Tests and diagnosis

By Mayo Clinic Staff

Tests to evaluate your condition may include:

  • Clinical breast exam. Your doctor checks for unusual areas by visually and manually examining your breasts and the lymph nodes located in your lower neck and underarm area. If your medical history and the clinical breast exam indicate normal breast changes, you may not need additional tests. If your doctor finds an unusual lump and suspects fibrocystic changes, he or she may ask you to return a few weeks later, after your menstrual period — then you'll have another breast exam to see if the changes were associated with your menstrual cycle. If the changes persist, you'll likely need a mammogram or ultrasound.
  • Mammogram. If your doctor detects a breast lump or unusual thickening in your breast tissue, you need to have a mammogram — an X-ray exam to evaluate a specific area of concern in your breast. Even if your breast exam is normal, your doctor may recommend a mammogram if you're age 30 or older to double-check for suspicious areas in your breast that may be too small to feel.
  • Ultrasound. An ultrasound uses sound waves to produce images of your breasts and is often performed along with a mammogram. Women younger than age 30 might have an ultrasound instead of a mammogram because ultrasound can better evaluate dense breast tissue — that is, tissue tightly packed with lobules, ducts and connective tissue (stroma) and less fat than older women have. Ultrasound is also helpful in distinguishing between fluid-filled breast cysts and solid masses.
  • Fine-needle aspiration. If your doctor thinks the lump detected on the clinical exam has the consistency of a cyst, he or she will order an ultrasound to confirm the presence of a cyst or use fine-needle aspiration to see if fluid can be withdrawn from the lump. This helpful procedure can be done in the office.
  • Breast biopsy. A breast biopsy is a procedure to remove a small sample of breast tissue for microscopic analysis. If your doctor finds a suspicious breast lump, an area of thickening or other unusual change during the clinical breast exam, you'll have an additional imaging test, such as a mammogram or ultrasound. You also may be referred to a breast surgeon to discuss whether you need a breast biopsy. If a suspicious area is seen during an imaging exam, the radiologist may recommend a breast biopsy.
March 08, 2013