Specialist surgical consultation

Discovering a breast lump, nipple discharge or other abnormality can be a frightening experience. With all the publicity surrounding breast cancer it is easy to assume the worst. Understandably you will want to see a breast specialist as soon as possible. Fortunately, appropriate investigations will prove that most of these problems are benign.

I will listen to your description of the problem and ask some relevant questions regarding your general health and life style.
Both breasts will be examined carefully. The use of ultrasound at the time of initial consultation significantly improves the speed, comfort and accuracy of assessment.

Ultrasound is painless and quick to use with no risk of radiation exposure. It distinguishes fluid filled cysts from solid lumps, guides needle-biopsy and accurately documents the size and shape of an abnormality. It allows rational decision making about the selection and sequence of other tests.

I will then discuss the place of any further investigations such as mammography or biopsy in your particular situation. This allows an individualised approach to your problem.

If mammograms are required they are performed at this stage.

If an abnormality is identified on these tests then a needle biopsy is necessary to get a sample of the tissue for testing in the laboratory. This is done under local anaesthetic and takes about ten minutes. Local anaesthetic is injected to numb the skin. A small needle is passed into the tissue under ultrasound guidance and a sample of tissue is removed.

By the end of this first consultation I will be able to give you a provisional diagnosis. Many lumps such as fluid filled cysts will be completely treated in this one visit. The result of the needle biopsy is usually available within 1-2 days and will confirm a diagnosis.