If you've felt a breast lump while doing your monthly self-breast exam, what's the next best thing to do?
Discovering a breast lump is alarming. You'll, of course, be thinking of breast cancer. According to Mayo clinic 4 breast lumps out of 5 biopsied were benign. It is best to be evaluated by a breast surgeon.
If you do seek an appointment with a breast surgeon, he or she will conduct a thorough breast examination called a clinical breast examination. You'll expect your breast surgeon to ask you about symptoms you're experiencing, presence of breast cancer risk factors and other benign breast diseases. Answer these questions to the best of your knowledge.
After your interview, your doctor will proceed to inspect your breasts, noting any changes in shape or size, condition of your breasts' skin, analyze your nipples for unusual signs like abnormal discharge or nipple retraction. Your doctor will feel the deeper breast tissues for thickened or nodular breast areas. Then, your doctor will check your armpits to look for lumps. If the lump you've discovered is confirmed by your doctor, you'll have to undergo other tests to determine if it is cancerous or not.
Here are the procedures you'll undergo:
Fine-needle aspiration breast biopsy- The procedure employs a fine but hollow needle thrust into the lump and gently, cells or fluid are aspirated. If the beast lump is buried deep in your breast tissue, ultrasound is utilized to guide the needle to the exact spot of the lump. The character of the aspirate will be analyzed. If the fluid is clear and non-bloody, it's considered benign. If it is bloody, it will be sent to a pathology lab for analysis. If there isn't fluid you'll have to undergo additional testing too.
Ultrasound - This technique uses sound waves to give a picture of your breast.
It can confirm if it's cystic or solid. If the ultrasound reveals like a cystic lump there would be no need of aspiration.Needle aspiration can sometimes relieve the pain of a painful breast lump. If the ultrasound reveals a solid lump, your breast surgeon excises a small sample of breast tissue for analysis.
Mammogram - A diagnostic mammogram utilizes higher magnification as opposed to a screening mammogram. Several angle views focus on the specific location of the breast lumpand enables your doctor to locate and visualize the size and exact location of the lump. If breast cancer is highly suspected needle biopsy or a lumpectomy will be scheduled next.
However, age also dictates the type of tests that you'll undergo. Women under 40 will just undergo an ultrasound. Because they have denser breast tissue it would be difficult to interpret the mammography result. Women 40 years old and older will undergo both ultrasound and mammography.
Magnetic Resonance Imaging (MRI)- If both diagnostic mammogram and ultrasound are negative but your doctor has concerns about your clinical breast examination, an MRI is in order. A dye will be injected intravenously. Since cancerous tissue is more vascular than normal breast tissue, the dye will show up in the cancerous tissue.
To know if the solid breast lump is cancerous, your breast surgeon will take a sample of your breast tissue called a biopsy by various means. Then the sample is sent to a lab for analysis.
Apart from fine needle biopsy, core needle biopsy is utilized to collect a small sample of the solid core of the breast lump employing a larger needle.
Stereotactic breast biopsy uses mammography to locate an abnormal area. When located, a hollow needle is poked to obtain a breast tissue sample.
Vacuum-assisted biopsy technique employs a hollow probe which is connected to a vacuum. The skin is cut and the hollow tube is inserted, a tissue sample from the abnormal area is excised.
Surgical biopsy entails removal of your entire breast lump and some surrounding tissue. Or if the breast lump is large a small portion is taken (ie. incisional biopsy).
It takes a week for a diagnosis. There are three scenarios:
It isn't breast cancer! Your doctor will advise monitoring. Once you feel any changes in your breast lump go back for re-evaluation.
Not sure. The clinical breast exam, mammography and/or ultrasound are suspicious but the biopsy samples from your breast lump reveals non-malignant cells. In this case, you'll be referred to a breast cancer specialist for additional evaluation.
It is breast cancer! Tests will be done for cancer staging and typing. Then, your breast surgeon will discuss a treatment plan.
Don't get scared. Early detection of breast cancer means the battle is half won. Take heart, many women are breast cancer survivors. Determine to be a survivor!