Step one: examination and imaging
A new lump is first examined and then imaged. Ultrasound is usually used for women under 30; older women usually have a diagnostic mammogram and ultrasound. Imaging often shows a simple cyst, which does not need a biopsy.
Understanding BI-RADS
Radiologists use a scale called BI-RADS to describe their level of concern:
- BI-RADS 1–2: normal or benign. Routine screening
- BI-RADS 3: probably benign. Short-term follow-up imaging, usually in six months
- BI-RADS 4: suspicious. Biopsy recommended
- BI-RADS 5: highly suspicious. Biopsy recommended
- BI-RADS 6: known cancer already confirmed by biopsy
Other reasons to biopsy
- A solid lump that cannot be confidently called benign
- A lump that is growing on follow-up imaging
- A lump you can clearly feel even if imaging looks reassuring
- Skin or nipple changes along with a lump
Talk with Dr. Arsenous about your options.
What a biopsy involves
Most biopsies are done with a needle under ultrasound or mammogram guidance, using local anesthesia. A few small tissue samples are taken, and a tiny marker clip is often left to identify the spot. Most people return to normal activities the same day. Results usually take several days.
Occasionally an excisional biopsy, removing the whole lump in a small operation, is recommended. See breast biopsy for more detail.
If you have found a lump
Don’t wait to see if it goes away beyond your next menstrual cycle. Schedule an evaluation. Bring any previous imaging. Read about our breast lump evaluation.