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"When do lumps in breasts need to be biopsied?"


I am a 37 year old woman. I found a lump in my breast. Will it have to be biopsied?


This question is asked relatively commonly within both primary care offices and of breast surgeons. The short and most honest answer that I can give you is that I'm not sure if it will be biopsied or not. The reason being, the decision of whether or not to biopsy a breast lesion is made after a thorough discussion with your breast surgeon about your history, and after they are able to perform a thorough exam.

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Let me commend you on performing regular exams that led to you detecting a lump. Even if there is a malignant process present (and I'm not saying there is), it is always better to catch it earlier rather than later. There are certain characteristics of breast lesions on physical exam that make them slightly more worrisome, and more likely to have a biopsy performed for pathologic diagnosis (no one will ever be able to tell you with 100% certainty that something is cancer by physical exam...a piece of tissue must be sampled and sent to a pathologist for histologic diagnosis). A skilled clinician will take into account the size of the lesion, location within the breast (superficial vs deep, topographic location within the breast, etc), firmness, whether it is mobile or not (whether you can move it around, or if it is stuck to the surrounding tissues), whether it is fixed to the skin or not, whether there is skin "dimpling" (this can give some insight to whether the suspensory ligaments of the breast may be involved), and whether there is change in the character of the overlying skin (like an orange peel appearance). Sometimes even if none of these characteristic are present, but you have a strong family history of breast cancer, or even if the patients anxiety level is very high and they want to "know", a biopsy may be performed. There are multiple ways to go about performing a biopsy which is a different talk altogether, but I hope that this is helpful. I would definitely recommend a consultation with a breast surgeon, an while I can't give you a straight answer whether you will get a biopsy or not, the physician you see will be able to give you more specific information directed just to you.

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