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.


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 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.


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: Lumpy Lucy, 35-44 Female (Patient) Published: November 19

Twenty years ago, when I was 23, I was pregnant with my first child and found a lump in my right breast. The lump was not painful, nor did it have any swelling or redness typical for mastitis. Despite that, my doctor tentatively diagnosed it as such and told me to wait until after the baby was born and I started nursing for the lump to go away. Needless to say, the lump continued to grow while still remaining asymptomatic. When my baby was three weeks old, I initiated another visit which culminated in a mammogram. I could tell during the procedure that the technicians were disturbed by what they saw. However, my doctor still claimed I had nothing to worry about, so I requested a second opinion. The next doctored scheduled a biopsy. Thankfully, the tumor was nothing more than a fibroadenoma. What had concerned them was the fact that it had shown calcification in the center, which is a sign of cancer. Apparently they deducted that the calcification was due to the tumor being so large (the size of a pear) and dying off in the middle. Fast forward twenty years and a ton of self-breast exams. I found a small mass in my right breast last night. This one feels different than the lump I had removed and vastly different than my typically fibrous breast tissue. It's pea sized and static, meaning it feels attached to the tissue around it rather than being moveable like fibrous tissue. So, I called the doctor this morning and scheduled an appointment for tomorrow along with a mammogram. I guess I'm thankful for the first tumor in that I learned to take control instead of simply letting the doctor 'assure' me everything was normal when I knew it wasn't. I suspect that if the doctor doesn't ask for an ultrasound or biopsy, I will. As an aside, the doctor all those years ago held onto the ideal that a) I was too young to worry about it, b) nobody in my immediate family had any history of breast cancer, and c) I was low risk due to not drinking, smoking or being on the pill. While it turned out to be a benign tumor, it still increased my chances of more tumors due to the calcification factor. I don't think I would have been as vigilant with self-exams had I not had that history to remind me. We shall see what tomorrow brings.

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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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