What To Do If You Find a Painful Breast Lump

Not every breast lump is cancer!

If you find a painful breast lump, chances are there is a benign cause behind it. Nonetheless, it is important to reach out to your healthcare provider for immediate evaluation. The doctor will ask you some questions, perform an exam, run a few tests and then determine further treatment options.

Breast lumps are common in young women especially around the time of menstruation as hormonal surges occur. This is also why women are encouraged to perform breast self-examination, so they can separate the normal from the abnormal and then seek timely help.

If you find a painful breast lump that wasn’t there before, its best to get it checked out. Similarly, a lump that is increasing in size, or one that doesn’t go away through the menstrual cycle, needs assessment. Be sure to make note of any changes in the breast size, shape, skin color as well as nipple discharge or puckering.

What to expect once you go to the doctor?

Once you have reached to your doctor for help, the doctor will ask about when you first had the symptoms, and what change you have noticed in the breasts since then. If possible, its best to write down the changes and make note of any changes thereafter. Don’t be shy with your doctor, and explain everything in detail.

Your healthcare provider will ask you details about your family history of cancer, or benign breast conditions. Additional questions may be asked to assess your risk factors. The doctor will then perform his own exam of the breasts, the nipple and the lymph nodes in the armpit.
Once the doctor confirms that the painful breast lump is concerning, you will need diagnostic testing.

What diagnostic tests are done for breast cancer?

Most painful breast lumps need evaluation through imaging techniques. These include:

Diagnostic mammogram: this is a specialized breast x-ray that takes pictures from several angles, and confirms the presence of lumps. A mammogram also picks up lumps that are too small to be felt during manual examination.

Breast ultrasound: the findings of the mammogram are usually corroborated with an ultrasound to create images from the inside of the breast. An ultrasound machine can help find if the lump is a solid, or cystic structure.

MRI of the breast: an MRI is a great imaging source for constructing an image of the soft tissue. It uses magnetic and radio waves to create pictures. This imaging technique is usually reserved for ambiguous diagnoses. A dye may be injected into the body through an IV to enhance the appearance of the tumor cells. A contrast or a dye also helps determine the vascularity of the tumor, as the blood vessels involved take up the dye.

Biopsy of the breast: The most definitive test is the biopsy of the tissue mass. A biopsy involves taking a sample from the tissue and examining it under the microscope. The needle may be inserted under the guidance of an ultrasound or mammography. A local anesthetic is often used to minimize the discomfort.

Breast tissue can be biopsied through different techniques, including the following:

Fine need aspiration biopsy (FNA): involves a thin and long needle to penetrate the painful breast lump and extracting cells and fluid from the region for examination under microscope. The procedure is small, and involves minimal discomfort.
Core needle biopsy: involves a slightly larger needle and a specialized tip to get a breast tissue sample.
Vacuum assisted biopsy: has a probe connected to a vacuum device to remove a small sample of breast tissue.
Stereotactic biopsy: uses the mammogram to produce several imaging of the painful breast lump. The doctor then uses these images to remove a sample through a needle.
Surgical biopsy: lastly, there is the option for surgical biopsy in case of very deep, or very small lumps. The procedure involves making a small incision on the skin, and then removing the whole lump or part of it to make a diagnosis.

The Follow-up:

Once the biopsy is done, the sample is sent to a pathology lab for diagnosis.
If the testing reveals that the lump isn’t concerning, then short-term monitoring is all that needed. Your doctor may ask you to keep performing breast self-examination monthly, or repeat breast imaging. The doctor may even call you for a follow-up in a few months to see if there are any change in size or appearance of the breasts.

In case the biopsy reveals benign tissue, you can be directed to a surgeon or a specialist for further evaluation and management.

If the lump turns out to be cancerous, then your doctor will plan further treatment plan, including the staging of cancer, and the subsequent treatment will depend on the type and stage of cancer.

If you have discovered a lump in your breast, or you would like to know more about your risk of getting breast cancer, then you can consult a top breast surgeon to aid you. Book an appointment with top breast surgeon in Lahore, Karachi and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT professional for your concerns