When should you see a breast specialist?

1.A new breast lump

A new breast lump is one of the most common reasons to visit a breast clinic.

Most breast lumps are benign. Possible causes include:

• Fibroadenoma
• Breast cyst
• Hormonal breast changes
• Infection or abscess
• Fat necrosis
• Other benign breast conditions
• Breast cancer

A lump cannot reliably be diagnosed by touch alone. A new persistent lump should be assessed.

2.A growing breast lump

A previously diagnosed lump should be reassessed if it starts growing significantly.

This is particularly important for a lump previously thought to be a fibroadenoma. Most growing lumps are not cancer, but significant growth may require repeat imaging or biopsy to confirm the diagnosis and exclude other lesions such as a phyllodes tumour.

3.Nipple discharge

Nipple discharge is often benign, but assessment is particularly important when it:

• Occurs without squeezing
• Comes from one breast
• Is bloody or blood-stained
• Is persistently clear
• Is associated with a lump
• Occurs with a new nipple change

Avoid repeatedly squeezing the nipple to check for discharge.

4.A newly inverted nipple

Some women naturally have flat or inverted nipples. A nipple that was previously normal and recently becomes pulled inward, particularly on one side, should be assessed.

5.Breast skin or nipple changes

Persistent or unexplained changes such as these should be evaluated:

• Skin dimpling or puckering
• Skin thickening
• Unexplained redness or swelling
• Nipple or areolar ulceration
• Persistent nipple crusting or scaling

Many skin changes are benign, but persistent unexplained changes should not be ignored.

6.Persistent breast pain

Breast pain is common and is usually not caused by breast cancer. Hormonal breast tenderness and diffuse cyclical pain often do not require specialist assessment.

Consider evaluation when pain:

• Persists in one particular area
• Is progressively worsening
• Occurs with a breast lump
• Is associated with nipple or skin changes
• Occurs with redness or swelling

7.Breast redness, fever or a painful lump

Breast redness and pain, particularly during breastfeeding, may be caused by mastitis. A painful lump with persistent inflammation or fever can indicate a breast abscess.

Prompt assessment is appropriate when:

• Fever persists
• A painful lump is enlarging
• Symptoms are severe or worsening
• Treatment is not working as expected

Breast ultrasound can help determine whether an abscess has formed.

8.A breast lump during pregnancy

Most breast lumps during pregnancy are benign. However, pregnancy should not delay assessment of a persistent breast lump. Breast ultrasound can be safely used during pregnancy, with additional imaging or biopsy when medically indicated.

9.A breast lump while breastfeeding

Breast lumps during breastfeeding may be related to:

• Lactational changes
• Galactocele
• Mastitis
• Breast abscess
• Fibroadenoma
• Lactating adenoma

Most are benign, but a persistent lump should not automatically be dismissed as "just milk." Appropriate breast imaging and biopsy, when required, can be performed during breastfeeding.

10.An abnormal mammogram

A mammogram may show a breast mass, calcifications, asymmetry, architectural distortion, or another finding requiring assessment.

An abnormal mammogram does not automatically mean breast cancer. Further mammographic views, ultrasound, comparison with previous images or biopsy may be recommended.

11.A BI-RADS 3, 4 or 5 report

BI-RADS is used to communicate breast imaging findings and recommended management.

• BI-RADS 3: Probably benign; imaging follow-up is usually recommended.
• BI-RADS 4: Suspicious; biopsy is generally recommended.
• BI-RADS 5: Highly suspicious for malignancy; biopsy is recommended to establish a diagnosis.

The BI-RADS category should not be interpreted on its own. Your imaging findings, symptoms and clinical examination should be considered together.

12.Breast calcifications

Most breast calcifications are benign. However, certain patterns of calcifications may require additional mammographic views or biopsy. If your mammogram recommends further assessment, it is important to complete the recommended evaluation.

13.Dense breasts

Dense breasts are common and are not a disease. Dense breast tissue can make some abnormalities harder to see on mammography and is also associated with increased breast cancer risk.

However, dense breasts do not automatically mean you need ultrasound or MRI. The decision about additional screening depends on factors such as age, symptoms, breast density and overall breast cancer risk.

14.A strong family history of breast or ovarian cancer

Specialist risk assessment may be appropriate if your family history includes:

• Breast cancer at a young age
• Several relatives with breast cancer
• Male breast cancer
• Ovarian cancer
• A known inherited cancer-predisposition variant
• Certain patterns of pancreatic or prostate cancer

Both your mother's and father's sides of the family are important. Not everyone with a family history needs genetic testing — the first step is understanding the family history accurately.

15.A breast lump in a man

Men can develop breast problems too. The most common cause of male breast enlargement is gynecomastia, which is benign.

A man should seek assessment for:

• A new persistent breast lump
• Nipple inversion
• Nipple discharge
• Breast skin changes
• A persistent underarm lump

Male breast cancer is rare, but it can occur.

16.If you have been advised to have a breast biopsy

Being advised to have a breast biopsy does not mean that you have breast cancer. A biopsy is performed when tissue is needed to establish the diagnosis. The pathology result should be interpreted together with the breast imaging and clinical findings.

What happens at a breast specialist appointment?

The appointment usually begins with a detailed history and clinical breast examination. Your specialist may ask about:

• Your symptoms and how long they have been present
• Menstrual and reproductive history
• Pregnancy or breastfeeding
• Previous breast problems
• Previous mammograms or scans
• Family history
• Current medications

Further investigation depends on the clinical findings.

Do I need an ultrasound or mammogram?

Not every patient needs every test. The appropriate investigation depends on factors such as age, symptoms, clinical examination, pregnancy or breastfeeding, previous imaging, and breast cancer risk.

Breast ultrasound

Useful for evaluating many breast lumps, cysts and suspected abscesses.

Diagnostic mammography / 3D mammography

May be recommended for appropriate breast symptoms or abnormal mammographic findings. At The Breast Centre, Vijayawada, mammographic imaging is performed using the Hologic Selenia Dimensions 3D mammography system.

Breast biopsy

A biopsy is recommended when tissue diagnosis is required.

The aim is to choose the right investigation for the right patient, rather than automatically performing every available test.

What should you bring to your appointment?

If available, bring:

• Previous mammograms and ultrasound reports or images
• Previous biopsy or pathology reports
• Details of when your symptoms started
• Information about changes in the lump or symptoms
• Relevant family history
• A list of current medications

Previous breast imaging can be particularly useful because comparison with earlier images may help with assessment.

Breast specialist in Vijayawada

The Breast Centre, Vijayawada provides focused assessment for women and men with breast symptoms and abnormal breast imaging. Assessment may include:

• Breast lumps
• Breast pain
• Nipple discharge
• Nipple inversion
• Breast cysts
• Fibroadenomas
• Phyllodes tumours
• Mastitis and breast abscesses
• Breast problems during pregnancy
• Breast problems during breastfeeding
• Gynecomastia
• Male breast lumps
• Abnormal mammograms
• Breast calcifications
• Dense breasts
• BI-RADS findings
• Breast cancer concerns

Where appropriate, assessment can combine:

Clinical examination → Breast ultrasound → 3D mammography → Image-guided procedure or biopsy when indicated

This allows clinical findings, imaging and pathology to be considered together.

Frequently asked questions