Clinical Evaluation of Breast Masses
The evaluation of a breast mass at a breast center may be different than at your physician's office. If a patient has had a mammogram, the films are requested and reviewed. If mammography films are not available, a mammogram may be requested, based on the age of the patient (a younger patient may undergo sonography (ultrasound) first, to characterize the lesion).
Are there any abnormalities noted on the mammogram? Sonography may be accomplished at this point to determine if the mass is cystic or solid. If the mass is a simple cyst, the evaluation is complete. The mass is a benign process (not cancer). However, if the cyst is tender or quite large, it can be aspirated with relief of these symptoms. 50% of cysts that are aspirated will recur. If however, air in injected into the cyst, only 2% will recur.
Is the fluid retrieved bloody or the cyst incompletely resolved? Injecting air into the cyst and repeating a mammogram may reveal an intracystic lesion (growth inside the cyst). A bloody aspirate or an intracystic lesion indicates the need for a breast biopsy.
The pathology report takes several days to return. Remember that 80%-90% of lesions that are detected by clinical examination or mammography are benign.
Mammography can reduce the mortality from breast cancer 30-40%.