The first and most important thing you need to try to do is to stay calm. Easier said than done, yes. Remember, however, that 8 out of 10 lumps found in breasts are not cancerous. Breast lumps are very common, especially in pre-menopausal women. During different phases of her cycle, a woman may notice breast changes that come and go. Hormones can cause breast tissue to fill with water, making the breast feel lumpy. More often than not, these cyclic-related breast lumps disappear on their own by the end of a woman’s menstrual cycle.
Nevertheless, you should never become complacent when it comes to your breasts! If you discover a lump, it is always best to consult your doctor immediately.
A doctor can learn a lot about a breast lump by carefully feeling the lump and the tissue around it. This type of examination by touching is called palpation. Doctors can often distinguish between benign and cancerous tumors just by touch. Benign lumps often feel like encapsulated grapes that you can move around. In contrast, cancerous tumors, on the other hand, tend to feel much harder to the touch and cannot be moved as easily.
To learn more about a lump, your doctor may choose to order a test that allows an image to be taken of the inside of the breast, using one of the following techniques:
The most common method is diagnostic mammography, which uses x-rays to take pictures of the breast.
A second common technique is called ultrasonography, which uses sound waves to establish whether a lump is solid or full of fluid. An ultrasound also can help distinguish between normal and abnormal lumps in the breast.
A third, but far less common method, is computerized thermal imaging, which works by analyzing temperature values in breast tissue to measure tiny shifts in physiological and metabolic activity.
Regardless of the imaging method used, if the image of the lump looks suspicious, the next step is to examine some of the cells from the lump (also called a mass). The removal of cells from the mass is done by one of four methods:
Fine needle aspiration biopsy (FNAB) uses a very thin needle to collect fluid or cells directly from the mass. Usually, the doctor can perform this procedure while feeling the
lump to help guide the needle. If the lump cannot be felt easily, the doctor may use ultrasound or computer-guided imaging to help locate the mass and guide the needle.
If this procedure locates fluid it is an indication that the lump is a cyst. If the procedure locates a solid mass, a biopsy sample of the mass will be removed and sent to a laboratory for further analysis under the microscope. Solid masses can be malignant.
Using FNAP, mammography, and a clinical breast exam, a doctor can determine with about 98% accuracy whether a lump is benign or malignant. If, however, there is still doubt, a core needle biopsy may be ordered.
Core needle biopsy, which uses a larger needle to remove a small cylinder of tissue from the lump and send it to a laboratory for further analysis under the microscope.
Incisional biopsy, which involves surgical removal of just a portion of the mass, which is sent to a laboratory for further analysis under the microscope.
Excisional biopsy, which involves surgical removal of the entire mass, which is sent to a laboratory for further analysis under the microscope.
Biopsy results yield one of the following diagnoses:
The lump is normal tissue, and is nothing to worry about. The lump of normal tissue represents one of several natural changes that the breast undergoes over time. Even if tests indicate that the lump is nothing to be concerned about, it is still important to be diligent about your monthly self exams and annual mammograms (if you are over 40) and clinical breast exams.
The lump is not cancer, but you need to be re-checked in 4 to 6 months to make sure that there have not been any changes in the tissue.
Not cancerous, but not completely normal. Sometimes tests reveal that, even though the lump is not cancerous, it is abnormal. Often such a diagnosis can mean that you may have a condition that puts you at higher risk of developing breast cancer in the future. If this is the case, your doctor may require that you get more frequent clinical breast exams.
Cancer. If the tests reveal that the lump is cancerous, your doctor will talk to you about the different treatment options available. Because treatment options usually depend on the type and characteristics of the cancer, your doctor usually will order additional tests to learn more about your cancer. For example, the cells extracted during your biopsy often are screened for an abnormality called HER-2 overexpression. HER-2 overexpression occurs in about 25% of all breast cancers. If your breast tumor is HER-2-positive and shows HER-2 overexpression, your breast cancer may respond well to an antibody-based drug, called Herceptin, that targets the HER-2 protein receptor on the surface of HER2-positive breast cancer cells.
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