Breast lumps

The majority of breast lumps will turn out to be benign but it is important to identify any cancer lumps as soon as possible to avoid delays in treatment.

Clinical examination of the lump with the aid of ultrasound is a very effective  way to evaluate a lump.

90% of lumps will be identified with this approach and  they can rapidly be categorised as cystic or solid.

Benign cysts only need aspiration if they are causing symptoms such as pain or if they have any atypical features on ultrasound.

Solid lumps require a needle biopsy to confirm a diagnosis and this can be done immediately under ultrasound guidance.

A mammogram may show a density in the breast but the lump will still require ultrasound and needle biopsy to make a diagnosis. In 10 - 15 % of cases a cancer lump will not show up on a mammogram at all!  A normal mammogram report should not delay complete assessment of a breast lump.

The mammogram is perhaps most useful in drawing our attention to subtle changes such as calcification or small impalpable densities in other areas of the breast tissue that may require evaluation in their own right.

If the process of triple assessment described above fails to provide a satisfactory diagnosis then further investigation is necessary.

MRI scanning may be considered.

Excision of the lump is a last resort that is sometimes recommended if there is still any doubt about the diagnosis or if the lump continues to cause anxiety.