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By Jim Stallard Wednesday, May 29, 2024
Medical oncologist Dr. Janice Shen says an important first step after detecting a breast lump is getting a thorough physical exam from a specialist.
You might know how to check yourself for breast lumps, but do you know what to do if you find one? Janice Shen, MD, a breast medical oncologist at Memorial Sloan Kettering Cancer Center (MSK) Commack offers these recommendations.
It’s natural to worry if you feel something new in your breast. But Dr. Shen says, “It’s extremely common for women of all ages to find lumps and bumps in their breasts. The majority will turn out to be benign.”
Some, like fibroadenomas, are harmless clumps of breast tissue. Some, like cysts, are related to hormones and can appear during a woman’s menstrual cycle, during pregnancy, or when she’s breastfeeding.
It’s not possible to determine whether a lump is cancerous or noncancerous based on how it feels. Not all breast lumps feel the same.
Dr. Shen stresses the importance of getting a good physical exam from either your primary doctor or gynecologist. That means your doctor should do more than just feel the lump in your breast. “Make sure they do a thorough exam of the breast, including feeling around the collarbone and underneath the armpit,” she says. Your doctor should also examine your skin and nipples to look for any changes and compare your breasts side by side to look for any differences between them.
During your exam, you’ll also want to give your doctor some additional details, including:
“Based on your physical exam, age, and your risk of breast cancer, your doctor will help determine if breast imaging may be appropriate for you,” Dr. Shen says. Usually, screening starts with a mammogram. If the mammogram is inconclusive, your doctor may call you back for more imaging. But Dr. Shen notes that this happens frequently and is not necessarily an indication that anything is wrong.
If your doctor wants a closer look at something — or if you have dense breasts, which makes it difficult to see breast tissue on a mammogram — you might also get an ultrasound or MRI. People with a higher risk of breast cancer than the general population, plus a strong family history of breast cancer, should ask their doctor about getting an MRI.
In many cases, doctors can tell from a mammogram that a breast lump appears benign. Sometimes, though, doctors may need to do a biopsy to confirm that a lump is benign. A biopsy is usually performed by a radiologist, who will insert a needle into the breast to take a sample of the lump’s cells. You will be awake for the biopsy, but you will be given medications to decrease any discomfort or pain.
Being anxious and worried about having a breast biopsy is entirely understandable. Most times, biopsies do not show cancer. “The vast majority of the time we biopsy a lump in the breast, it’s not breast cancer,” Dr. Shen says. “We recognize the anxiety that comes with a biopsy. Most of the time, we are doing one just to make sure we’re absolutely positive, above and beyond, that we’re not missing any cancer.”
Dr. Shen recommends that women check their breasts for any changes once a month. She suggests the first of the month so it’s easy to remember, or right after completing a menstrual cycle (after your period ends) when breasts are less likely to be tender and lumpy.
“It is important for women to get a baseline sense of how their breasts look and feel on a monthly basis so that any new changes are easier to detect,” she says. However, she emphasizes that self-exams do not replace the need for routine breast cancer screenings with a healthcare professional.
Learn how to perform a self-breast exam.
“In the unlikely event that a breast lump turns out to be cancer, MSK is a leader in caring for people with all forms of the disease,” Dr. Shen says.
Recognizing that breast cancer isn’t one-size-fits-all, MSK has special programs in place for treating people with unique subsets of the disease, including inflammatory breast cancer, rare breast cancers, male breast cancer, and breast cancers in young women.
b cell lymphoma cancer MSK specialists also understand that healthcare goes beyond medicine and are here to support your mental, social, and emotional health. Dr. Shen says, “We have a team of experts ready to assist and help you along the way.”