Breast Lumps and Biopsies
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Breast Lumps and Biopsies
What are the options for diagnosing a breast lump while nursing?
I've developed a lump that feels different from the plugged ducts
I've had before--it's larger, not painful, and doesn't go away
with hot compresses. It's on the underside, close to where the
chest strap of my bra goes. My doctor wasn't too concerned, and
given that I'm breastfeeding and plan to be for a long time, just
wants me to check in again in a couple months. However, this
practice doesn't have a lot of experience with nursing moms, and
I can't change doctors, so I thought I'd check in on the
collective wisdom. I see from the archives that mammograms can be
done while nursing, but what about biopsies? What have you and
your doctors done about lumps like this while breastfeeding?
Ask for an ultrasound of your breast. You can instantly see if the lump
is fluid-filled and most likely milk or a cyst, or if it is tissue and
needs further investigation. It's painless and won't hurt anything. I
had a cyst diagnosed this way when I was a teenager. Cysts are not
cancerous, just fluid and generally go away on their own after a while
I also developed a different lump when I was nursing my first child. My
ob sent me for an ultrasound, which she felt was a better option than a
mammogram. It was painless and was a good way to alleviate my concerns.
Find a new doctor asap. The first of my close friends is fighting breast
cancer this year. She found a small lump while nursing her 6 month old
and her MD dismissed it. She insisted on having it further checked out
and lo and behold, Stage 1 breast cancer. She is 39. She caught it very
early and her prognosis is excellent. She's almost done with treatment.
But it does happen. Get it checked Better safe than sorry
Hello -- I wanted to reassure your that your breast lump is probably
nothing to worry about... lactation induces many changes in the breasts
(understandably!), and sometimes lumps of fatty tissue appear. I
discpvered a lump in my breast 7 1/2 months into my pregnancy. My Kaiser
nurse practitioner suggested I get a sonogram to locate the lumps (I had
a cluster), and to get a view of their shape. Apparently the shape of
lumps is a relatively good predictor of what they might be. She
suggested that I NOT biopsy the lump during the pregnancy or while I was
breastfeeding, nor should I get a mammogram, both are too potentially
damaginfg to the milk producing tissues of the breast during pregnancy
The radiologist who reviewed the films indicated that it was very normal
to develop lumps duriong pregancy and lacattion, and that MOST lumps
that formed during this period were benign adn would go away eventually,
but that a VERY few forms of rare and aggresive breast cancers did
devlop during pregnancy...
that a sonogram could rule out the possability with near total certainty
(not complete, but near). I had a sonogram during the pregnancy and
again 6 months later when I had a followup appointment. Now that my
daughter has weaned I will schedule a followup mammogram. This is the
second lump I have had... I had a biopsy about 2 years b/f I became
pregnant... again nothing was found. It has made me take seriously the
need to do monthly self exams of the breast and to followup with
diognostic screening on the schedules suggested. Trust your instinct,
you konw what is normal for your body; take this seriously, but don't
Get yourself referred to a breast surgeon and try to have it biopsied.
Mammograms aren't always accurate. I was told to wait a few months after
finishing breast feeding to have a routine mammogram. I did that and the
mammogram came back negative.
However, just two months later I discovered a lump in my breast that did
in fact turn out to be cancerous. The mammogram didn't pick it up at
all. The only way to truly know the status of the lump is to have a
biopsy. At the very least you can get an ultrasound of the lump which
can also be effective in ruling out cancer.
I had a needle biopsy on a lump in my breast while I was nursing my son.
It turned out to be benign, & the process was simple & quick. If you
can't afford to change doctors, check with Planned Parenthood -- they
have lists of doctors who examine/treat women's breast issues, often
free or on the cheap!! Good luck!
I had a similar experience when breastfeeding my 1st kid - a lump that I
thought was a clogged duct but wouldn't go away via all the usual
methods. I finally saw a midwife in my dr's practice who immediately
diagnosed it as a fibrocystic lump.
She said they are very common during breastfeeding because of all the
hormonal changes, and that they typically go away by themselves (it
did). So it could be that your doctor is right.
Now this doesn't mean you should self-diagnose and assume your lump is
not worth checking out. Is there a way you can get in to see someone who
has more experience with breastfeeding patients? I have an HMO, but mine
allows me to see both my regular doctor and the OB who delivered my
baby, even though I no longer need postpartum care. (I see her for
stuff.) So you might try your OB and/or a midwife in his/her practice
who can advise you. And if you still think you need a mammogram, they
could probably help you with how that works for a breastfeeding mom
I am still breastfeeding my 13-month-old, and I dealt with this very
issue not 4 weeks ago. My doctor also gave me the all-clear after a
manual exam, but I was still distressed by the lump (which is in the
same place as yours, and fits the same description), so he suggested an
ultrasound. I believe this is the preferred method of screening for
nursing moms, so perhaps you could ask your doc for a scrip/ referral
for the procedure.
By the way, everything turned out to be fine. Apparently I have 'dense'
breasts that became even more nodular with extended breastfeeding, and
everything was exacerbated by my underwire bras (which I've since
ditched). Wishing the same outcome for you.
I found a breast lump while nursing and my doctor recommended a core
needle biopsy. For the procedure, I was wide awake, the area was
anesthetized. The doctor took four samples using a hollow needle. My
lump turned out to be a fibroid adenoma (sp?) and I didn't have to stop
By the way, I go to Dr. Lisa Bailey in Berkeley. She's got an excellent
reputation, a great personal style.
Hope this helps
- Been There
There is a whole lot doctors can do to figure out what's going on in
your breast without resorting to a mammogram. I had a mass the size of
a golf ball in my breast while I was nursing. It felt much harder than
a clogged milk duct and did not respond to hot compresses. All the
doctors thought it was a fibroadnoma. I went to see the breast surgeon
and she did an ultrasound and then a needle biopsy. Guess what? It was
a clogged milk duct. She anesthetized my breast, used a big needle and
pulled the gunk out. Good luck and best wishes with your breastfeeding
I had the same thing and my ob had me start with an u/s which showed it
was just a cyst. The u/s was quick, easy and painless. Seems like a good
place to start at least just a cyst
I am currently nursing and my OB found a lump. He thought it was
probably a plugged duct, but wanted to make sure and sent me to a
specialist, Dr. Consorti.
She did an ultrasound and found something that looked a bit suspiscious.
She performed a biopsy and it came back as a lactating adenoma, which is
non cancerous and basically calsified milk. Before the results came, she
did mention that if further testing was necessary that she could get a
better sample by taking a small sample surgically, but the risk of milk
fistula was great. That's when the milk makes it's way out of the
incision and becomes infected. Hope this information helps.
I can't speak specifically to a lump WHILE NURSING, but I will say that
my mom was told ''not to worry'' and ''to come back in a few months''
when she felt a lump on her breasts. She died of breast cancer. If you
feel something weird, don't wait. Don't listen to doctors who tell you
to wait. If its nothing, then great. You'll know for sure.
But if its something, you do not have a few months to wait to find out.
How can I say this without putting you into a panic? You need to get an
ultrasound and/or a mamogram NOW. I was nursing when I had the same
experience that you described, and now I am finishing radiation
I would rather have you irritate your doctor and be ''wrong''
and ''make a fuss over nothing'' than to under go a radical mastectomy
as I have- which might have been avoided had I gotten tested earlier,
but no one thought twice about it- not my doctor, not my lactation
consultant, not my midwife- because I'm young, I'm healthy, breast
cancer doesn't ''run in the family'', I was nursing, it's just tissue
changes, it's just a blocked duct, cancer doesn't hurt the way you're
describing, yadda yadda yadda....
Bottom line- you need information, not soothing. There are some kinds
of breast cancers that thrive on estrogen, so women do get them after
pregnancy. Push your doctor for an
ultrasound- this will give a general idea of the abnormality.
The tech that did mine said- OK, what are you doing this afternoon, can
you stay and have your mammogram now? He knew right away it was serious
sh--. Then after the mammogram they wouldn't let me leave until the
doctor spoke with me.
Sadly, it was a year and a half after I noticed the problem that the
ultrasound was done & by then the tumor was really big.
I am glad that I got to nurse my daughter until she was two (I might
have had to end nursing sooner if I had been diagnosed sooner), I'm glad
that I have had great treatment, but damn- I miss my breast. I miss my
lymph nodes in my arm. I miss taking life for granted. If you want
support- I'll go with you- just don't ignore the little voice inside
that says ''it doesn't feel like nothing. I think there's something
I had to repsond to yoru question about a beast lump while nursing. I
am going through the same thing right now. Although it does not present
itself like normal mastitas, mine is still an infection. In fact, it is
a non painful absess and needs to be treated with antiobiotics or it
will become a bigger problem. I would suggest you see a breast surgeon.
My ob tried to aspirate my lump and when she realized it wasn't a milk
duct she sent me to a surgeon. He is also doinga tissue culture to rule
out any kind of other benign or malignant lump. I am continuing to
breastfeed and it doesn't look like I will have to quit even if I need
I also found a breast lump while nursing. It was in a differnet place
than yours and it wasn't painful. I had my obgyn check it out. She
thought it was clogged duct but had me get an ultrasound to be sure. I
was told they cannot do mammogram on nursing women. The ultrasound
didn't detect a mass but just to be sure, I am to go back in six months.
Maybe you should request an ultrasound for your piece of mind. Good
I am 42 and recently had my first mammogram (delayed getting
this done earlier due to interruptions in insurance.)
They found a very large mass and I was given a core-needle
biopsy -- thankfully it turns out to be a fibroedenoma, a
benign lesion. Apparently common in your 20s and 30s (estrogen
sensitive) and less so in women my age and older. No one I have
talked to about this among friends and family have ever heard
Although this mass is the size of a lemon, it was not something
I ever noticed -- or even the two physicians who have been
giving me breast exams. My breasts are quite large -- about an
E cup -- and you can ony really feel it if I am lying on my
side so that most of the breast falls out of the way and there
is less fat/tissue to feel through. Also, because of its size,
when I do feel it, I can see that I though it must have been
ropey tissue -- it wasn't the kind of ''lump'' I would have been
I have a follow up mammogram in a few months to see if the size
has changed, and they may decide to take it out, or not. It
doesn't necessarily lead to cancer and may shrink with age --
or grow larger. I do feel some twinges of pain there sometimes.
Will taking out something so large cause my breast to have a
big dent? Doctors say probably not, but can't say for sure.
Does anyone have any experience with this? It's amazing that
with all the breast awareness promotion out there, no one has
much to say about this.
If you are an E-cup and the fibroadenoma has to come out, talk to your
doctor about a referral to a plastic surgeon. Your insurance should pay
for a reduction (or reconstruction) so you match bilaterally.
I had two fibrous lumps removed from my breasts in my 20's. It was
outpatient surgery - quick and easy. My impression is that women with
larger breasts are prone to these benign tumors. They really aren't
harmful, but I think medically, the consensus is that they should be
removed. While this may not be an option for you, after my breast
reduction, I never had another one of these lumps appear.
There is a very informative article in the oct. issue of Organic Style
(saw it at my hairdressers!) that explains the fibroadenoma. And
further says that, though it isn't a precursor to cancer, it can be sore
particularly around the menstrual cycle. It also suggested that laying
off caffeine may help reduce discomfort.
Mom with similar symptoms
I had a fibroadenoma removed at age 28. It was about the size of a
ping-pong ball, and my breasts are fairly small (B-cup). There was no
dent whatsoever after the surgery, though there was a small scar (much
smaller than the diameter of the tumor). Recovery from the surgery was
painful and awkward for a few days, but my doctors told me it was really
a good idea to prevent ambiguities with future breast exams. I was just
so thrilled not to have cancer (they had told me it was a 50/50
chance!), the experience was weirdly exhilarating. I have never had any
problems or other lumps in the 5 years since then, and have had no
problems breastfeeding on
Don't worry. Doctors could be more helpful about your fears, but it's
unlikely to be a health threat. Talk to a surgeon. I had my first
fibroadenoma 25 yrs ago, when I was 19. Back then they couldn't explain
a thing, so it was scary & painful, size of a ping-pong ball on my
then-size A breast. No dents, just a long scar, which bothered me then,
but not anymore (and it faded). It probably won't affect a size E,
though if it's buried deep they'll cut a little tissue to get to it. I
had my second one a few years after that, but it was small, and not
painful to have or to remove. I found a third one a few years ago at the
age of 40 or so. It is NOT UNCOMMON for a physician to miss it! In my
experience, only the surgeons know how to find & diagnose them.
Neither the physician nor any of her NPs ever found it. (They'd declare
me lump-free, and if I showed them, still couldn't find it, & told me
not to worry.) I've had breast exams by surgeons and regular docs & NPs
for 25+ years, and most don't do a proper breast exam. (Kaiser used to
schedule regular exams with a surgeon once you've had a tumor, w/ an HMO
the only way you can see a surgeon is to insist! So after INSISTING on a
surgeon, whaddya know, they found the new tumor, and did a core-needle
biopsy (which wasn't an option with my first tumors), and it was benign.
Since then it either shrunk or disappeared into the mass of my nursing
breasts (I scheduled one more surgeon appt when nursing). Sometimes it
hurts. So make an appointment with a surgeon. They can tell a lot from
the biopsy & ultrasound, and the shape and characteristics of the tumor
whether it's likely to be cancerous. The surgeon can help you understand
risks and learn more how to recognize the difference between a tumor or
a cyst-which are other lumpy growths that are not problematic (I happen
to have lots of those too). ASK QUESTIONS! In my case I felt much better
leaving it be after talking to the surgeon. Be assertive with your GP.
If you have it removed, don't worry. The pathologist will look at it and
reassure you, and it will probably be a local anesthetic procedure,
short- lived. My first tumor started out small and grew, so I'd agree
it's a good idea to take it out if it's growing (easier to remove it
when smaller, plus you don't want worry about changes). For the pain,
cut out caffeine. Vitamin B & E supplements also worked for a while-I
think the B vitamins have a diuretic effect. Pain is probably b/c the
tumor is pushing other tissue.
I had two rather large fibroadenomas removed a few years ago and neither
left any sort of indentation. I still have faint scars from the
surgery, but that's it.
I was told I might have difficulties breastfeeding (or a weaker milk
supply in that
breast) ... but I had my first child six months ago and that has
certainly not been the case. In fact, my milk supply is greater in that
breast than the other.
So from my experience: I have had no problems with fibroadenoma removal
and would make that choice again should I develop another.
When I had my daughter in June, I found a lump in my breast
about when my milk came in. Ultrasound has confirmed it is not
a milk cyst because it is solid. The usual recommedation is to
biopsy with either a needle (getting a core sample of tissue)
or by surgical removal of the lump. However I'm told because
I'm breastfeeding, breast milk will probably leak out the
incision, perhaps as long as I am lactating.
Because I suspect it is benign (I have had a benign lump (a
fibroadenoma), removed before, my mother also had multiple
fibroadenomas, my PCP and a surgeon I've consulted also say
it ''feels'' like a fibroadenoma), I am considering putting off
biopsy/removal of the lump until after my baby is weaned, or at
least until she is primarily on solids. Breastfeeding has not
been easy for us and of course I want to avoid making it more
difficult than it already is. SO here are my questions: Does
anyone have experience with getting breast surgery while
breastfeeding? If so, did milk leak out the incision, for how
long, and would you recommend your surgeon or oncologist?
I had a fine needle aspiration done while I was nursing for a
similar situation. There did not seem to be a problem with
Please don't put off getting the lump biopsied, specially since
putting it off until you are finished breast feeding may mean a
year or two? (Since your child is still so young.) Plus, when
hopefully they'll confirm this is benign, you won't have it
hanging over your head for so long.
I had a stereotactic needle core biopsy done while I was
still breastfeeding, where they remove a ''core'' or sample of
tissue. My surgeon, who is very nice and seems to be very well
respected, was Barry Gardiner. His nurse, who really is the one
you talk to a lot, is terrific. But they're in San Ramon, and
it's a trek from Berkeley, but I think was worthwhile. However,
this type of biopsy is not done by a surgeon, but rather a
radiologist, since they use mammographic images to guide the
needle. I don't know if they would recommend this for you. I
know the surgeon didn't want to do the surgical biopsy because of
concern that milk would leak and there would be possibilities of
infection. But with the stereotactic, they weren't very
concerned about this -- stereotactic was also the more
appropriate procedure in my situation anyway. The radiologist
did suggest that I not! nurse on that side for a day or perhaps
two? (I can't recall), to not contaminate the milk with traces of
blood. They said I may see some blood in the milk from that
side, but I never did. I don't know if it's really a health
issue if there are traces of your blood in the milk to be honest.
My child was older and so not nursing for that amount of time on
one side didn't seem problematic, and I don't know if you've
already tried pumping which is what you'd have to do. But I
still think going forward with a biopsy, if that is what the
doctors are recommending, is definitely worth it. La Leche
League also has some information on their website, and perhaps
some of the lactation consultants would be able to talk to you
more about how to do this without impacting the breast feeding.
An update: after two surgical consultations, we decided to take
a cell sample by fine needle aspiration (quick and painless),
which revealed a lactating adenoma (i.e. benign)! Great news
for me and for continuing to breastfeed w/o further
complications. Thanks for those who responded. mc
A few months ago I discovered a lump on my breast. My MD said it felt very
typically like a fiberous lump, nothing suspicious about it. I had a
mammogram done and he called to say nothing suspicious showed up, don't worry
about it.....however, I keep thinking about it and keep checking to see if
it's still there....it is.
I'm going to see someone for a 2nd opinion, but I'm wondering what some of
you in the health related field (or have experienced same) know about various
kinds of breast lumps, tissue, etc. Is it a good idea to have this lump (not
very big) removed even if it's totally benign? Will it go away? What does a
fiberous lump feel like compared to a cancerous lump?
Any info will be helpful. Thanks. Anonymous please
I went through the same ordeal a few months ago. I did mammogram,
ultrasound, X-ray, and core biopsy. Try to see a breast surgeon or breast
specialist for advice. I highly recommend Dr. Charles Jenkins, he is a
specialist on diseases of the breast and thyroid. He is very thorough. His
office is near Alta Bates, 2435 Webster St. (510)486-0818 I also recommend
"Dr. Susan Love's breast book" by Susan Love. A very good resource. Barnes
& Noble has it for $20 or check with your local libraries. Best wishes!
I have gone through what you are going through. This has happened twice.
Both times, I had mammograms first. In my case they did see the lump and
so I was referred to a surgeon to do a biopsy. When I got to my appointment,
the surgeon felt the lump but the room had not been set up correctly and he
had to leave to get something. When he returned, neither one of us could
find the lump! He chalked it up to a cyst that burst. Several years later (I
think 4), in the same spot it reappeared. This time I made it all the way
through the biopsy and it came back fine. I understand your concerns and
empathize with your anxiety. But, the progress that has been made even in
the last 6 years has been great and if the mammogram reads fine, than this
should help to allay your fears. I still have this lump, sometimes more
evident than others. I've been told that cancerous bumps are hard and don't
move with the tissue as much as fibrous ones. If this becomes consuming,
than by all means get a second opinion but I too have been there and
all is well. Good luck!
You should request to see a surgeon if you are concerned about the
lumps. This will give you some reassurance. If you had a mammogram,
ask them what they thought the lump was. If they thought it was a
cyst, don't worry about it. If they thought it was a benign fibrous
tumor, ask more questions about how they know, and what they know. I
have had 3 tumors over the last 20 years, the first when I was 19 and
it scared the heck out of me. The surgeon kept checking it rather than
taking it out, b/c the chances of it being cancerous were so low. When
it started growing and changing rapidly, we took it out in an
outpatient procedure, using novacain as an anesthetic. The second I
took out right away. The larger they are, the more uncomfortable to
take out. And it's not a horrible procedure, but it's not
comfortable. Plus, any movement in your breast can hurt once it's
out. With my third, the reg. med doctor didn't believe I had a lump.
I insisted on getting it checked out and getting a mammogram. The
surgeon was confident that it was benign, but I still had a biopsy,
which is somewhat less trouble than taking the whole thing out:
essentially a doctor finds the lump via ultrasound, uses that to guide
a biopsy needle, which is kindof like a gun, that shoots into the
tumor and draws out a sample. It's also a little shocking and
uncomfortable, and aches for a while, and takes a few days to a few
weeks before you feel normal again. The sample is investigated at the
cellular level for abnormalities. A few things you should know (and
again, best to have a surgeon walk you through this and correct any
potential misconceptions that I have): tumors tend to be loose,
whereas cysts tend to be connected to the rest of the breast
tissue. Cancerous tumors tend not to be regular in shape, or smooth in
shape, whereas benign tumors tend to be smooth, oval or roundish. (My
surgeon explained this to me). Ultrasounds and mammograms generally
indicate whether a mass is likely to be benign or malignant, but its
not foolproof. Biopsies increase that likelihood, but are not
foolproof (e.g., cancerous cells could be somewhere in the far end of
the tumor in an area not sampled-it's just not likely). You can choose
to have it taken out anyway, but in my case I asked lots of questions,
and feel confident that this one is another benign growth. If it
changes, I'll ask for another u/s biopsy, and go back to the
surgeon. Cysts and tumors tend to be associated with caffeine and high
fat foods. I've been told by many different doctors to have NO
caffeine, since I also have cystic breasts. No one has ever explained
to me what the association is based on. The important thing in my
opinion is to ask as many questions as possible, read about it if it
helps, and to make an informed decision that's right for you, once you
understand all the risks and statistics. Keep in mind that most lumps
are not cancerous, so don't spend the next month completely frantic
about it. Hopefully you'll also get some replies from cancer
survivors, who will have a different perspective than me.
did you see an gp or a gyn about the lumps? apparently gyns aren't as good
at realizing when they are malignant, they are more in the ob/gyn business.
my best friend (who is now 41) consulted her gyn about a lump and was told
it was fine, then 7 months later got worried and pushed the issue and it
turns out it was malignant, she's just started treatmenet. she found out that
a lot of women had similar experiences when they asked their gyn about
lumps, that a general md was better at telling which was which. i odn't know
why but if you get a second opinion you might try a gp not a gyn.
I had a very similar experience. I developed a lump in my breast while
breastfeeding my infant daughter. My gynecologist immediately referred
me to a surgeon to have it removed. I met with the surgeon and
immediately disliked him. I have a lot of physician friends so I asked
around for advise. They all suggested I have a fine needle biopsy
prior to surgery. I went to UC Davis Med Center in Sacramento (they
have two days a week where they do almost a "drop in" breast
biopsy). You only need to make an appt. one day in advance. The biopsy
doesn't hurt and the doctors are kind and caring. They give you the
results immediately, too! They just take the sample and look at it
under a microscope (they're also cytologists and pathologists). Of
course, if the sample is benign, they give you the standard "the lump
could be heterogenous and there is a small chance we just didn't
biopsy the part with the malignant cells" disclaimer. However, they
puncture the lump over 16 times and look at cells from every puncture,
so it's a pretty good sample, and I was confident in the results. My
lump was benign. I did eventually have it removed, but I was able to
take my time and find a surgeon that I liked to do it. One more note,
my gynecologist felt it should come out or be biopsied immediately,
because she believes you can not tell from feeling or ultrasound if
the lump is benign. She said she's had people that were told by a
radiologist that the lump was benign when in fact it was not. After
all my reading on the subject I've decided she's right. No one can
tell benign or malignant for sure unless they biopsy it. Also,
although I knew the lump was benign, it still bothered me a lot and I
feel much better with it gone. I really think you need more
information or your mind will not rest. Hope this helps, and feel free
to email me if you have questions.
You should get an
opinion from a good GYN who has experience with breast exam. It is quite
common to do a needle biopsy on the lump in the office (no more painful
than the dentist) and send it out for pathology to relieve everyones concerns.
It is usually fully covered by most insurance. The non- insured cost is @
$250.00 including labs - which may be worth it for peace of mind. Often the
biopsy itself will cause certain types of benign lumps to dissolve on their
own. As you probably know, many women have naturally fiberous breasts,
but that does not change the need to take a persistent lump seriously. You
should get a copy of Dr. Susan Love's Breast Book - in any bookstore in
Berkeley - and read the chapter on lumpy breasts. Good luck.
Don't fool around with breast lumps. I'd go to Oakland breast surgeon Lisa
Bailey, MD, 883-1095, for a second opinion.
Your lump is probably fibrous, based on what you described. However,
it's good that you are pursuing follow-up anyway. And if it changes in
size, you should definitely follow-up. And mammograms are not
failsafe. If you're really concerned, it's best to go to a doctor
really qualified to do a breast exam. I recommend the breast health
center at UCSF. 415-353-7111. A surgeon/nurse practitioner can see you
there. Or, in the east bay, Barry Gardiner is a surgeon in Oakland who
is highly qualified in doing breast exams. I am responding as a breast
cancer survivor who was diagnosed at 32 and as a pharmacist. I
hesitated responding for fear of being alarming, but, although your
lump sounds fibrous, a second opinion is always important.
To the woman with a breast lump:
It's good to take these things seriously; 80 percent of breast lumps are
benign, but you want to know for sure if yours is in the 20 percent. I would
recommend getting a second opinion from someone who deals with breast
lumps all the time, like a breast surgeon. The person I have seen and whom
I really respect is Dr. Lisa Bailey. She's on Milvia Street in Berkeley. I'm
not sure what kind of insurance she takes, so you may want to ask about
that. She may recommend a sonogram or maybe she will recommend
nothing. This may help give you peace of mind.
I had a similar experience with breast lumps several years ago and I know it
can be very scary. My GP said she had read that there was an association
between fibrous breast lumps and caffeine consumption. I knocked the
caffeine out of my diet (switched to de-caf coffee for that all-important
morning cup) and, for me, the results were strikingly positive. The lumps
were gone within about four months and have not returned. (It's been about
8 years.) This may not work for everyone, but it's worth a try just for the
peace of mind it might bring, as it did for me.
an anonymous Mom
I am a Physician Assistant and have worked in the area of Women's
Health for several years. I can give you some general information
about breast lumps and what standard practice is regarding medical
management. First of all, a large percentage of women (maybe even
50%) have fibrocystic breasts, which is a benign condition due to
cystic (fluid filled) lumps. These lumps may get tender at certain
times of the month, like 1-2 weeks before the start of the menstrual
period. They may go away or change throughout the month, or they may
persist. Drinking caffeine may contribute to their presence. In
general, lumps that are more worrisome for cancer would be more solid
and fixed. It is of course best to let your medical provider
determine the qualities of any lump. Your risk should also be
determined. For example, if you're 40 or older, or you have a family
history of breast cancer, that should be considered. If a lump feels
fibrocystic, you provider may decide to have you return after your
next period. The lump may be smaller, which would point towards a
benign process. When a mass persists, often a surgeon is consulted
for a second opinion. They may evaluate further using ultrasound, a
fine needle biopsy (to see if it's fluid filled), or tissue biopsy.
They may just recommend a removal depending on circumstances. A
mammogram may or may not be done. This is not as effective a tool for
younger women with more dense breast tissue, for example. If your
specialist is convinced that the lump is just fibrocystic, especially
after a second opinion, there is not much reason to remove it. It has
been evaluated and should be monitored for changes, but it is not
pre-cancerous. Women should do a monthy self exam after their period
and have a clinical exam yearly, or as recommended by their provider.
Remember that most breast lumps are not cancer, but they do need to be
evaluated. Good luck to you.
I have had what I think are called fibrocystic lumps which early on in my
twenties turned into a big scare for me sending me in for a mammogram, etc.
But they were nothing, and I've had other lumps I've asked about at various
check-ups and the nurse practitioner or doctor always seemed to be able to
tell the fibrous ones. And they do go away on their own. However, it scares
me to think I might miss something cancerous since I've gotten used to
having lumpy breasts (different since breastfeeding, however). I just found
a ton of information on this subject at
I encourage you to ask your doctor to refer you for a second opinion on your
breast lumps. While the chances are that they are benign, all lumps should
be evaluated carefully. If the mammogram shows nothing, an ultrasound
should usually be considered. There are "Breast Centers" at Alta Bates (at
the Herrick Campus) and at Summit Hospital, where you can get more
information and referrals. Good luck!
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