologist so we can really see if there is an abnormality,” Dr. Jones adds.

A biopsy may be necessary.
If the breast abnormality is still deemed suspicious, a biopsy will be performed. There are two types of biopsies:

Surgical Biopsy
Sometimes a lump or suspicious area has to be removed surgically and examined under a microscope to determine if cancer is present. This can usually be done on an outpatient basis with either local or general anesthesia.

Stereotactic Biopsy
This minimally invasive alternative to a surgical biopsy uses a computer-guided imaging system to precisely locate the suspicious breast tissue and remove a small sample with a needle. With very little discomfort or recovery time, this outpatient procedure allows you to return to normal activities immediately afterward, with only a small adhesive strip to cover the small prick where the needle was inserted.

A diagnostic pathologist will review the tissue collected from your biopsy to determine if it contains breast cancer cells.

Remember, even if your biopsy reveals the presence of breast cancer, early detection and state-of-the-art treatment are helping countless women defeat breast cancer every day. Early detection saves lives—that’s why conducting monthly breast self-exams and following up with your doctor right away are so important!

If you have questions or concerns about breast cancer or your breast health, the caring team at USMD Breast Health Center is here to help. Call us at 1.888.444.USMD.