What do I do if I find a lump?

In younger women:
Most lumps have a hormonal basis, so if any lump persists after one menstrual cycle it should be examined by your local doctor.
In older women:
Discrete lumps with no similar past history should be investigated after they are found.

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Are all lumps suspicious?

All breasts have areas of lumpiness that fluctuate with the menstrual cycle. "Suspicious" lumps are those which are painless, irregular, unchanging or slowly enlarging, or new.

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What is the significance of breast pain and tenderness?

This is mostly associated with hormonal fluctuations which occur naturally with the menstrual cycle, pregnancy and periods of severe stress, or artificially with hormone medication, such as the oral contraceptive pill or hormone replacement therapy.

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How safe is the Pill?

Very safe. But prolonged, uninterrupted exposure (5-10+ years) may slightly increase the risk of breast cancer.

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How safe is hormone replacement therapy?

Very safe with significant advantages, but exposure beyond 7-8 years may increase the risk of breast cancer.

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When should I start having regular screening mammograms?

Though a mammogram can be done at any age if an area of suspicion is to be investigated, general population screening should start from the age of 50 onwards. High risk patients (ie. those with a family history of breast cancer) may start having screening mammograms from age 35.

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How often should they be done?

Screening of well women over the age of 50 should be done about every 1-2 years. Younger women who are at risk should have a screening mammogram every 2 years until age 50 and every year thereafter.

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When should I also have an ultrasound?

Ultrasound is a complementary examination to mammogram and is not better. It is often done at the the discretion of the radiologist when further information is sought about the appearance of breast tissue on mammogram. It is helpful in delineating cysts (fluid collections) from solid lumps. Only a very small number of cancers are only seen on ultrasound.

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At what stage should I see my local doctor?

The local doctor is the linchpin to continuing breast care. Always consult your local doctor if there is any question about the nature of any breast lump.

The local doctor should include breast examination as part of a normal yearly consultation (such as at the time of your pap smear).

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What is the significance of a family history of breast cancer?

Breast cancer develops for many reasons, none of which are yet understood. Family history is only one of them and is, in fact, a relatively minor factor, being seen as significant in only 5-10% of cases.

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When should I be referred to a breast specialist?

Your local doctor is responsible for your overall routine care. Because of the complexity of breast problems and the increase in incidence of breast cancer in the past 30 years, GP's will generally refer you to a specialist for an expert assessment if there is any doubt about the diagnosis of a finding in the breast.

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