Breast Lumps In Women - Diagnosis

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How are breast lumps evaluated?

Physical Examination

A manual examination of the breast is an important screening method for detecting cancer and is the first step in the evaluation of a breast lump. Unfortunately, the manual examination of the breast is not perfect. However, if a mass can be felt manually, it is important to estimate the location of the mass so that the mammogram and/or other diagnostic examinations can focus on the particular area. A doctor also inspects any suspicious skin changes that may be a sign of breast cancer. Since the manual examination can miss breast cancer, mammography is also important as a screening tool.

Mammogram

Women with a breast lump need to have a mammogram of both breasts. A mammogram is estimated to be able to detect about 90% of breast cancers. This means that about 10% of breast cancers are missed by mammography. Therefore, if a woman or her physician feels a lump and the mammogram is normal, further studies or biopsies are carried out to rule out cancer. Sometimes, a certain pattern of calcium deposits appears on the mammogram that makes the doctor suspicious of cancer. In these cases, it is often recommended that a biopsy be taken that is guided by mammogram images to be sure the correct area is sampled.

Ultrasound

Ultrasound is useful in the evaluation of breast lumps. It can distinguish between a cyst (such as a benign cyst, which is filled with fluid) and a solid lump (which may or may not be cancerous). The first step in the evaluation of a breast lump is to determine whether it is a cyst or solid mass, and this is what an ultrasound can do best. Especially in young women, in whom a benign cyst may be suspected, if the woman's ultrasound confirms a typical cyst, she may not require any procedures or biopsies. If it is unclear on the ultrasound whether the lump is completely a cyst, a further evaluation is usually recommended.

MRI

Magnetic resonance imaging (MRI) is becoming more widely used in the evaluation of breast lumps because it is particularly sensitive to small abnormalities in breast tissue. MRI is a special radiology technique designed to image internal structures of the body using magnetism, radio waves, and a computer to produce the images of body structures. Cancers require a greater blood supply than non-cancerous growths, and the images obtained from an MRI may help determine whether a particular area is cancerous because the MRI shows greater contrast in those areas with an increased blood supply. In most cases, MRI is performed if results of mammography and ultrasound evaluations are not conclusive.

MRI also has limitations. For example, MRI cannot detect the presence of calcium deposits, which can be identified by mammography and may be a sign of cancer.

Return to Breast Lumps (In Women)

See what others are saying

Comment from: giel, 25-34 Female (Patient) Published: April 15

After reading almost all the stories here on, I have been worried on my breast lump and the pain I feel and all the symptoms, that it might be a breast cancer. In February 2015 I finally went to see my general physician (GP). At first she said she thought it was nothing, it was so small she hardly could feel it. She didn't feel actually but I took her finger and let her feel the lump and she said it might be because of my period being almost due. I went back home and started to make myself relax. My period is over but I am still in pain that goes to my armpit into my collar bone, my shoulder and in my hands. So I went back to her again on March 4, 2015 and this time I asked if I could go at least for an ultrasound, and she gave an appointment. I called my insurance and set an ultrasound over a Monday. I waited to get an appointment last Sunday, April 12, 2015. The radiologist said I have a 5 mm suspicious tumor that needed a biopsy as soon as possible! He asked me to go back to my GP and set an appointment with a breast surgeon. I am scared but who wouldn't be when you hear of tumor.

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Comment from: Thip, 35-44 Female (Patient) Published: January 19

I found lumps on my left breast 6 months ago. I went to see the doctor and he sent me to a breast clinic to get a mammogram and ultrasound done. The doctor came in and told me it was nothing to worry about but didn't tell me what it was. I continue finding more lumps and bigger also, so painful. Just recently I found more lumps on my right breast. So I went back to see my doctor and he sent me back to get another mammogram and ultrasound. When I got to the clinic the clerk refused to make an appointment, she said it was too soon and there was nothing they can do to help me. I don't know what I should do at this point. They refused to help and the doctor didn't tell why I have these lumps. I still don't have any clue what kind of lumps are growing inside both my breasts. I am feeling very frustrated and angry.

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