I Found A Lump In My Breast – What Should I Do?
You’d think that all my friends were participating in breast cancer awareness month – first the abnormal mammogram scare, now a new email from a young, worried friend: “I found a lump in my breast. What should I do?”
My friend is 28 years old, with no family history of breast cancer. However, I take all lumps seriously because my husband’s sister was diagnosed in her early 30′s, after complaining of some hip pain followed by an x-ray which revealed diffuse metastases. Nonetheless, it bears repeating that a breast lump in a woman in her 20′s is highly unlikely to be cancer. For those of you out there who have found a lump in your breast, here are the statistics:
- An estimated 90% of breast lumps are benign (and that includes lumps in significantly older women).
- The number one risk factor for breast cancer is age. The risk of a woman in her 30′s having breast cancer is <0.43%. The National Cancer Institute doesn’t have per cent risks for women in their 20′s but I’m sure it’s even lower.
- Fibrocystic breast tissue occurs in up to 60% of all women, and has a lumpy texture.
- Breast cysts are fairly common, up to 7% of western females have a breast cyst at some point in their lifetimes.
- Breast lumps often occur in response to normal hormonal fluctuations in the menstrual cycle
So if you find a breast lump, you should have it evaluated, but please keep in mind that there’s a 60% chance that it’s due to harmless fibrocystic changes, and (if you’re in your 30′s) a 0.43% chance that you’ll develop cancer. Indeed, most lumps are benign at all ages.
The next step in a lump evaluation is to have an ultrasound and if you’re over 35 to also have a mammogram, and then if the clinical images warrant it, a biopsy to confirm the contents of the lump. Also keep in mind that once you’ve had a biopsy, you can expect some scarring which could be read as “abnormal” in future mammograms. So don’t be surprised if you get an abnormal mammogram later on after the biopsy.
Breast cancer awareness is very important and can save lives, but on the flip side it can also make us paranoid about our breasts. My advice would be to take any lumps seriously, but also know that it’s not cancer until proven so – and that most women have breasts with a somewhat lumpy texture, so if you don’t have any lumps, you’re technically in the minority.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
Very well said, Val, except for one thing.
ALL palpable lumps (lumps you can feel) need an ultrasound, regardless of age. Some lumps (including a few that are cancerous) don’t show up on mammograms. The single biggest mistake in managing a breast lump is ignoring it after a negative mammogram. If you can feel it, you need to know what it is. Period.
What this means, when you stop to think about it, is that the mammogram (in women over 35) isn’t really to evaluate the lump, since you’re going to ultrasound it and decide on biopsy based on factors other than mammogram results. Technically, the mammogram is to make sure there isn’t something else — something you haven’t felt — that might be suspicious. You’d be surprised how often a woman has a benign fibroadenoma in one breast and a tiny, early cancer in the other. (Cue the spiritual discussions of God’s mysterious ways.)
Excellent point, Dino – I slightly revised my blog post to reflect your suggestion so as not to mislead others. Thanks again for the clarification!
Nice post (& comments).
Thanks for the revision. No more quibbles.