A new breast lump - What should I do?

Discovering a new breast lump can be worrying, but taking prompt action and seeking the right care can make a significant difference.

Miss Susan Hignett, distinguished consultant oncoplastic breast surgeon, will guide you through the steps you need to take if you find a new breast lump, the diagnostic tests involved, and the treatment options available if required.

What should I do if I find a new breast lump?

If you discover a new lump in your breast, the first step is to consult a healthcare professional as soon as possible. Early evaluation is critical to determining whether the lump is benign or requires further investigation.

During your consultation, your doctor will perform a physical examination to evaluate the lump's size, shape, texture, and mobility.

To gain more clarity, your doctor may recommend imaging tests. A mammogram is an X-ray of the breast that helps detect abnormalities in breast tissue, while an ultrasound is a test that uses sound waves to distinguish the lump’s composition, such as whether it’s solid or fluid-filled. In some cases, an MRI scan may be used for more detailed images.

If imaging tests suggest the lump could be suspicious, a biopsy will be performed to determine whether it’s cancerous. This procedure involves removing a small sample of tissue from the lump for laboratory analysis under a microscope.

Is a new breast lump always a sign of cancer?

Not all breast lumps are cancerous. Common benign conditions that can cause breast lumps include cysts, fibroadenomas, and fibrocystic changes, which are often linked to hormonal fluctuations.

Regardless, a new breast lump should never be ignored. Some lumps can indicate breast cancer, especially if they are hard, irregular in shape, immobile, or associated with skin changes, nipple discharge, or swelling. Early detection and diagnosis are key to effective treatment, so even if a lump seems benign, it’s important to get it checked as soon as possible.

What surgical options are available if surgery is necessary?

If your lump is cancerous or causing significant discomfort, surgery may be recommended as part of your treatment plan to remove the lump while preserving the breast’s appearance and function.

The two most common surgical options include:

• Lumpectomy: This procedure involves removing the lump along with a small margin of surrounding tissue. It’s performed if the lump is small and localised, preserving the majority of the breast.
• Mastectomy: This procedure involves removing the entire breast. It’s performed if the lump is large or involves multiple areas of the breast.

Your oncoplastic breast surgeon will recommend the most appropriate option based on the size, location, and nature of the lump. For benign lumps that cause discomfort or anxiety, removal may also be an option.

If a mastectomy is required, what reconstruction options will I have?

For patients requiring a mastectomy, breast reconstruction is an option to restore the breast’s shape and appearance. Reconstruction can be performed either immediately during the mastectomy (immediate reconstruction) or at a later date (delayed reconstruction).

There are two main types of reconstruction:

• Implant-based reconstruction: This procedure involves placing a silicone or saline implant under the chest muscle or skin to create the new breast.
• Autologous (flap) reconstruction: This procedure involves using tissue from another part of your body, such as the abdomen, back, or inner thigh create the new breast.

Your oncoplastic breast surgeon will discuss the options with you, considering factors such as your anatomy, lifestyle, treatment plan, and personal preferences. Advances in oncoplastic surgery ensure that both medical and aesthetic outcomes are carefully considered.

How often will I have follow-ups after surgery?

After surgery, follow-up care is crucial to monitor your recovery and check for any signs of recurrence.

If the lump was cancerous, your oncoplastic breast surgeon will recommend follow-up appointments every 3 to 6 months during the first couple of years. In the UK, breast cancer patients typically have annual mammograms for at least 5 years after treatment, with care tailored to individual risk factors.

If the lump was benign, your oncoplastic breast surgeon will recommend follow-up appointments every 6 months to 1 year to monitor for any changes or new developments.

If you would like to book an appointment with Miss Susan Hignett, head on over to her Top Doctors profile today.