What should you do if you discover a lump in your breast?

Q.
If a woman finds a nodule on her breast, does it have to be removed immediately? Does it matter if it is cystic?

A. Any time you discover a breast lump, you should see a doctor. But finding a lump does not always mean you will need a biopsy or surgery. This is especially true if the lump appears to be a simple cyst.

Breast lumps are common in women, especially during their reproductive years (between puberty and menopause). When there are multiple small lumps, they are usually noncancerous (benign). A single lump is more concerning.

My approach is to examine the area where the woman feels the lump. I then do a full exam of both breasts and check the armpits for lymph node swelling. If I feel the lump, the next step often depends on the woman’s age and when her next menstrual period is due.

The choices may include:

• repeating the breast exam at the end of the next menstrual cycle
• inserting a fine needle into the lump: if it is a cyst, fluid will come out
• sending the woman for an ultrasound or mammogram.

If I don’t feel the lump, I will have the woman return again next month, or order a mammogram or ultrasound during this visit.

Whenever a woman feels a persistent lump in the same spot in her breast, she should have it evaluated. This is true even if a prior exam suggested there was nothing to worry about.

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