Breast Lumps: Could It Be Cancer and Where to Seek Help?

Breast lump

Hello: I felt a hard lump in my left breast near the nipple.
It is not painful and can be moved when touched.
When I press it to the side, the lump is clearly visible.
Could this possibly be breast cancer? If I go to the hospital for an examination and some hospitals do not have a breast surgery department, which department should I consult? Thank you for your response.

Shi xiao jie, 30~39 year old female. Ask Date: 2015/09/07

Dr. Chen Sirong reply Oncology

Ms.
/ 36 / 11.
It is recommended that you undergo a mammogram.
Based on the examination results, the probability of cancer can be estimated (see attachment below).

2.
General Surgery attachment below: The interpretation of breast imaging results is primarily divided into 7 categories of reports: BI-RADS 0, BI-RADS 1, BI-RADS 2, BI-RADS 3, BI-RADS 4, BI-RADS 5, and BI-RADS 6.

- 0: Incomplete.

- 1: Normal.

- 2: Benign findings.

- 3: Probably benign findings.

- 4: Suspicious abnormality.

- 5: Highly suspicious for malignancy.

- 6: Biopsy confirmed malignancy.

Classification explanations:
- 0: Requires further imaging studies and should be compared with previous films.
Additional examinations should be performed before the report is finalized; efforts should be made to avoid this type of report.
- 1: Normal, unremarkable.
Breast tissue is symmetrical; no masses or distortion of tissue structure or suspicious calcifications are present.
- 2: Benign findings.
The results are very similar to category 1, indicating normalcy, but there are some clearly defined calcifications such as fibrocystic adenomas, lipomas (lipid cysts, lipomas, breast cysts, overlapping defect tumors), all of which have benign characteristics.
This can also be interpreted as lymph nodes, vascular calcifications, breast implants, or tissue distortion due to previous surgery.
Overall, no malignant features are visible on the images.
- 3: Probably benign findings.
The risk of malignancy is less than 2%.
The tumor characteristics at this stage include a mass that cannot be palpated but has clear imaging boundaries; asymmetric tissue shows decreased density during focused examination, with clustered punctate calcifications.
To confirm stability, short-term follow-up is recommended.
A re-examination of the same breast should be performed after six months; subsequently, bilateral mammograms should be done in the first and second years.
If results remain unchanged, it will revert to routine follow-up as BI-RADS 2; if changes occur, such as an increase in calcification points, it will be classified as BI-RADS 4 or BI-RADS 5, requiring appropriate management.
- 4: Suspicious abnormality.
Consideration should be given to performing a biopsy.
The probability of malignancy ranges from 5% to 95%, with significant variation; thus, it can be further subdivided into 4A, 4B, and 4C for better communication between physician and patient.
- 5: Highly suspicious for malignancy.
Surgical treatment is necessary, with a probability of malignancy greater than 95%, possibly indicating breast cancer.
Characteristics include spiculated, irregular high-density masses, with segmented or irregular linear arrangements of tiny calcifications.
At this stage, surgery can be performed directly without a biopsy.
Current management, if surgical treatment includes sentinel lymph node biopsy or preoperative chemotherapy, must first involve a tissue biopsy.
- 6: Biopsy confirmed malignancy.
Imaging shows established lesions, with biopsy-proven cancer, which is an assessment for preoperative chemotherapy.
After chemotherapy, lesions may become obscured and difficult to visualize.
Thank you for your letter.

Taoyuan Hospital, Chen Sih-Rong

Reply Date: 2015/09/07

More Info

When it comes to breast lumps, it is essential to approach the situation with caution and awareness. The presence of a hard lump in the breast, especially one that is movable and not painful, can be concerning, but it does not automatically indicate breast cancer. There are various types of breast lumps, some benign (non-cancerous) and others malignant (cancerous).
The characteristics of the lump you described—hard, movable, and painless—can be associated with several conditions. Common benign breast conditions include fibroadenomas, cysts, and fibrocystic changes. Fibroadenomas are solid, non-cancerous tumors that are often found in younger women and can feel like a firm, smooth lump. Breast cysts, on the other hand, are fluid-filled sacs that can also present as lumps. Both conditions are generally not serious but should be evaluated by a healthcare professional.

However, it is crucial to rule out breast cancer, especially if there are changes in the breast tissue, such as new lumps or changes in size or shape. Breast cancer can present in various forms, and while many lumps are benign, any new or unusual lump should be evaluated by a medical professional.

If you suspect you have a breast lump, the first step is to seek medical attention. If your local hospital does not have a breast surgeon, you should consider visiting a general surgeon or a gynecologist. Both of these specialists can perform a clinical breast examination and may refer you to a breast specialist if necessary. Additionally, they can order imaging tests such as a mammogram or ultrasound to further evaluate the lump.

In the United States, it is recommended that women begin regular breast cancer screenings at age 40, or earlier if they have a family history of breast cancer or other risk factors. If you have concerns about your breast health, do not hesitate to seek help. Early detection is key in managing breast cancer effectively.

In summary, while the lump you described could potentially be benign, it is essential to have it evaluated by a healthcare professional. If you are unsure where to go, starting with a general practitioner or gynecologist is a good option. They can guide you through the necessary steps for diagnosis and treatment. Remember, being proactive about your health is crucial, and seeking help is the best course of action when it comes to any changes in your body.

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