Suspicious breast lumps

Diagnosis

Diagnosis of a breast lump involves getting an exam and possibly tests to find out the cause of the lump. During the physical exam, your healthcare professional checks your breasts, chest wall, underarms and neck. You're checked while you're sitting upright and again while lying on your back.

You'll likely need one or more imaging tests to check for changes in the breasts. These include:

• Diagnostic mammogram. This is an X-ray of your breasts. During a mammogram, your breasts are compressed between two firm surfaces. Then an X-ray takes black-and-white images. When your healthcare professional orders a diagnostic mammogram, this tells the radiologist who reviews your images that you have a new breast concern. A diagnostic mammogram is different from a screening mammogram, which looks for breast cancer before a person has symptoms.
• Focused or directed ultrasound. This test uses sound waves to make images of the inside of your breasts. The sound waves come from a wand-like instrument called a transducer that is moved over your breasts. Your healthcare professional tells the radiologist about the area of concern on the breast.
• Magnetic resonance imagining (MRI). This exam is done less often than mammogram and ultrasound. An MRI uses a magnetic field and radio waves to see inside your breasts. During an MRI, you lie in a large, tube-shaped machine that scans your body and makes images. Sometimes, the breast MRI may be done even if the diagnostic mammogram and ultrasound look regular. For example, MRI may be used if your breasts are very dense, and your healthcare professional has concerns about the clinical exam of your breasts.

If these tests show that your lump is not cancer, you might need follow-up appointments. That way, your healthcare professional can check to see if the lump grows, changes or goes away.

If imaging tests don't help diagnose the lump, your healthcare professional might take a sample of cells for lab testing. This is called a biopsy. There are various types of biopsies. Your healthcare professional recommends the one that is right for you. Breast biopsies include:

• Fine-needle aspiration. A small amount of breast tissue or fluid is removed with a thin needle. This procedure can be used to check a complex cyst or to drain fluid from a painful cyst.
• Core needle biopsy. A healthcare professional called a radiologist may do this procedure. A radiologist finds and treats health problems using medical imaging tests. With core needle biopsy, ultrasound is used to guide a needle into the breast lump and take a sample to check. Often, a tiny clip that you can't see or feel also is placed into the biopsied area. It serves as a marker that lets healthcare professionals find the area again during future checkups.
• Stereotactic biopsy. For this procedure, you lie face down on a padded table. One of your breasts is placed in a hole in the table. Breast X-rays provide a 3D view of the breast to help guide a needle to the lump to collect a tissue sample. You may need this procedure if a suspicious area shows up on a mammogram, but the area can't be found with ultrasound. A tiny clip often is placed at the time of the biopsy and serves as a marker for future appointments.
• Surgical biopsy. This procedure removes the entire breast lump. It's also called a lumpectomy or wide local excision. You receive medicine to keep you from feeling pain. You also may be given medicine that makes you sleep during the procedure.

Whichever type of biopsy you have, your healthcare professional sends the tissue samples to a lab to be checked by a pathologist. That's a doctor who studies diseases and the changes they cause in body tissues.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Treatment

Treatment for a breast lump depends on its cause. Your healthcare professional helps you choose the treatment that's right for you. Causes of breast lumps and their treatment options include:

• Fibrocystic breasts. If you have fibrocystic breasts, your healthcare professional may suggest pain medicines that you can buy without a prescription. These include nonsteroidal anti-inflammatory medicine. Or you may need prescription hormone therapy, such as birth control pills.

• Breast cysts. Some breast cysts go away without any treatment. If the cyst is painful, you may need fine-needle aspiration. This procedure drains the fluid out of the cyst with a needle. This can ease the pain.

  If you have painful breast cysts that last a while and keep coming back, your healthcare professional may suggest surgery to remove the painful breast tissue. But most often, painful, recurring breast cysts go away around the time of menopause. That's when hormone changes happen less often.

• Fibroadenomas. A fibroadenoma might go away without treatment after a few months. You'll have regular ultrasound exams of your breast tissue to check the size of the fibroadenoma and how it looks. Ultrasound exams also can check whether the lump stays the same size or grows. If it grows or looks unusual during an ultrasound, you may need a biopsy. Depending on lab findings, your healthcare professional may suggest surgery to remove the fibroadenoma.
• Infections. Medicines called antibiotics cure most breast infections caused by germs called bacteria. But you may need a procedure known as an incision and drainage if a pocket of pus called an abscess forms and does not get better with antibiotics.
• Lipoma. Most often, a lipoma in the breast doesn't need to be treated. But if a lipoma causes painful symptoms, it can be removed with surgery or a procedure called liposuction that removes fat cells.
• Intraductal papilloma. These may not need treatment. But sometimes, intraductal papillomas and the part of the duct they are in are removed with surgery.
• Breast cancer. Treatment for breast cancer depends on the type of cancer and whether it has spread. Your healthcare professional may suggest treatments such as surgery, chemotherapy, hormone therapy such as anti-estrogen medicines or radiation therapy. Or you might be able to join a clinical trial that tests new treatments.

Living with suspicious breast lumps?

Connect with others like you for support and answers to your questions in the Breast Cancer support group on Mayo Clinic Connect, a patient community.

Breast Cancer Discussions

See more discussions