The Doctor Says, "Don't Worry About That Lump" - But You Disagree. What Next?
You find a lump in your breast. You’re concerned, so you call the doctor.
Your doctor examines you and tells you it’s probably nothing to worry about—many women your age find lumps, and this one feels normal.
But you’re still worried.
What do you do?
If you’re postmenopausal, start looking for a new doctor. According to the American Cancer Society, breast lumps in older women are much less common than they are in younger women; any new lump you feel needs to be diagnosed. If your doctor doesn’t know that, s/he’s probably not someone whose opinion you can trust.
And if you’re pre-menopausal?
Give the lump time to disappear
First of all, don’t panic. Wait a week or two, or three. Many women experience breast lumps as part of their regular menstrual cycle. As hormone levels ebb and flow, so does the amount of fluid in your breasts; this fluid can sometimes cause an existing cyst to enlarge, and make it feel like a lump.
If the lump disappears over the course of a few weeks, then it was probably hormonally induced, and nothing to worry about. If the lump doesn’t disappear, then you have a decision to make: Is your fear of cancer realistic – or are you over-reacting? Do you trust your doctor’s assessment – or rely on your own instinct that something’s not right?
According to Johns Hopkins Medicine, the vast majority of breast lumps (about 80 percent) are indeed benign; no cancer. So odds are your doctor’s right. Still, there’s that 20 percent chance…
If you decide a 20 percent chance of having breast cancer is high enough to worry you – what’s your next step?
Make a follow-up appointment with your doctor
Tell your doctor you respect his or her opinion, but would like some real-time data to back it up. An ultrasound will reveal if the lump you feel is a cyst; a mammogram will detect solid tissue that seems out of place in its surroundings. While neither of these screening methods is foolproof, both are better than the doctor simply palpating the lump and giving an opinion.
Unfortunately, some doctors are reluctant to order screening tests when they “know” that your lump isn’t serious. While your hesitant doctor has a point – screening is expensive – you have a point, too. Only via screening can an accurate diagnosis be made. So if your doctor refuses to order screening tests, ask to be referred to another doctor for a second opinion.
Get a second opinion
It may be uncomfortable asking for a second opinion, but do it anyway. Even though s/he’s been your trusted GP for 30 years, your doctor isn’t infallible. Be polite, but firm: you want a second opinion.
Tell your doctor you’d like to see a breast specialist. This is a medical professional whose focus is breast issues, from skin conditions to infections to nipple discharge.
If your doctor is ultimately unable or unwilling to connect you with a breast specialist, you’ll have to do the legwork yourself. These specialists are usually found in a hospital; start with your local hospital and ask for the women’s health program. If that doesn’t yield results, seek out a cancer center, and ask for the breast oncology department. The staff there should be able to advise you on how to get an appointment with someone who can do diagnostic testing on your lump.
When you meet with the breast specialist, come prepared: know the date you first noticed the lump; whether it’s changed; and the date of your last period (if you’re pre-menopausal). Be upfront about wanting to know specifically what’s caused the lump, and using diagnostic testing to get the answer.
At the same time, be reasonable. If the breast specialist says s/he’d like to wait a few weeks to see if the lump resolves on its own, that’s fine; breast cancer isn’t an emergency. And at least you have a plan: if, after several weeks, the lump is still there, you’ll need an ultrasound or mammogram.
Is a second opinion really worth the work?
Yes, if you’re not onboard with your GP’s original “nothing to worry about” diagnosis.
A study done at the University of Michigan Comprehensive Cancer Center back in 2006 reveals that more than half of breast cancer patients see significant changes to their treatment protocol after seeking a second opinion.
The Michigan study indicates that treatment changes for the survivors come as the result of new mammogram and pathology evaluations by doctors specializing in breast issues, rather than by the generalists who’d originally examined the mammograms or tissue samples.
The same outcome would reasonably apply to women dealing with a new breast lump. If a generalist (GP) is unable or unwilling to diagnose the lump, turn to a breast specialist: even if you get bad news, knowing for sure what’s causing the lump is better than doing nothing.
See More Helpful Articles:
Sabel, Michael. "Half of Patients Change Cancer Treatment after 2nd Opinion." November 29, 2006. Accessed April 17, 2016. http://www.med.umich.edu/opm/newspage/2006/secondopinion.htm.
Breast cancer survivor and award-winning author PJ Hamel, a long-time contributor to the HealthCentral community, counsels women with breast cancer through the volunteer program at her local hospital. She founded and manages a large and active online survivor support network.