Breast lump

Cancer

Report in 240Hrs

At Home

No Fasting Required

Details

To identify cancerous, precancerous, or non-cancerous changes

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Breast Lump - Comprehensive Medical Test Information Guide

Why is it done?
- Breast lump evaluation is performed to identify and characterize abnormal masses or nodules found in breast tissue through clinical examination, imaging studies, and tissue analysis
- Primary indications include: patient self-discovery of a palpable mass, clinical breast examination findings, imaging detection (mammography or ultrasound), or routine screening in asymptomatic patients
- Typical circumstances for performance: when a patient reports a new lump, during routine physical examination, as follow-up to abnormal imaging findings, or for monitoring of known benign lesions
- Determines whether a lump is benign or potentially malignant and guides decisions regarding further diagnostic workup, treatment options, and management strategies
- Helps establish a baseline for comparison with future examinations and assists in cancer risk stratification and prevention planning
Normal Range
- Normal finding: Absence of palpable masses, lumps, or nodules on clinical breast examination; breasts appear soft, symmetric, and without abnormal tissue
- BI-RADS Classification (Breast Imaging-Reporting and Data System) used for imaging interpretation: • BI-RADS 0: Incomplete - need additional imaging • BI-RADS 1: Negative - no abnormalities detected • BI-RADS 2: Benign finding - no malignancy • BI-RADS 3: Probably benign - <2% malignancy risk • BI-RADS 4: Suspicious abnormality - biopsy recommended (subdivided into 4A, 4B, 4C based on malignancy risk) • BI-RADS 5: Highly suggestive of malignancy - >95% malignancy probability • BI-RADS 6: Known biopsy-proven malignancy
- Size measurement: Normal variations include fatty involution and normal glandular tissue; concerning lumps are typically >1 cm in diameter, firm, fixed, or with irregular borders
- Characteristics of benign findings: mobile, soft, non-tender, well-demarcated, bilateral and symmetric, and lacking skin changes or nipple discharge
- Interpretation: Normal/negative result indicates no evidence of malignancy; abnormal findings require further characterization through imaging and/or tissue diagnosis
Interpretation
- Benign Lesions (80-90% of breast lumps): • Fibroadenomas: smooth, firm, mobile, well-circumscribed masses typically in younger women • Cysts: fluid-filled sacs that may be tender; ultrasound typically confirms benign nature • Fibrocystic changes: multiple lumps, tender, cyclical pain pattern • Papillomas: usually small, may present with nipple discharge • Fat necrosis: usually in history of trauma, mammographically characteristic
- Suspicious/Malignant Features: • Hard, fixed mass with irregular borders • Size >2 cm or rapidly enlarging • Skin dimpling, peau d'orange appearance, or skin retraction • Nipple retraction, discharge, or ulceration • Axillary lymphadenopathy • Associated pain in postmenopausal women
- Clinical significance of findings: • BI-RADS 1-2: Routine screening; no additional workup needed • BI-RADS 3: Short-interval follow-up at 6 weeks, 6 months, and 12 months • BI-RADS 4-5: Tissue diagnosis (biopsy) is indicated • BI-RADS 6: Known cancer; proceed with treatment planning
- Factors affecting interpretation: patient age (younger patients at lower risk), menopausal status, hormonal therapy use, family history of breast cancer, imaging modality used, and radiologist experience
- Clinical significance: Early detection and characterization of breast lesions significantly impacts prognosis; benign identification provides reassurance, while suspicious findings require expedited evaluation to exclude malignancy
Associated Organs and Conditions
- Primary organ system: Mammary gland tissue (epithelial, stromal, and adipose components); part of the integumentary system
- Benign conditions commonly associated: • Hormonal-responsive changes (fibroadenomas, cysts) • Inflammatory conditions (mastitis, abscess) • Injury-related lesions (fat necrosis) • Ductal abnormalities (papillomas, ectasia)
- Malignant conditions this test helps diagnose: • Invasive ductal carcinoma (IDC) - most common type (~70-80%) • Invasive lobular carcinoma (ILC) • Ductal carcinoma in situ (DCIS) • Lobular carcinoma in situ (LCIS) • Inflammatory breast cancer • Paget's disease of the nipple • Phyllodes tumors
- Secondary involvement in malignancy: Axillary lymph nodes (nodal staging), chest wall, pectoralis muscles, and potential distant metastases to bones, lungs, liver, and brain
- Potential complications of abnormal results: Anxiety and psychological distress, need for invasive procedures (biopsies), risk of infection from procedures, and potential for cancer diagnosis requiring extensive treatment
- Risk factors associated with abnormal findings: Age >40 years, family history of breast cancer, personal history of breast cancer, BRCA1/BRCA2 mutations, hormonal therapy use, obesity, alcohol consumption, and nulliparity
Follow-up Tests and Monitoring
- Imaging studies recommended: • Mammography (standard for women >40 years) • Ultrasound (superior for cyst characterization, evaluating palpable lumps) • MRI (for high-risk patients, silicone implant evaluation, or problem solving) • Tomosynthesis (3D mammography with improved specificity)
- Tissue diagnosis procedures if imaging is suspicious: • Fine-needle aspiration cytology (FNAC) • Core needle biopsy (CNB) - preferred method • Excisional biopsy (diagnostic and therapeutic) • Vacuum-assisted biopsy
- Laboratory/pathology tests for biopsied tissue: • Histopathological examination • Hormone receptor testing (ER/PR) • HER2 status (immunohistochemistry or FISH) • Ki-67 proliferation index • Genetic testing (BRCA1/BRCA2, if indicated) • Multigene assays (Oncotype DX, MammaPrint, etc.)
- Staging and metastatic workup if malignancy confirmed: • CT chest/abdomen/pelvis • Bone scan or PET-CT • Liver function tests • Complete blood count (CBC)
- Monitoring frequency for benign lesions: • BI-RADS 2: Annual mammography/clinical exam • BI-RADS 3: Ultrasound at 6 weeks, 6 months, and 12 months; then annual if stable
- Complementary information from related tests: • Clinical breast examination (every 6-12 months) • Breast self-examination (monthly) • Genetic counseling and testing (for high-risk families) • Risk assessment tools (Gail model, BRCA pre-test probability)
Fasting Required?
- Fasting requirement: No - Fasting is NOT required for breast lump evaluation
- Patient preparation for clinical breast examination: • Wear comfortable, easily removable clothing • Remove all jewelry from the neck and chest area • Empty bladder before examination • Avoid application of lotion, powder, or deodorant to breast area on day of exam
- Optimal timing: Schedule examination during follicular phase of menstrual cycle (days 5-10) when breast engorgement and tenderness are minimal; avoid luteal phase when hormonal changes increase lumpiness
- Preparation for imaging studies (mammography/ultrasound): • Wear two-piece outfit for easy disrobing • Remove all metal objects • Avoid antiperspirant or deodorant (may contain metallic particles) • Arrive 10-15 minutes early for check-in
- Pre-biopsy preparation (if tissue sampling required): • Fast 4-6 hours prior to biopsy procedure • Discontinue anticoagulants if safe to do so (under physician guidance): warfarin (5-7 days), aspirin/NSAIDs (3-5 days), newer anticoagulants (as directed) • Stop herbal supplements (garlic, ginkgo, ginger) 1 week prior • Arrange transportation as sedation may be used • Wear comfortable clothing; a sports bra is recommended post-procedure
- Post-procedure care instructions: Apply ice packs for 20-30 minutes; take over-the-counter pain relievers as needed; wear supportive bra; avoid strenuous activity for 24-48 hours; report excessive bleeding, severe pain, or signs of infection

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