Head, neck, and breast disease

Breast lump management

What is a breast lump?

A breast lump is a lump in the breast that grows over time. Breast lumps come in a variety of sizes and textures and can be painful or not. Some are only discovered after a physical or imaging examination. Most breast lumps are harmless (non-cancerous). The significance of finding a breast lump is to differentiate the harmless from breast cancer. A lump can be found by a patient performing a breast self-exam or by a health care provider performing a physical check-up.

Suspicious lumps can also be found during annual mammography screenings. Breast lumps can also occur in men.

How are breast lumps diagnosed and evaluated?

Most breast lumps are harmless (not cancer). Imaging examinations are frequently used to determine whether a lump is cancerous. One or more of the imaging tests listed below may be performed:

  • Mammogram: Mammography examines the breasts using low-dose x-rays. The breasts are exposed to a modest amount of ionising radiation to produce images of the inside of the breasts.
  • Breast ultrasound: Breast ultrasonography creates images of the inside of the breasts using sound waves. Breast ultrasound can capture pictures of parts of the breast that mammography may not be able to view. It can also assist in determining whether a lump in the breast is solid or fluid.
  • Breast MRI: Breast MRI creates comprehensive images of the inside of the breasts, using a high magnetic field, radiofrequency pulses, and a computer. Breast lumps that are not evident on mammography or ultrasound can be evaluated with an MRI.

A biopsy may be required if these tests do not clearly reveal that the lump is benign. One of the image-guided methods listed below may be used:

  • Ultrasound-guided biopsy: A radiologist will use ultrasound imaging to locate the lump, then provide local anaesthetic before inserting a small sampling needle into the bump to retrieve tissue for examination under a microscope.
  • Stereotactic (x-ray guided) biopsy: A radiologist will provide local anaesthetic and then position a sampling needle at this spot to collect thin tissue samples for further evaluation, utilising a digital mammography x-ray machine to scan the area of concern.
  • MRI-guided biopsy: A radiologist will provide local anaesthetic and then place a sampling needle at the location of concern, utilising an MRI machine to locate the area of concern. Thin tissue samples will be removed for further assessment.
  • Percutaneous image-guided core breast biopsy: For diagnosing breast lesions, percutaneous image-guided core biopsy provides an accurate, quick, minimally invasive, and less expensive alternative to surgery.
  • Open breast biopsy: An open breast biopsy is a procedure that removes abnormal breast tissue through surgery.


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Breast lump treatment

The definitive management of a breast lump is to distinguish benign disease from breast cancer or treating symptoms. Unfortunately, some benign breast lumps might still need surgery. Surgery is frequently undertaken if a definitive diagnosis cannot be made or a clearly benign mass is symptomatic. In other words, there is a lump, and we know it is benign, but it is causing enough symptoms to warrant surgical removal. For the management of malignant breast lumps, please refer to the breast cancer information page.

 

FAQ

1How long does a breast biopsy take?
A breast biopsy typically takes between 30 minutes to an hour. This is done as a day procedure, and the patient will be admitted in the morning and go home in the afternoon. The results of the histological analysis typically take three days.
2How long does recovery take?
Most open breast biopsies done for breast lumps require a drain placement. This will be removed the day after surgery. Dr Bruwer usually advises 2 to 3 days off work. The tenderness should subside within a week, and the bruising should vanish after two weeks. Swelling and firmness may continue for 6 to 8 weeks.