I didn't mean to sound glib. Every breast lump deserves to be diagnosed.
Yes, she had been examined and mammogrammed and ultrasounded.  The surgeon
had wanted to take it out (with circumareolar incision!) without doing any
further diagnostic workup to see whether it really needed to come out.
Certainly, many premenopausal breast cancers fall "out of" the risk
groups, and are often more aggressive.  But, in general, premenopausal
lumps aren't usually cancer. Fine needle biopsies are done under local
anesthesia, in the doctor's office, and aren't generally any more painful
than an immunization.  Baby can nurse right before (good if he does, when
doing one on a lactating breast, because there will be less glandular
tissue in the way) and as soon as five minutes after.  Any suspicious
or inconclusive result is grounds for an excisional biopsy (through a
radial incision to preserve ductal structure, of course).


Becky Saenz, MD
Assistant Professor
University of MS Medical Center
Department of Family Medicine
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