Tests and diagnosis

By Mayo Clinic Staff

You'll need a screening and diagnosis once you or your doctor identifies a breast lump. After discussing your symptoms and health history, your doctor will do a breast exam and may order a diagnostic mammogram and or a breast ultrasound. Based on the findings on the imaging tests and the clinical examination by your doctor, you may be referred for a fine-needle aspiration or breast biopsy.

Breast exam

Your doctor will physically examine the breast lump and check for any other breast abnormalities. Because your doctor can't tell from a clinical breast exam alone whether a breast lump is a cyst, you'll need another test. This is usually either an imaging test or fine-needle aspiration.

Breast ultrasound

Breast ultrasound can help your doctor determine whether a breast lump is fluid-filled or solid. A fluid-filled area usually indicates a breast cyst. A solid-appearing mass most likely is a noncancerous lump, such as a fibroadenoma, but solid lumps also could be breast cancer.

Your doctor may recommend a biopsy to further evaluate a mass that appears solid. If your doctor can easily feel a breast lump, he or she may skip breast ultrasound and perform fine-needle aspiration instead.

Fine-needle aspiration

During a fine-needle aspiration, your doctor inserts a thin needle into the breast lump and attempts to withdraw (aspirate) fluid. Often, fine-needle aspiration is done using ultrasound to guide accurate placement of the needle. If fluid comes out and the breast lump goes away, your doctor can make a breast cyst diagnosis immediately.

  • If the fluid is not bloody and the breast lump disappears, you need no further testing or treatment.
  • If the fluid appears bloody or the breast lump doesn't disappear, your doctor may send a sample of the fluid for lab testing and refer you to a breast surgeon or to a radiologist — a doctor trained to perform imaging exams and procedures — for follow-up.
  • If no fluid is withdrawn, your doctor will likely recommend an imaging test, such as diagnostic mammogram and or ultrasound. Lack of fluid or a breast lump that doesn't disappear after aspiration suggests that the breast lump — or at least a portion of it — is solid, and a sample of cells may be collected to check for cancer (fine-needle aspiration biopsy).
Oct. 08, 2015