So, you've felt a lump in your breast - what next?

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Firstly, there are lots of breast lumps that are perfectly benign - such as a fibroadenoma, which is important to know. Regardless, it is vitally important to get checked out by a medical professional. 

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You'll likely be examined by a GP, who will determine the size, location, feel and mobility of the lump. They may ask you to raise your arms - which can promote skin changes such as dimpling. They will also feel under your armpit for lymph nodes. 

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Following this, you will be urgently referred to a breast clinic (if you haven't gone there already) - some lumps are found incidentally at breast screening assessments.

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You will have a mammogram (an x-ray of your breasts).

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If the mammogram does see a concerning lump/lumps - you will have an ultrasound and a biopsy of the lump done with a needle. 

- The sample will be looked at under a microscope by a pathologist who will conclude the diagnosis. 

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In a few days time, you will be brought to clinic for your result. 

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Invasive ductal carcinoma is by far the most common type of breast cancer, originating from the milk ducts. Before it has broken through the duct wall into the surrounding breast tissue, it is known as ductal carcinoma in-situ (DCIS). 

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Lobular carcinoma originates from the milk-producing lobules at the end of the duct. Lobular carcinoma in-situ (LCIS) is the precursor state before the gland wall has been breached. 

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There are other less common types of breast cancer we won't get into here. 

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You will get further imaging so that the cancer can be staged (please read more in our staging section). Typically, stage one is still local. Stage two has grown into the surrounding neighbourhood. Stage three has reached the lymph nodes, and stage four has spread elsewhere. 

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Your pathologist will also test the cancer to see if it is HER2 receptor positive, hormone receptor positive, etc. 

- This will give your oncologist more information regarding prognosis and ultimately, the most appropriate treatment (including tablets). 

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Regarding surgical removal, if a tumour is just local, sometimes a lumpectomy (lump removal) may suffice. If it is bigger, a mastectomy (breast removal) with or without sparing of the nipple may be required. 

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If it has reached the lymph nodes - an axillary node clearance (removal of all the armpit nodes) will likely be required. This does make patients prone to lymphoedema on that side. 

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Sometimes, people genetically susceptible to breast cancer (BRCA gene) may choose to have a double mastectomy to prevent it. The most famous case of which is actress, Angelina Jolie. 

 

After surgery, chemo/radiotherapy and/or hormonal therapy is common to reduce the risk of recurrence.