Our step-by-step guide to what to do next if you suspect breast cancer.
Step 1: See Your Doctor
Your suspicious finding needs to be thoroughly checked out, so make an appointment with your doctor. What's reassuring is that 90% of women under age 55 who detect a lump turn out not to have cancer. Here's what to expect checkup day:
"I kept thinking I was too young."
- Clinical breast exam. Your doctor, using his fingers, locates your lump and also feels for certain clues. If the mass is soft, movable, and has a smooth oval or round circumference, it's more likely to be a cyst—a harmless, fluid-filled sac. If it's firm and fixed with irregular borders, it's more worrisome. Either way, your doctor needs to confirm what was felt. So, usually within the next week, you'll be scheduled for one or all of the following tests.
- Diagnostic mammogram. Unlike a routine screening mammogram—which takes less than 15 minutes, involves just two views of breast tissue, and should be a yearly ritual for all women over age 40—a diagnostic mammogram takes about twice as long. Because your lump needs to be looked at from lots of different angles, your breast is compressed between two plastic plates in additional uncomfortable ways during the exam. The squeeze will feel less severe if you take an over-the-counter pain medicine, such as ibuprofen, at least 30 minutes beforehand.
- Ultrasound. Women under age 50 tend to have dense breast tissue that doesn't always show up well on mammograms, so if you're premenopausal, chances are you'll need an ultrasound. The exam uses high-frequency sound waves to create images and typically takes less than 30 minutes. "It's especially good at distinguishing a benign, fluid-filled cyst from a solid mass," says Katherine B. Lee, M.D., a breast specialist at the Cleveland Clinic Breast Center. After squirting gel on your breast the technician presses a wand all around the tissue, which is pretty painless.
- MRI (magnetic resonance imaging). If neither the mammogram nor the ultrasound yields clear results, you may need an MRI, which provides a 3-D view of your breast. You receive an injection of dye that helps highlight abnormalities. Then you lie on your stomach inside a tube-like "capsule" for 20 minutes. You may be able to listen to music. If you're prone to claustrophobia, ask for anti-anxiety medicine.
Five years ago Becky Cwiek, a 43-year-old mother of two from Brighton, Michigan, felt a grape-size lump in her breast after taking a shower. "I wasn't too worried. I told myself it must just be a cyst." Instead, it was an aggressive form of cancer that was caught early enough to treat successfully—all because Becky didn't blow off her discovery. "On the one hand, I was so sure it was nothing, but on the other, I did make an appointment to have it checked out right away."