Wednesday, October 23, 2013 at 10:59AM

At any one time in a woman’s life the term breast lump will come up as part of the discussion with a group of friends or closer to home having the discussion with the family.  The term breast lump is a generic term used to describe most any type of one sided breast mass from a small abscess to a cancerous lesion. The majorities of breast lumps occur in women from the ages of 30 to 50 and are benign (not cancerous).  More than half of women who present with any breast complaint will have a palpable mass. Of this group, over 70 % will be diagnosed with benign disease. Still, this is not reassuring to hear when this experience comes first-hand. 

When a physician confirms a palpable mass, he or she will offer reassurance and systematically begin to eliminate any diagnosis that can be treated and taken to resolution. A breast cyst aspiration is one such procedure.  This simple yet effective procedure is done in the office the same day and results in immediate resolution of the mass. An in-office aspiration is one of the most gratifying procedures performed as patients are always reassured and physicians feel confident in their diagnosis.  After the aspiration, the physician will follow the case to be sure the cyst has not recurred. 

There are certain instances when the aspiration either does not result in resolution of the mass, recurs or results in a blood tinged sample.  These instances are frustrating and will generally require further studies or a referral to a surgeon. Certain conditions such as skin infections, lipomas, cysts, hematomas or abscesses can present as a precursor or as a confounding factor to breast cancer, so the key is to have the physician follow any non-healing, persistent or recurrent lesion to resolution. 

On occasion, a physician will identify a lump as a dominant mass. This term is used to distinguish a suspicious mass from any lump, lumpiness or other non-suspicious, cyst-like lesions of the breast.  The term is used by primary doctors and surgeons to describe any mass that feels like it should not be there or stands out from the other lumps. A dominant mass trumps all negative history, lack of risk factors or prior history of cysts.  A dominant mass will incur further testing which will include:  1) A re-exam, 2) A mammogram and 3) A diagnostic procedure such as core needle aspiration, or an open biopsy.  This three tiered approach is crucial because it yields up to a 98% accuracy of findings.

As breast cancer month unfolds, it’s important to undertake a yearly review of your own risk factors, your family history and schedule any needed appointments with your physician. For more information on screening, diagnosis and management of breast lumps or dominant masses, please contact us and schedule your appointment for a free consultation. We offer well woman visits including experienced and detailed exams as well as in-office cyst aspirations. 

Risk Factors for Breast Cancer

  • Age greater than 50
  • Personal history of breast cancer
  • First generation maternal family history
  • Prior history of endometrial cancer
  • Early menarche, prior to age 12
  • Late menopause, after age 50
  • 40% or more overweight
  • Childless or first pregnancy after age 30
  • Prior history of breast problems
  • Any association of a lump to menses

Recommended Breast Cancer Screening for women of average risk

  • Yearly review of risk factors
  • Monthly self-breast exam starting at age 20
  • Yearly breast exam by a physician
  • Mammogram by age 50

M. Chavez, MD, SC