Suspicious Breast Lumps

Diagnosis

Diagnosis of a breast lump begins with a physical exam and may include imaging tests and biopsies to determine the cause. During the exam, your healthcare professional checks the breasts, chest wall, underarms, and neck while you are sitting upright and lying on your back.

Imaging tests often include:

• Diagnostic mammogram, an X-ray that captures black-and-white images of the breasts and highlights areas of concern.

• Focused or directed ultrasound, which uses sound waves to create images of the inside of the breast. A transducer is moved over the area of concern.

• Magnetic resonance imaging (MRI), which uses a magnetic field and radio waves to create detailed images. MRI may be used for dense breast tissue or when other imaging is inconclusive.

If imaging tests are inconclusive, a biopsy may be needed to examine breast tissue or fluid. Types of biopsies include:

• Fine-needle aspiration, using a thin needle to remove tissue or fluid.

• Core needle biopsy, guided by ultrasound, often with a tiny clip placed at the site.

• Stereotactic biopsy, using 3D breast X-rays to guide a needle when an area cannot be seen on ultrasound.

• Surgical biopsy, also called a lumpectomy or wide local excision, removes the entire lump under anesthesia.

All tissue samples are sent to a pathologist to check for cancer or other conditions.

Treatment

Treatment for a breast lump depends on the cause identified during diagnosis.

If the lump is benign, your healthcare professional may recommend:

• Monitoring with regular follow-up exams and imaging to ensure the lump does not grow or change.

• Procedures to drain fluid from cysts if needed.

If the lump is cancerous, treatment options may include:

• Surgery to remove the tumor, which may involve lumpectomy or mastectomy.

• Radiation therapy to target remaining cancer cells.

• Chemotherapy or hormone therapy depending on cancer type and stage.

• Targeted therapy for specific cancer markers.

The treatment plan is individualized based on the size, type, and location of the lump, as well as overall health and personal preferences.