>> There are a lot of reasons you
might feel a lump in your breast.
Sometimes what you're feeling as a lump is
actually a part of your normal breast tissue.
This is especially true if that lump is coming
and going at different times during the menstrual cycle
and that's because the breast is very sensitive to
hormonal changes that we see in the menstrual cycle.
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There are a lot of different types of breast lumps and many of
them are benign or non-cancer.
One of the most common types of benign or
non-cancer breast lumps is a breast cyst.
This is an envelope of fluid that has
no chance of turning into a breast cancer.
Another common breast lump is a fiber adenoma.
These are solid lesions, but again,
have no chance of turning into
a breast cancer and are very common,
especially in younger women.
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Another non-cancer benign cause of a breast lump is fat necrosis.
This can occur to the breast
after you've had trauma, for example,
if you've been in a car accident and the seatbelt at your breast.
Fat necrosis also has no chance of turning into a breast cancer.
We always hope that when you feel a breast lump,
it's not breast cancer, but there's always a chance.
Breast cancers don't change at different times of
the menstrual cycle and never gets smaller.
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If you find a lump, it's important to
let your primary care doctor know.
Your primary care doctor will probably do
a breast exam and then refer you to get breast imaging performed.
When you come in for breast imaging,
we'll usually do a diagnostic mammogram and ultrasound.
If you're under 30 years old,
we'll probably start with just an ultrasound exam.
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All breast imaging performed at Johns Hopkins is done by
a subspecialized breast radiologist
who only performance breast imaging.
At the end of your diagnostic appointment,
you'll get your results.
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A mammogram uses low dose X-ray is to image the breast.
The breast is compressed between
two plates to allow us to best see the breast tissue.
A 3D mammogram allows us to image the breast in thin slices,
which allows us to even better differentiate
your normal breast tissue from a breast cancer.
A mammogram uses different features
than an ultrasound in order to visualize the breast.
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Breast ultrasounds use high frequency sound waves
and convert that information into an image.
The primary advantage of a breast ultrasound is the ability
to differentiate a solid lesion from a cystic lesion.
A breast ultrasound is usually performed
following a diagnostic mammogram.
Sometimes for patients under 30,
we start with the ultrasound.
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At the end of your diagnostic
mammogram and ultrasound appointment,
you'll get one of three recommendations.
Hopefully, we'll be able to tell you with
certainty that the lump is benign.
We'll tell you this if the lump represents
normal breast tissue or a simple cyst.
If this is the case, then we'll recommend that you come back
in a year for your annual screening exam.
We also always recommend that you follow up with your doctor.
Any finding that we believe has
over two percent chance of being a breast cancer,
we recommend for a biopsy.
That's because as breast imagers,
we know that breast cancer is very common
and also very treatable when we find it early.
The breast biopsies are performed at one of our outpatient sites.
They're very safe and their well-tolerated.
They're performed by one of our subspecialized breast radiologist.
These breast biopsies use image guidance either with
ultrasound or mammogram to take
small samples of the suspicious area.
We use local anesthesia so you can
drive yourself back and forth to your appointment.
They leave little or no scarring.
We ask that you don't shower the day
of the biopsy or lift anything heavy,
but otherwise you can resume normal activities right away.
The third possible recommendation is a six-month follow-up.
We give this recommendation when we
believe a finding is almost certainly
benign but we don't want to let you go a
whole year before being imaged again.
We'll do a six-month follow-up appointment to make
sure that that finding isn't changing at all.
I hope that this discussion helps to
clarify what you should do if you feel
a lump in your breast and some other reasons that a lump can form.
Also if you're over the age of 40,
I recommend that you get scheduled for
a screening mammogram as soon as you can
because we know that screening mammography
is the best form of early detection.
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