Women's health (7)
- Health issues for lesbians: Tips to stay healthy
- Kegel exercises: How to strengthen pelvic floor muscles
- Women's health: Preventing top 10 threats
- see all in Women's health
Breast health (10)
- Is it breast cancer? Procedures to evaluate breast lumps
- Breast implants: A choice between saline and silicone
- Breast cancer prevention: Lifestyle factors that can reduce risk
- see all in Breast health
Women's sexual health (55)
- Birth control pill FAQ: Benefits, risks and choices
- Women's sexual health: How to reach sexual fulfillment
- Emergency birth control
- see all in Women's sexual health
Women's life stages (12)
- Delaying your period through oral contraceptives
- Weight gain after menopause
- Fitness tips for menopause: Why physical activity matters
- see all in Women's life stages
Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
continued:
Is it breast cancer? Procedures to evaluate breast lumps
Clinical breast examination
Evaluation of a breast lump begins with a breast examination performed by your doctor or nurse practitioner (clinical breast examination).
During this exam, your doctor or nurse practitioner:
- Questions you about your symptoms
- Looks at your breasts, noting their shape and size
- Observes the condition of the overlying skin on your breasts
- Checks for nipple problems, such as inversion or discharge
- Feels (palpates) deeper tissue in your breasts and armpits for lumps, prominent nodular areas or areas of thickening
If your doctor confirms that you have a breast lump or other area of concern, the next step is to determine whether it's caused by a noncancerous condition or whether it's a cancer. However, the cause of a breast lump or other change can't be determined based on a clinical breast exam alone — more testing will be needed.
Other tests and procedures to evaluate a breast lump
To further evaluate a breast lump — including determining whether it's fluid-filled or solid — your doctor may recommend one or a few of these tests or procedures.
Fine-needle aspiration
Your doctor performs fine-needle aspiration (FNA) during an office visit or refers you to a surgeon or radiologist for this procedure.
In FNA, the doctor inserts a thin, hollow needle into the lump and removes (aspirates) any fluid. If the results of FNA show:
- Straw-colored, nonbloody fluid, the breast lump is most likely a benign cyst and will probably disappear with aspiration.
- Bloody fluid, the fluid is sent to a laboratory for further analysis.
- No fluid, the breast lump is likely solid and requires further testing to determine whether it's cancer.
Your doctor may perform FNA with or without ultrasound guidance. Ultrasound — a noninvasive procedure that uses sound waves to create images of organs and tissues — can ensure the accuracy of FNA. If your doctor performs the FNA without ultrasound guidance, he or she will probably ask you to come back for a follow-up exam in four to six weeks. If the breast lump has returned during that time, you'll need to undergo more testing.
Ultrasound
Your doctor might not perform FNA right away, opting instead for a breast ultrasound to examine the area of concern. If you don't feel any pain associated with the lump, and the ultrasound confirms that it's a cyst, you may not need aspiration. If you do have pain, the doctor can use ultrasound to guide FNA. Removing the fluid from the cyst helps relieve the pain. If ultrasound reveals that the lump is solid, the doctor can collect a small amount of breast tissue with a needle (biopsy). Samples collected go to a laboratory for analysis.
Mammography
Mammography uses X-rays to reveal early evidence of breast cancer. It can detect calcium deposits (microcalcifications) that mark benign or cancerous (malignant) conditions. Diagnostic mammography helps your doctor investigate lumps and other signs and symptoms such as pain, nipple discharge, areas of thickening, or change in breast size, shape or overlying skin. It differs from screening mammography — a test done when there are no particular breast concerns — which usually requires only two standard views of your breasts.
A diagnostic mammogram requires views at higher magnification from more angles, and it focuses on the area where the lump is. It can help the radiologist and surgeon precisely locate and determine the size of the lump or other abnormality. Findings may indicate whether the area of concern is benign or cancerous. If the radiologist suspects cancer, you'll need a needle biopsy and possibly surgery.
Depending on your age, your doctor might rely on ultrasound to make a diagnosis — either alone or in conjunction with mammography. Because a younger woman's breasts are denser than are an older woman's breasts, a mammogram on a younger woman can be more difficult to interpret. In general, if you're younger than 30, ultrasound may be the only imaging test ordered. If you're 30 or older, your doctor might order a diagnostic mammogram of both breasts and an ultrasound of the breast lump.
Magnetic resonance imaging
In conjunction with mammography, magnetic resonance imaging (MRI) can be of help in distinguishing between benign and cancerous lumps — and it's becoming more and more widely used. Cancerous tissue requires a greater blood supply than does normal tissue to support the growth of a malignant tumor. Because MRI shows greater contrast in areas of increased blood supply, your doctor can tell which areas might be cancerous and which aren't, based on the images. Your doctor may recommend an MRI if he or she still has concerns about a breast lump despite normal mammography and ultrasound test results.
Breast biopsy
If the breast lump is solid, your doctor obtains a tissue sample to send for laboratory analysis. This may be done through one of several procedures:
- Fine-needle aspiration biopsy. During FNA, your doctor uses a special needle to collect a sampling of cells and not just fluid.
- Core needle biopsy. Core needle biopsy uses a larger needle than used with FNA biopsy to obtain a small, solid core of tissue.
- Stereotactic biopsy. This type of needle biopsy uses mammography to pinpoint an abnormal area that shows up on a breast-imaging test but isn't felt during a clinical examination. The technique uses stereo images — images of the same area obtained from different angles — to locate the area of concern, and a radiologist or surgeon removes a sample of breast tissue through a hollow needle.
- Excisional biopsy. This type of biopsy — also called surgical biopsy or lumpectomy — removes the entire breast lump as well as some surrounding breast tissue for analysis.
If you have a biopsy performed, you should have your test results in about a week.
Follow-up to breast lump evaluation
After you've undergone a clinical breast exam, imaging tests and a needle biopsy, your doctor checks to see that all findings are in agreement. Your doctor may suspect that a breast lump is cancerous after the clinical breast exam and the mammography results may show areas of suspicion, but the pathology results from the needle biopsy reveal benign tissue. In this case, despite benign biopsy results, your doctor can't tell you for certain that you don't have breast cancer. You may be referred to a surgeon for a consultation.
If, after the clinical breast exam, your doctor thinks your breast lump likely isn't cancerous, the mammography results are normal, and the needle biopsy is benign, you and your doctor can keep a close watch on the area for a few months. If your breast lump changes at all, your doctor will probably send you for a surgical consultation for further evaluation and, possibly, an excisional biopsy.
Remember that a normal mammogram, ultrasound or breast MRI doesn't mean the breast lump you feel isn't cancer. See your doctor right away for re-evaluation of the breast lump if you notice any changes or if you develop any new areas of concern.
Previous page(2 of 2)
