A patient with a breast lump that has no features suggesting cancer should still be immediately evaluated, according to a primer for physicians in CMAJ
(Canadian Medical Association Journal
) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj090416.pdf
This article provides an "in office" approach for immediate evaluation of women who present to their family physician with a breast lump.
"As a family physician and a GP Oncologist who specializes in breast disease, I know how important it is to quickly evaluate breast lumps and reassure women who have benign cysts," says author Dr. Ruth Heisey, Women's College Hospital.
Aspiration, the removal of fluid with a needle, is a fast first approach for patients with a breast lump that does not have cancerous features. The fluid removed from the lump can determine the type of lesion. This procedure, which does not need an anesthetic, can be done in a doctor's office on women who do not have breast implants and who are not on anticoagulants.
"Our suggested approach enables family physicians to follow the same evaluation pathway using needle aspiration to determine at that visit which women need referral for further investigation and which women may be reassured that their lump is benign," write the authors.
The patient should have a follow-up if the lump is a cyst or referred for further tests or possible surgery if the lump is solid.