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Breast Lumps

Your mind whirls as you slowly slide your fingertips over it — a breast lump.

It's probably nothing. But what if it is? Should I see a doctor? Should I wait? What if it's cancer? What do I do now?

Finding a breast lump can be one of the most frightening discoveries a woman can make. Your breast is a very private and intimate part of your body. The thought of having a disease invade it can be upsetting, even emotionally devastating. You may feel so overwhelmed that you put off getting the medical care you need. But that's a mistake.

Most of the time, a breast lump isn't cancer. But if it is, getting an early diagnosis and taking an active, knowledgeable role in your care can increase your chances of beating this disease.

Breast changes

Breast changes, which include lumps, pain and nipple discharge, are probably more common than you think. Over a lifetime, half of all women become concerned enough about a breast change to see a physician. And, one of eight women will develop breast cancer.

A variety of factors can cause your breasts to change in size or feel, among them, pregnancy and your menstrual cycle. Other conditions include:

  • Fibrocystic changes — These changes can cause your breasts to feel ropy or granular. Also called benign breast "disease" or fibrocystic "disease," these changes are very common (more than half of women have them) and typically harmless.
  • Cysts — These fluid-filled sacs occur most often in women ages 35 to 50. Cysts often enlarge and become tender just before your menstrual period.
  • Fibroadenomas — These benign tumors are often solid, round and painless. They may feel rubbery and are often movable, not fixed.
  • Infection and trauma — Sometimes, a milk duct may become blocked and infected, causing a reddened area that feels warm, tender and lumpy. A bruise or blow to the breast can also cause a lump.

Preparing for an exam

Once you're in the exam room, be prepared to tell your doctor:
  • When you found the lump
  • The date of your last period
  • If you've had nipple discharge
  • About any previous breast problems
  • The size of the lump and whether it's gotten smaller or larger
  • How the lump feels
  • Where the lump is
  • Medications you're taking
  • Your family history
  • Whether you've had a breast biopsy in the past
Your doctor will examine your breasts. He or she may also recommend one or more of these tests:

  • Mammogram — A mammogram is an X-ray of your breast. It helps your doctor evaluate what you felt.
  • Ultrasound — This uses sound waves to create a picture of your breast. It can help show whether the lump is a cyst or a solid mass.
  • Needle aspiration — With this test, fluid or cells from the lump are withdrawn via a small, hollow needle. The test helps distinguish a cyst (which is usually benign) from a solid mass. It also drains large cysts in a single procedure.
  • Biopsy — In this procedure, a small piece of tissue is removed from the lump and examined.

What to ask

If you understand what's happening and what's expected from you, you can help your doctor provide the best care. Questions you may wish to ask include:

  • What kind of lumps do I have?
  • Do I need a mammogram? If not, why?
  • Do I need to have a biopsy? If not, why?
  • Should I go to a medical center with a breast health clinic?
  • When should I schedule a follow-up exam or visit?
  • How often should I have a mammogram?
  • What's the correct way to do a breast self-exam

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