Breast Lumps: When to Seek Ultrasound and What to Expect

Breast lump

Doctor, I would like to ask you about a small lump I felt about a month ago on the left side of my breast, slightly outward from the nipple.
It doesn't seem to have changed in size, and I can feel it move a bit, with a small edge that I can also touch.
However, recently, as my menstrual period is approaching, it seems to have shrunk and is painful when pressed, whereas it wasn't painful before.
I also have a fibroadenoma in my left breast that seems to have shrunk in the past few days.
Is this related to my upcoming menstrual period? Doctor, may I ask you: 1.
Is it appropriate to have an ultrasound examination of that lump in the days leading up to my period? 2.
The left side of my breast appears significantly larger; what could be the reason for this? It also feels like there are many lumps.
Could you please respond to me as soon as possible? Thank you.

Heihei, 10~19 year old female. Ask Date: 2010/10/05

Dr. Zhao Ming reply Breast and Thyroid

Your issue should be addressed directly at a breast surgery outpatient clinic.
Although breast cancer is rare in 18-year-old females, it is still advisable to see a doctor.

Reply Date: 2010/10/05

More Info

When it comes to breast lumps, it’s essential to approach the situation with caution and awareness. Breast lumps can arise from various causes, including hormonal changes, benign conditions like fibrocystic changes or fibroadenomas, and, in some cases, malignancies. Given your description of a lump in your left breast that feels movable and has changed in size and tenderness, it’s understandable to have concerns.

1. Timing of Ultrasound: It is generally advisable to perform breast imaging, such as an ultrasound, during the first half of your menstrual cycle, typically one week after your period ends. This timing is recommended because hormonal fluctuations can affect breast tissue, making it denser and potentially more difficult to evaluate accurately. Since you mentioned that your period is approaching and the lump feels smaller and tender, it might be beneficial to wait until after your menstrual cycle to schedule the ultrasound. However, if you experience any significant changes, such as increased pain, changes in the appearance of the lump, or any new symptoms, you should seek medical attention sooner.

2. Understanding the Changes: The changes you’re experiencing in the lump's size and tenderness could indeed be related to your menstrual cycle. Hormonal fluctuations, particularly the rise in estrogen and progesterone levels before menstruation, can lead to breast tissue swelling and tenderness. This is common in many women and can result in the sensation of lumps or changes in existing lumps. The fact that you have a known fibroadenoma, which is a benign tumor, may also contribute to the changes you’re feeling. Fibroadenomas can fluctuate in size and tenderness due to hormonal influences.

3. Multiple Lumps: If you are noticing multiple lumps or areas of fullness in your breast, it’s crucial to have a thorough evaluation. While many breast lumps are benign, the presence of multiple lumps warrants further investigation to rule out any serious conditions. An ultrasound can help differentiate between solid masses and fluid-filled cysts, providing clarity on the nature of the lumps.

4. Next Steps: It’s essential to maintain open communication with your healthcare provider. If you have not already done so, consider scheduling an appointment for a clinical breast exam. Your doctor may recommend an ultrasound or mammogram based on your age, risk factors, and the characteristics of the lumps. If any lumps appear suspicious or if there are significant changes, further diagnostic procedures, such as a biopsy, may be necessary.

In summary, while hormonal changes related to your menstrual cycle can influence breast lump characteristics, it’s vital to monitor any changes closely. If you have concerns about the lumps or experience any new symptoms, do not hesitate to seek medical advice. Regular breast self-exams and awareness of your body are crucial for early detection and peace of mind. Always prioritize your health and consult with a healthcare professional for personalized advice and management.

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