What's a Breast Specialist - and Should I See One?

Patient Expert

Why do my breasts hurt? What's this lump? Is the nipple discharge I have normal? When your family doctor and gynecologist can't nail down the cause of those bothersome breast symptoms you're experiencing, it's time to see a breast specialist.

Here's a typical scenario faced by many younger women.

You feel a lump in your breast. Your family doctor orders an ultrasound.

The ultrasound rules out a cyst, but is inconclusive. So you have a mammogram.

That, too, is inconclusive. The radiologist says he thinks it's just an area of scar tissue, or perhaps a fibroadenoma - a benign tumor common in women your age.

He tells you it's probably nothing to worry about, but you should come back for another mammogram in 6 months - to see if anything's changed.

So, you have a lump in your breast; it appeared out of the blue, and no one knows what it is.

You're unable to shake it off as "probably nothing to worry about."

"What if it IS cancer? Do I really want to wait 6 months to find out?"

What's your next step?

Well, you can ignore the lump, and hope it goes away. Many women are comfortable with this course of action; it saves money, time, and odds it's nothing to worry about - since the vast majority of breast lumps are NOT cancer.

But some women are simply unable to let go and move on. If you're one of those women - someone who wants definitive answers, who won't be comfortable until you find out exactly what that lump is, and what it might become - you'll want to see a breast specialist.

Why can't your family practitioner help you? Doesn't "general practice" mean your GP knows a little bit about everything?

Yes, but the key words here are "little bit." Your GP knows just enough about that lump in your breast to get the diagnostic process started with a mammogram or ultrasound. If those tools don't identify a specific cause for your symptoms, your GP is probably at the end of his/her range of knowledge, and will need to hand you off to someone else - a breast specialist.

What kind of health care professional is a breast specialist (or breast health specialist)? And where would you find one?

A breast specialist - unlike, say, a pathologist, dermatologist, or oncologist - is not board-certified in that specific specialty. Instead it's a doctor, physician's assistant, or nurse practitioner who's focused his/her study on diseases and conditions of the breast.

Think of the breast specialist as someone who handles breast health, just as your OB/GYN handles reproductive health.

Breast specialists deal with all kinds of breast issues, from breast pain and soreness, to mastitis (breast infection), to unexplained nipple discharge. They're usually found at a hospital, as part of the women's health program

You may also be referred to abreast specialist at a cancer center. This isn't because most breast issues turn out to be cancer. Indeed, the vast majority of breast problems have nothing to do with cancer. But many women seeing a breast specialist are there to rule out cancer, and cancer centers have the diagnostic tools and health-care personnel necessary to do that.

Your family doctor or OB/GYN is the best person to refer you to a breast specialist in your local area, or within your health insurance plan's network.

So, what will your visit to the breast specialist entail?

S/he will take your complete history, including any family history of breast cancer, which may or may not increase your personal risk. S/he will also ask you about diet; exercise, and lifestyle, all of which can impact breast health. For instance, caffeine can exacerbate a painful (though basically harmless) fibroadenoma, a benign breast tumor.

S/he'll also look at any results of prior tests; and will order any new diagnostic tests s/he feels necessary.

A breast specialist's greater depth of experience treating breast issues gives him or her more insight into just what might be causing a specific type of lump; and this added experience may translate into additional tests - or it may not.

After listening to you, examining you, and looking at your tests, the breast specialist may say, "I think you need a biopsy ASAP."

On the other hand, s/he may conclude, "I agree with the opinions you've gotten so far; there's really no need for a biopsy at this time, though you should have another mammogram in 6 months."

What's really important, at the end of the day, is that you can reassure yourself you've seen the health-care professional best able to assess and evaluate that lump in your breast.