What Do I Do if I Have a Breast Lump?

A breast lump is something no woman wants to find, but it’s important not to panic if you feel something suspicious in your breast. The first thing to do is take a deep breath, and keep breathing.

Most women seem to find a breast lump just by chance, or something draws them to it — an itch, a pull or a pain. The point of doing breast self exams is to know what is normal so that when you feel a “lump” you will know it is different. Most breasts are naturally lumpy, and many of these lumps are normal or benign. It is a rare woman whose breasts are lump-free. However most of these “lumps” are normal fatty, fibrous, cystic breast tissue.

That’s why I encourage women to get to know their breasts. You should feel comfortable touching yourself to determine what is typical for you. I don’t think there’s a specific, strict way you have to examine your breasts; just feel good about knowing what your breasts are like, and realize that at different times of the month they may be lumpier than others. Typically, breasts are more swollen, tender, and lumpier the week before your period, and less so the week after.

If you do find something that feels different, after breathing and considering where in your cycle you are, I recommend making an appointment with your provider as soon as possible. Most practices try to accommodate women who are concerned about differences in her breast quickly. Some women are comfortable waiting through one cycle to see if the lump shrinks or disappears; cancers won’t.

You should also be able to obtain an ultrasound of the lump in a timely fashion. An ultrasound will be able to determine if the lump is a fluid-filled cyst, something solid, or breast tissue. If you haven’t had a mammogram recently, that could also be helpful. In younger women (less than 35 or 40 years old) mammograms are less useful. And I wouldn’t rely solely on a mammogram to ease your mind. I have seen too many women who present with breast cancer after having been told their mammograms were normal.

If the ultrasound indicates an issue, or is questionable, you should be seen by a provider who specializes in breast problems, who can decide if the lump should be tested for a tissue sample. This can be done usually at the same visit with either a fine needle aspirate or a core needle aspirate. These tests, done by experienced hands, are quite accurate. Only in very rare cases, with a rare type of breast cancer called colloid cancer, have I heard of a needle biopsy spreading cancer.

It can be nerve wracking waiting for results of tests, but these results should be available in 24 to 48 hours. Not all breast lumps need to be surgically excised. The decision to remove a breast lump should be made after gathering as much information as possible, from ultrasound, mammogram, your doctor’s input, and your own research. If you decide you’d like to have it removed, however, your wish should be respected.

Likewise, you shouldn’t be rushed into having a lump removed if you aren’t comfortable with that decision; you have the time to contemplate it or get a second, or even third, opinion.

Now that you know a little more, you can feel more confident about what to do if you find a lump while doing a self examination. Remember these key points: