Breast Evaluation

Breast evaluation can begin with routine screening or with a new breast concern that needs attention. At the Margie Petersen Breast Center at Providence Saint John’s Health Center, our team helps determine which type of examination, imaging or testing is appropriate based on why you are being evaluated. You do not need to know whether you need a mammogram, ultrasound, MRI or biopsy before contacting us—the purpose of breast evaluation is to determine the appropriate next step.

Routine Screening or a New Breast Concern?

There are two important ways to be proactive about breast health. Routine breast cancer screening can help detect cancer before symptoms develop, while prompt evaluation of a new lump or other breast change can help determine what is causing a concern rather than waiting for the next scheduled screening mammogram.

Routine Breast Cancer Screening

Mammography is the primary imaging method used to screen for breast cancer in people who do not have symptoms. Screening generally begins at age 40 for women at average risk, although recommendations about how often to have a mammogram vary among national organizations. Your healthcare provider can help determine a screening schedule based on your age, personal and family history, breast density, genetic risk and other factors that may affect your breast cancer risk.

When You Notice a Breast Change

Do not wait for your next routine mammogram to report a new breast lump or another concerning change. A new lump, thickening, nipple or skin change, unusual discharge or other persistent breast concern should be discussed with a healthcare provider so the appropriate evaluation can begin. Most breast changes are not cancer, but determining the cause may require a clinical examination, diagnostic imaging or, in some cases, a biopsy.

Rapid Evaluation at the Breast Clinic

Waiting for answers after discovering a breast lump or other change can create significant anxiety. Through the Breast Clinic, patients with a new breast concern may be evaluated quickly with a clinical assessment and breast ultrasound often the same day when appropriate. Depending on what is found, you may need no additional testing, be asked to return for follow-up, have additional breast imaging or undergo a biopsy to determine what an abnormality represents.

If a biopsy confirms breast cancer, the focus shifts from evaluating the finding to understanding the cancer and developing a treatment plan. Depending on the diagnosis and individual needs, care may be coordinated among breast surgery, medical oncology, radiation oncology and other specialists so that appropriate treatment planning can begin without unnecessary delays.

Clinical Breast Examination

A clinical breast examination may be used when evaluating a new symptom or breast concern. Your healthcare provider examines the breasts and surrounding areas for changes such as a lump, thickening, skin or nipple changes or other findings that may need further evaluation. A clinical examination does not replace mammography for routine breast cancer screening, but it can help determine what additional evaluation may be appropriate when a breast change is present.

Learn more about breast examinations and breast self-awareness.

Breast Imaging

Mammography, ultrasound and breast MRI provide different kinds of information and may be used individually or together depending on the reason for evaluation. One imaging method does not simply replace another; your care team selects the approach that can best answer the clinical question and may recommend additional imaging when more information is needed.

Mammography

Mammography uses low-dose X-rays to create images of breast tissue and is the primary imaging method used for routine breast cancer screening. Mammograms can identify abnormalities before they can be felt and may also be used diagnostically to examine a particular area more closely when a symptom or screening finding needs additional evaluation.

Breast Ultrasound

Breast ultrasound uses sound waves to evaluate breast tissue and can provide additional information about an area found during an examination or on a mammogram. For example, ultrasound can help determine whether a breast mass is fluid-filled, such as a cyst, or solid and may also be used to help guide certain breast biopsy procedures.

Breast MRI

Breast MRI uses magnetic fields rather than X-rays to produce detailed images of breast tissue. It may be used along with mammography for some people at increased risk of breast cancer or when additional information is needed to evaluate a breast finding or known cancer. MRI is generally used for specific clinical reasons rather than as a replacement for routine mammography.

Learn more about Breast Imaging Methods.

When Is a Breast Biopsy Needed?

Imaging can help clinicians identify and characterize a breast abnormality, but imaging alone cannot always determine exactly what an abnormality is. When a finding requires tissue evaluation, a breast biopsy removes cells or tissue so a pathologist can determine whether the finding is benign, cancerous or represents another breast condition. Different biopsy methods may be used depending on the location and characteristics of the area being evaluated.

Learn more about Breast Biopsy.

What Happens After Breast Evaluation?

Many breast findings turn out to be benign and require no cancer treatment. Depending on the results of your examination, imaging or biopsy, you may return to routine screening, have follow-up imaging, undergo additional testing or be referred for treatment planning. Your care team can explain what the findings mean and what, if anything, should happen next.

Breast Cancer Screening Methods and Myths Webinar

Janie Grumley, MD, FACS, Breast Surgical Oncologist and Director of the Comprehensive Breast Program at the Margie Petersen Breast Center, discusses breast cancer screening and evaluation, including breast examinations, mammography, ultrasound, MRI and biopsy, and addresses common questions and misconceptions about breast cancer screening.

Contact us if you have a new breast concern or would like to schedule an evaluation.