What are breast lumps?
A breast lump is a mass of tissue that develops in the breast. Depending on the type, breast lumps may be large or small and may feel hard or spongy. Some lumps cause pain or nipple discharge, while others go unnoticed until felt or seen during an imaging test.
A lump may be discovered by a woman doing breast self-exam or by her health care provider during a physical exam. Suspicious lumps may also be detected during annual screening exams. Although uncommon, breast lumps can occur in men.
It is important to become familiar with how your breasts normally look and feel so that you are able to report any changes to your doctor.
How are breast lumps evaluated?
Most breast lumps are benign (not cancer). Proving that a lump is not cancer often involves imaging tests. One or more of the following imaging tests may be performed:
- mammogram: Mammography uses low dose x-rays to examine the breasts. This type of imaging involves exposing the breasts to a small amount of ionizing radiation to obtain pictures of the inside of the breasts. See the Safety page for more information about x-rays.
- breast ultrasound: Breast ultrasound uses sound waves to create pictures of the inside of the breasts. Breast ultrasound can capture images of areas of the breast that may be difficult to see with mammography. It can also help to determine whether a breast lump is solid or fluid.
- breast MRI: During breast MRI, a powerful magnetic field, radio frequency pulses and a computer are used to produce detailed pictures of the inside of the breasts. MRI is helpful in evaluating breast lumps that are not visible with mammography or ultrasound, particularly in women with dense breast tissue.
If a lump is proven to be benign by its appearance on these exams, no further steps may need to be taken. Your doctor may want to monitor the area at future visits to check if the breast lump has changed, grown or gone away.
If these tests do not clearly show that the lump is benign, a biopsy may be necessary. One of the following image-guided procedures may be performed:
- ultrasound-guided biopsy: During this type of biopsy, using ultrasound imaging to find the lump, an interventional radiologist will administer local anesthesia, and then advance a thin sampling needle into the lump to remove some tissue for evaluation under a microscope. The biopsy procedure is usually quick, but it may take a few days before the final tissue analysis (pathology report) is ready.
- stereotactic (x-ray guided) biopsy: During this type of biopsy, using a digital mammography x-ray machine to image the area of concern, an interventional radiologist will administer local anesthesia and then position a sampling needle at this site to remove thin tissue samples for further evaluation.
- MRI-guided biopsy: During this type of biopsy, using an MRI machine to localize the area of concern, the interventional radiologist will administer local anesthesia and then position a sampling needle at this site to remove thin tissue samples for further evaluation.
How are breast lumps treated?
If a lump is proven to be cancer, surgery is usually performed. The surgeon will explain appropriate surgical options (known as oncoplastic surgery) and provide you with the information necessary to make this decision.
You may have several consultations with other physicians for additional treatment, including radiation therapy and chemotherapy or hormone therapy.
One of the following radiation therapy treatments may be used after surgery to ensure any microscopic cancer cells are eliminated:
- External Beam Therapy
- Intensity-Modulated Radiation Therapy (IMRT)
- Brachytherapy (Interstitial Therapy)