1. For women who have felt a breast lump, this is the best time to have a provider you can call and get direction as to what to do next. They will take into consideration your age, your hormonal status, your history and then do an examination.
2. For most women, as soon as you feel a breast lump, you should also let your gyno consider whether you need an actual ultrasound or needle biopsy.
3. Mammograms can be helpful for those over the age of 30. however, studies show that 50-70% of masses felt by the patient or on a physical exam are actually not not seen on mammogram, but with the new updates to mammography including computer aided diagnosis and tomosynthesis 3D mammograms the this data is improving. If this seems confusing remember that on an x ray test, which a mammogram is, only structures which have different shadow densities will show up. So in breast tissue, which may be on the lumpy side anyway, you may have a mass that you can feel but is not seen on the mammogram.
4. Masses in the breast for a woman who is young, that also do not show up on mammogram well, are not worrisome in most cases, but it means the mammogram may not accurately predict what the mass is, so it may be a reason your gyno would recommend a breast biopsy.
5. Ultrasound has been said to be is more accurate than mammogram in young women (those under age 25 absolutely) and in very dense breasts ultrasound may be more accurate for finding cancers, and the right answer…as to which test or combination of tests you need, has to be decided by your gyno, as based on what is felt, and what other symptoms you have, how long the mass in your breast has really been there, and your medications (are you on the pill?) and your family history (any breast cancer in your family) as well as your personal history (have you already had a mass biopsied).
6. Often a lump will resolve over the course of one menstrual cycle, so just being patient may be the best prescription.
7. There is a way to examine breast cells from breast ducts, and that’s what a Breast Pap Test is. This really aren’t for lump evaluation, or to replace mammograms as per the 2013 FDA communication. If there is nipple discharge this can be sent on a slide to be read as a pap.
8. Lumps should be evaluated whether or not you have pain.
8. See your Gyno yearly and discuss any breast concerns, how to reduce your risk of breast cancer, and how to best manage lumps to prevent others in the future.