Found a Breast Lump? Your Guide to Getting It Checked

Finding a lump in your breast can be worrying. You might wonder whether it is cancer, whether you should wait to see if it disappears or which hospital to visit. The first step is to have a new or unexplained breast lump examined. Many breast lumps are caused by non-cancerous conditions, but their appearance or feel alone cannot reliably tell you what is causing them. The World Health Organization (WHO) advises people with an abnormal breast lump to seek medical attention, even when it is painless.

Knowing what happens during an assessment can help you understand why a doctor may recommend certain tests and what those tests are intended to find.

Breast Changes That Need Medical Attention

A breast lump is one possible sign of a problem, but it is not the only one. Other changes include a thickened area in the breast or armpit, a change in breast size or shape, dimpling of the skin, a nipple that turns inward, or unusual nipple discharge, particularly if it contains blood. Changes to the skin around the nipple, such as scaling or a persistent rash, should also be assessed.

Benign breast conditions and other health problems can cause similar changes. However, a new or unexplained change deserves medical attention, even if it does not hurt.

The National Cancer Institute's guide to breast cancer symptoms explains the changes that may need assessment.

Where to Seek Care in Nigeria

A general hospital or teaching hospital is a practical starting point. You can visit the General Outpatient Department (GOPD) and explain that you have noticed a breast lump and need it examined. If a specialist breast clinic is accessible to you, you can contact the clinic to ask about appointments.

During the consultation, the doctor will ask about the lump and your medical history, then examine your breasts and armpits. The findings help determine whether you need imaging, a biopsy or an assessment by a specialist.

You do not need to identify the cause of the lump or decide which test to take before seeking care. The purpose of the first assessment is to establish what needs to be investigated.

Investigating a Breast Lump

Doctors assess breast lumps using the findings from a clinical examination and, when needed, imaging or a tissue sample. These methods provide different kinds of information, so one test does not automatically replace the others.

• Clinical breast examination: The doctor examines your breasts and armpits for changes and asks when you first noticed the lump, whether it has changed and whether you have other symptoms.
• Breast ultrasound: This uses sound waves to produce images of breast tissue. It can help the doctor assess the lump and determine whether further investigation is needed.
• Diagnostic mammogram: This uses X-rays to investigate a breast lump or another unusual finding. It is different from screening mammography, which checks for signs of cancer in people who do not have symptoms.
• Biopsy: This involves taking a sample of cells or tissue for laboratory examination. It may be recommended when the examination or imaging identifies an area that needs further investigation.

Not everyone needs all these tests. The appropriate investigation depends on factors such as your age, symptoms and clinical findings. A scan shows what the tissue looks like; a biopsy allows the tissue itself to be examined. When a biopsy is needed, the laboratory findings help doctors determine whether the change is cancerous or non-cancerous.

A recommendation for further testing is not a cancer diagnosis. It means the doctor needs more information to understand the finding. The National Cancer Institute's guide to breast cancer diagnosis explains how these tests are used.

Frequently Asked Questions

Can a breast lump be painless and still be cancer?

Yes. Some breast cancers present as painless lumps. The absence of pain does not rule out cancer, so a new or unexplained lump should be examined.

Does every breast lump need a biopsy?

No. A biopsy is recommended when further investigation of the tissue is needed. The doctor considers the clinical examination and imaging findings before deciding whether one is appropriate.

Will I need a mammogram if I find a breast lump?

Not necessarily. Depending on your symptoms, age and examination findings, the doctor may recommend an ultrasound, a diagnostic mammogram or another investigation.

Can men develop breast cancer?

Yes. Breast cancer is much less common in men, but it can occur. A new lump or unusual change in a man's breast should be assessed by a doctor.