Should You Remove a Breast Nodule: Atypical Findings? - Breast and Thyroid

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Nipple lump


Previously, a tumor was found 2-3 cm below the areola, and after examination, the doctor indicated that it was atypical, falling between benign and malignant, and recommended surgical removal.
However, in the past few days, as my menstrual period is coming to an end, the lump has noticeably decreased in size.
Is surgical removal still necessary, or should I seek a second opinion from another hospital?

wa, 20~29 year old female. Ask Date: 2006/03/25

Dr. Wu Jingtang reply Breast and Thyroid


Dear Miss Anette: Based on your description, it is more likely to be a fibroadenoma.
However, since it has already reached 2-3 centimeters, you should see a breast surgeon for further evaluation.
Wishing you good health.
Dr.
Wu

Reply Date: 2006/03/25

More Info


When faced with a breast nodule that exhibits atypical findings, such as being described as "between benign and malignant," it is essential to approach the situation with a comprehensive understanding of the implications of these findings. The recommendation for surgical removal often stems from the need to ensure that any potential malignancy is addressed promptly, especially when there are atypical cells present in the biopsy results.

1. Understanding Atypical Findings: Atypical cells in a breast biopsy can indicate a range of possibilities. They may suggest that the cells are not normal but do not definitively indicate cancer. The presence of atypical cells often raises concern and may warrant further investigation or intervention, such as surgical excision. This is because atypical findings can sometimes precede the development of breast cancer, and monitoring alone may not be sufficient.

2. Changes During the Menstrual Cycle: It is not uncommon for breast nodules to fluctuate in size and tenderness in relation to the menstrual cycle due to hormonal changes. If you notice that the nodule has decreased in size after your menstrual period, it could indicate that the nodule is influenced by hormonal factors, which is typical for many benign breast conditions, such as fibrocystic changes. However, this does not negate the importance of addressing the atypical findings.

3. Consulting with Healthcare Providers: If you are uncertain about the need for surgery, it is advisable to seek a second opinion from another healthcare provider or a breast specialist. They can review your imaging studies, pathology reports, and clinical history to provide a more tailored recommendation. It is crucial to ensure that you feel comfortable and confident in the treatment plan moving forward.

4. Surgical Considerations: The decision to remove a breast nodule should consider several factors, including the size of the nodule, the characteristics of the atypical cells, your personal and family medical history, and any symptoms you may be experiencing. If the nodule is small and stable, and if your healthcare provider believes that it is safe to monitor it, they may suggest a follow-up rather than immediate surgery. However, if there is any concern about the potential for malignancy, surgical removal may be the best course of action.

5. Follow-Up and Monitoring: If you decide against immediate surgery, ensure that you have a clear follow-up plan in place. Regular monitoring through imaging studies and clinical evaluations can help track any changes in the nodule's characteristics. If there are any new symptoms or changes in the nodule, it is essential to report these to your healthcare provider promptly.

In conclusion, while the reduction in size of the nodule is a positive sign, the atypical findings necessitate careful consideration. Engaging in open discussions with your healthcare provider about the risks and benefits of surgery versus monitoring is crucial. Ultimately, the goal is to ensure your health and peace of mind, and making informed decisions based on expert advice is key to achieving that.

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