Should My Friend Get a Breast Biopsy for a Lump? Expert Advice Needed

Is a biopsy of the left breast necessary?

Hello, doctor.
I have a female friend who is about 26 years old (she started menstruating around 13 or 14).
She is unmarried and has discovered a hard lump in her left breast.
She has consulted both China Medical University Hospital and Changhua Christian Hospital, where she underwent ultrasound examinations.
The doctor at China Medical University Hospital recommended a biopsy, while the doctor at Changhua Christian Hospital suggested it might be fatty tissue and advised a follow-up in three months.
Given these differing diagnoses, should she proceed with the biopsy at China Medical University Hospital or wait for the follow-up at Changhua Christian Hospital in three months?
Additionally, I have some questions for the doctor.
If the lump is indeed a malignant tumor, will delaying the biopsy and waiting for three months to follow up affect her condition? Furthermore, if it is a malignant tumor, will performing a biopsy lead to further spread and worsen the situation? She is feeling very scared and confused.
Could you please provide your professional advice?

Xiao Ming, 20~29 year old female. Ask Date: 2003/05/07

Dr. Lin Shuilong reply Surgery

Director Lin Shui-long of Tainan Hospital, Department of Health, responded: Hello, Xiao Ming.
Generally, when a physician diagnoses a condition similar to a malignant tumor, they will recommend an immediate biopsy.
If it is confirmed to be malignant, a radical surgery will be performed to prevent further spread.
If the diagnosis is more likely to be benign, observation for a few months followed by a follow-up appointment may be suggested.
Some physicians may recommend immediate removal of the tumor.
Therefore, in your case, you should ask your physician to clarify whether the diagnosis is malignant or benign.
If it is malignant, immediate surgical intervention is necessary; otherwise, surgery is not urgent for your overall health.

Reply Date: 2003/05/07

More Info

When it comes to the concern of a breast lump, especially in a young woman like your friend, it is crucial to approach the situation with caution and thoroughness. The differing opinions from the two medical institutions she visited highlight the complexity of breast health assessments.
Firstly, a breast lump can arise from various causes, including benign conditions such as cysts or fibroadenomas, as well as malignant tumors. The fact that your friend has already undergone an ultrasound is a positive step, as this imaging technique can provide valuable information about the characteristics of the lump. However, ultrasound alone may not be definitive in determining whether a lump is benign or malignant.

The recommendation from the Chinese Medical University for a biopsy suggests that the physician there may have identified features of the lump that warrant further investigation. A biopsy is a procedure that involves taking a small sample of tissue from the lump to be examined microscopically for cancer cells. This is often the most reliable way to ascertain the nature of a breast lump. On the other hand, the recommendation from Changhua Christian Hospital to wait three months for a follow-up suggests that they may believe the lump has benign characteristics that do not require immediate intervention.

In terms of your friend's concerns about the potential for a malignant tumor, it is important to understand that early detection and diagnosis are key factors in successful treatment outcomes for breast cancer. If the lump is indeed malignant, delaying a biopsy could allow the cancer to progress, potentially complicating treatment options later on. However, it is also important to note that a biopsy itself does not cause cancer to spread. The procedure is generally safe and is performed with the utmost care to minimize any risks.

Given the conflicting advice, it would be prudent for your friend to seek a third opinion, preferably from a breast specialist or a surgical oncologist who can provide a comprehensive evaluation of her situation. This specialist can review the ultrasound results, discuss the need for a biopsy in detail, and help her understand the implications of either decision.
Additionally, if your friend is feeling anxious or fearful about the situation, it may be beneficial for her to speak with a counselor or support group. Emotional support is an important aspect of dealing with health concerns, especially when facing the possibility of a serious diagnosis.

In summary, while the decision to proceed with a biopsy or wait for further evaluation is ultimately up to your friend, it is crucial that she feels confident in her choice. Seeking a third opinion from a specialist can provide clarity and help her make an informed decision. Early diagnosis and intervention are vital in breast health, and addressing her concerns promptly will contribute to her overall well-being.

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