|
I just found a lump in my breast. What should
I do?
I have a lump, but my mammogram is normal,
so it's not cancer, right?
I had a routine mammogram and it showed
"calcifications", or a "nodule". I have been
referred to a surgeon. Does this mean I have
cancer?
My doctor says I just have a cyst in my
breast. What causes cysts? Should I have it
removed? Should it be drained with a needle?
Will it come back?
I
had a cyst drained, and the fluid looked green.
Should the fluid be tested for cancer?
My teenage daughter found a lump in her
breast. What should we do?
Return to Breast Problems Home Page
I just found a lump in my
breast. What should I do?
Any lump in your
breast should be checked by a qualified
physician to determine what it is. If you are
not sure whether it's really a "lump", or not,
you may wish to wait through a menstrual period
to see if the new finding is still present. But
if it is a definite lump, you should not
delay.
It is not uncommon for me to
see a woman in the office who is not sure
whether they are feeling a "lump" or not.
Sometimes what they describe as a "lump" feels
to me like just some thickening of the breast
tissue. Distinguishing between a "lump" and
thickened breast tissue is not always easy. We
rely a lot on any corresponding findings on
mammogram or, particularly, on ultrasound, to
guide us. If there is a definite finding on
mammogram and/or ultrasound, a biopsy is almost
always recommended. If the area feels more like
a "thickening" to me, and the mammogram and
ultrasound don't show anything, and these
situations, a biopsy may not be necessary.
A new lump may simply be a
benign cyst, or it may be the first sign of a
breast cancer. So it is important to be
examined promptly, to see which you might have.
There is no need to remain anxious about whether
your lump is cancer or not. In most cases, at
DeKalb Surgical, if the biopsy is necessary you
can usually be done at your very first visit,
with a result in just 1-2 business days.
As noted above, ultrasound is
frequently used to evaluate a breast lump, and
this is often more helpful than the mammogram,
though the mammogram of course is important. At
DeKalb Surgical, a biopsy is often done at the
time of your very first visit for any
well-defined breast lump. We utilized the
findings on ultrasound to decide if a biopsy is
necessary, and then to guide the biopsy. Here
are some examples of what different types of
breast lumps may look like on ultrasound.
Here is a typical cyst (also
showing a needle tip in it):
Here is a typical
fibroadenoma, which is a very common finding in
teenage girls and young women:
Here is an example of what a
cancer might look like on ultrasound:
If a biopsy is done, it is
important to be sure that the biopsy is taken
from the right place. The ultrasound
visualization makes it very clear that the
needle is placed within the lump as you can
easily see here:
Return to top of page
I have a lump, but my
mammogram is normal, so it's not cancer, right?
You must understand that not all cancer
shows up on mammography. Any lump needs to
be examined by a qualified physician, whether it
shows up on mammography or not. If the lump is
not seen on mammography, it may be still need to
be biopsied. An ultrasound may be helpful. But
the most important thing to remember is that if
you have a lump, it should be evaluated
promptly, regardless of what the mammogram might
show.
I had a routine mammogram
and it showed "calcifications", or a "nodule".
I have been referred to a surgeon. Does this
mean I have cancer?
Screening mammograms
have become an important method to screen for
breast cancer. We have learned that mammograms
can often detect the earliest signs of breast
cancer, at a point in time when it can not yet
be felt. Early breast cancer often shows up as
a small cluster of calcifications, which look
like a small grouping of tiny white flecks on
the mammogram, or as a small nodular area which
is more white than the surrounding breast
tissue. But, these same abnormalities
can be caused by breast changes that are not
breast cancer as well. Only about one in six of
these abnormalities end up being cancer when
they are biopsied. But the only way to be sure
is to sample the tissue with some sort of
biopsy. This means that most of those who have
a biopsy will find out that there is no evidence
of cancer.
Return to top of page
BREAST
CYSTS
My doctor says I
just have a cyst in my breast. What causes
cysts? Should I have it removed? Should it be
drained with a needle? Will it come back?
Breast cysts are very
common. They are frequently quite large, and
often a bit tender. They may seem to have
popped up overnight, as a very large lump, the
size of a grape or larger. Although we don't
know why they occur specifically, it seems they
develop as a response to the normal hormone
variations that occur through the monthly
menstrual cycle. Sometimes they will go away on
their own as quickly as they come, but often
they remain for some time.
Cysts can be classified as
"simple" or "complex". An ultrasound is
especially helpful in evaluating cysts; in fact,
if a lump has all the characteristics of a
simple cyst on ultrasound, it can be safely
"left alone". But when it can be clearly felt,
and doesn't go away, it may be best to drain it
with a needle. This is simple to do, and it can
relieve any tenderness. What's more, there is
nothing more reassuring about a new lump in your
breast than to make it disappear!
Cysts can come back, but
most do not. Some women tend to develop new
cysts over and over, and some women develop so
many cysts that it seems impossible to try to
drain all of them. This situation is
challenging, because it makes it hard to decide
if there may be a "new" lump hiding in the
background of all the cysts. In such cases, it
may be best to plan to have your breasts checked
by a physician more frequently, perhaps every
3-6 months. Though this is no guarantee of
finding any beast cancer early, it should help.
Having lots of cysts does not appear to increase
your chances of having breast cancer; it just
makes it harder to check.
Return to top of page
I had a cyst drained, and
the fluid looked green. Should the fluid be
tested for cancer?
In years past,
doctors routinely sent cyst fluid to be analyzed
for cancer. But it turns out that the
information obtained is not really helpful in
deciding what to do, so most doctors have
stopped doing this routinely. There may still
be situations in which cyst fluid analysis is
helpful. This may include cases in which the
fluid is crystal clear, bloody, in cases where
the cyst looks unusual on ultrasound, or in a
patient who has an especially high risk of
cancer.
Return to top of page
My teenage daughter found
a lump in her breast. What should we do?
It is very rare for
lumps in teenagers to be cancer, but it should
still be checked out by a physician. In most
cases, it is a benign growth called a
fibroadenoma, which is not cancer, and except
for rare cases, will not turn into cancer. If
left alone, they usually will eventually go away
(regress), but this process may take years.
Fibroadenomas usually have
very typical features on ultrasound, and they
have a very typical rubbery feel, and can be
"pushed around" in the breast tissue very
easily, so your physician may be quite certain
that your lump is a fibroadenoma even without a
biopsy. But, a biopsy is very simple to do,
using a "fine needle" or a "core biopsy", so if
you or your doctor have any anxiety about it, a
biopsy or excision should definitely be done.
Sometimes it may make more
sense to just remove the lump rather than do a
biopsy. A lump brings with it a certain amount
of anxiety even if a biopsy is "benign". If you
feel that leaving the lump in would cause you
too much anxiety, even if benign, then you and
your doctor may want to skip the biopsy and just
remove it.
Return to top of page
Return to Breast Problems Home Page
|
