Breast lump
Alternative names:
lump in the breast
Home care:
Treatment for known, diagnosed fibrocystic breast changes
includes the following: Perform a breast
self examination monthly; wear adequate bras for good
breast support; and avoid caffeine.
The effectiveness of vitamin
E, vitamin B6, and
herbal preparations such as evening primrose oil are somewhat
controversial and should be discussed with your health care
provider. Oral contraceptives may be prescribed because they
often decrease symptoms.
For a lump in the breast caused by a benign
cyst, see your health
care provider who may take a biopsy
or aspirate (use a needle and syringe to obtain a sample of
fluid) to be sure the cyst is benign.
For a lump in the breast caused by an injury, it should clear
up eventually without treatment.
For a lump in the breast caused by a drug reaction, consult
with your health care provider about discontinuing the offending
drug. NEVER CHANGE MEDICATIONS WITHOUT CONSULTING YOUR HEALTH
CARE PROVIDER.
For a lump in the breast caused by cancer,
follow the provider's recommendations for appropriate treatment.
The choice of initial treatment for biopsy-confirmed breast
cancer is based upon the extent of the disease and it
aggressiveness. Currently, breast cancer is viewed as a systemic
disease that requires both local and systemic treatment. Local
treatment may include lumpectomy,
mastectomy (partial,
total, or radical with axillary dissection) and radiation
therapy, all directed at the breast and surrounding tissue.
Systemic treatment includes chemotherapy
and hormonal therapy--both of which circulate throughout the
entire body to, hopefully, eliminate cancer cells that may
be present in distant parts of the body. Most women receive
a combination therapy including surgery, radiation, chemotherapy,
or hormonal therapy.
Note: Self monitoring of a breast lump may be done in premenopausal
women for 1 to 2 months to observe for any cyclical changes
associated with the menstrual period. Self care may also include
restricting dietary fat
to approximately 25% of the total daily calorie intake and
eliminating caffeine intake and cigarette
smoking to see if symptoms subside.
Call your health care provider if:
- there is any unexplained breast lump! EVERY breast lump
should be checked by the health care provider.
- you are a woman, 20 years or older, unfamiliar with how
to perform breast self-examination.
- you are a woman, 40 years or older, with no baseline
mammogram.
There are 3 general rules:
1) ALL lumps should be checked three ways--by breast self-examination,
by the health care provider, and by mammography.
2) Any new breast lump, particularly if painless and located
in one breast, could be cancer
until proven otherwise.
3) Many breast lumps need to be biopsied, particularly if
the results of mammography do not clearly show the lump to
be benign.
What to expect at your health care provider's office:
A complete history should be obtained, with special attention
to factors that increase the patient's risk of breast
cancer. A thorough breast examination will be performed.
If you don't know how to perform breast
self-examination, ask your health care provider to teach
you the proper method.
Medical history questions documenting breast lumps include:
- How did you notice the lump?
- What part of the breast is affected?
- How many lump(s) are present?
- Are both breasts affected?
- Has there been an injury to the breast(s)?
- What other symptoms are present?
Diagnostic tests that may be performed include:
- cytologic examination of nipple discharge (a study of
the types of cells)
- mammography
- needle aspiration
or open biopsy of the
nodule to see if the
fluid indicates a cyst
- thermography (similar to mammography)
- transillumination
- mammography to delineate a breast
mass
- ultrasound to detect
cancer.
- breast biopsy to
confirm or rule out suspected cancer in solid masses:
- needle biopsy involves removal of cells for evaluation
directly from the mass (can be done in conjunction with
needle aspiration procedure)
- incisional biopsy involves surgical removal of a
portion of the mass for evaluation
- excisional biopsy includes surgical removal of entire
mass for evaluation
After seeing your health care provider:
You may want to add a diagnosis related to a breast lump to
your personal medical record.
Update Date: 02/09/00
Updated by: J. Gordon Lambert, MD, Associate Medical Director,
Utah Health Informatics and adam.com
editorial
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