Answers to common questions

by those referred for a

mammogram or an ultrasound

for breast lumps/lumpy breast

What Ultrasound and Mammograms May Show

Mammograms may show the lump in question and provide

some clues as to its nature. A metal marker is taped to the

skin of the breast over the lump to assist this evaluation and

special mammogram views are taken of the area in question.

More importantly,

however, the mammogram

allows assessment of

tissue elsewhere in both

breasts for possible

abnormalities which are

non-palpable. Breast

ultrasound is frequently

more informative than mammography in breast lump

evaluation. If ultrasound shows a simple cyst, no further

diagnosis or treatment is usually necessary, unless the

lump is tender or painful.

Some complex cysts and solid lumps have overlapping

ultrasound features and require further investigation by

removal of tissue for laboratory analysis. Removal of fluid is

called an aspiration and removal of tissue a biopsy. If the

affected area is well-demonstrated using ultrasound or

mammography these images can be used to allow a

radiologist to precisely guide a needle into the lump

removing either fluid, or cores of tissue for microscopic

analysis. Alternately, the entire lump can be removed in a

surgical operation.

Darlene G. Cass Women's Imaging Center provides breast health diagnostic procedures such as: screening and diagnostic mammography, breast magnetic resonance imaging (MRI), stereotactic biopsy, ultrasound and ultrasound-guided biopsy. Bone density screening and evaluations are also provided.

Patient Scheduling: (214) 820-2430Scheduling Hours: Monday – Friday, 8 am – 5 pmOffice Hours: Monday – Friday, 8 am – 5 pm Two Saturdays a month, 8 am – Noon

Two locations to serve your needs:

Baylor University Medical Center at DallasDarlene G. Cass Women’s Imaging Center at JuniusBaylor Medical Pavilion3900 Junius St., Ste. 200, Dallas, Texas 75246

Baylor University Medical Center at DallasDarlene G. Cass Women’s Imaging Center at North DallasBaylor Health Center at North Dallas9101 N. Central Expwy., Ste. 200, Dallas, Texas 75231

BaylorHealth.com

The W. H. & Peggy Smith Baylor Sammons Breast Center provides education on breast health including benign breast conditions, screening and diagnostic services, and breast cancer treatment options. Information is also provided about breast cancer prevention, hereditary risk, clinical trials and reconstructive surgery.

For information call (214) 820-9600.

Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor University Medical Center at Dallas or Baylor Health Care System. ©2008 Baylor Health Care System. MOD-08030 BUMC-DCWIC. 5,000. 5/08

Breast Lumpsor Lumpy Breast?

The Lumpy Breast

“Lumpiness” is a term frequently

used to describe the palpable texture

of the breast in many women. This is

usually due to prominent normal milk

glands, ducts and the

fibrous supporting tissue

which surrounds these

structures. This

lumpiness may vary from

fine irregularities to more

coarse and nodular

alterations in breast

texture and is most prominent in the

upper outer and underside areas of

the breast. Such findings are

frequently cyclical, changing during

the menstrual cycle as normal breast tissue reacts and

responds to the fluctuating influence of normal female

hormones (estrogen and progesterone). Such lumpiness may

be associated with cyclical pain or discomfort (see our

pamphlet entitled “Breast Pain”).

For many years women with lumpy breasts have been

diagnosed with “fibrocystic

disease”. This term is both

unfortunate and erroneous.

Most such women do not have

prominent cysts and any

condition affecting at least half

of normal women should not

be considered a “disease.” Mammograms and ultrasound

examinations of areas of lumpiness are most often normal.

There are no effective treatments and none are needed for

this essentially normal variation in breast texture. We urge all

women to learn and regularly practice breast

self-examination so that they can become familiar with the

texture and cyclic variation of their own breasts.

The Breast Lump

A breast lump as distinguished from the “lumpiness”

discussed above, will feel different especially to the women

practicing regular breast self-examination. Lumps are

frequently not a subtle finding for women experienced at

breast self-examination. They usually feel more discrete and

stand out from the surrounding tissue.

Many doctors will insert a thin needle into the lump for

diagnosis in their office. If the lump is a fluid filled cyst this

procedure can both diagnose and

treat the lump by removal of cyst

fluid and cause the lump to

disappear. If no fluid is extracted

the needle contents can be sent

for laboratory analysis (fluid

needle aspiration cytology).

Breast ultrasound can both find

lumps and distinguish between

fluid-filled (cysts) and solid

lumps (see our pamphlet

entitled “Breast Cysts”). When

a woman is referred to Baylor

Women’s Imaging Center with

an undiagnosed breast

lump, an ultrasound

examination will usually

be performed.

For young women for whom a mammogram may

not be appropriate, the ultrasound examination may

be the only test needed.

The Palpable Lump with a Normal Mammogram and Ultrasound

Sometimes a palpable lump cannot be seen on either the

mammogram or the ultrasound images. This suggests that

the lump is a benign process and may be formed by normal

breast tissue.

Occasionally, however, a real breast lump may not be seen

with either mammograms or ultrasound. Although these

normal imaging tests are reassuring, continued monitoring

of the palpable area by the woman herself and by her doctor

is essential. Examination by a surgeon is recommended for

any persistent or enlarging lump despite normal

mammograms and ultrasound tests.

Monthly

breast self-

examination

provides

women the

opportunity

for early

detection of

a breast

“lump,” which

may be a

life-saving

discovery.

The term “palpable” is used to define anything that can be felt by

the examining fingers of a health care provider or of the woman

herself. Such palpable findings may be normal or abnormal.