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.
PJ Hamel is senior digital content editor and food writer at King Arthur Flour, and a James Beard award-winning author. A 16-year breast cancer survivor, her passion is helping women through this devastating disease. She manages a large and active online survivor support network based at her local hospital and shares her wisdom and experience with the greater community via HealthCentral.com.