Lump in breast; what do?

August 28, 2015 9:26 PM

I have a lump in my breast and I need to know what to expect when I go to the doctor.

Okay, I feel dumb writing this, but. I’m 25 and I have a lump in my breast. It’s been there for about three years (you see why I feel dumb). In fruit terms it’s about the size of a plum, I guess. It sprang up pretty much out of nowhere (I think there might have been some noticeable growth in the first few weeks after I first noticed it, but since then it’s been the same size).

As you’d expect I did some googling and came to the conclusion that it was most likely a fibroadenoma. But, of course, google is not my doctor, and I know I really should go to one. But. I am SUPER anxious about doctor visits in general, and I’ve been putting it off and putting it off, and now I’ve put it off so long that it’s ridiculous and what am I even going to say when the doctor asks me how long the lump has been there?

In other areas of my life where my anxiety is an issue I’ve found it helps for me to know as much as possible about what I should expect, so I guess my actual questions are:

1) What should I expect in terms of how a doctor’s appointment for this would proceed? One of the things that makes me nervous is, I’m too young to be eligible for breast screen services without a referral, so I guess I basically go to a random GP and be all like “look at my boob it’s weird help pls?!” Then what? Please walk me through it like I’m an alien who has never been to the doctor before, which is actually not too far from the truth.
2) If it is a fibroadenoma, what is the process for getting rid of it likely to look like? It doesn’t hurt, but it’s kind of interfering with my sex life because it’s very visible and it makes me self conscious. So I want it gone, ideally.

(Also: Bonus if you can recommend a non-scary doctor in Victoria, Australia I could go to about this. I don’t have a regular GP, obviously. Cost doesn’t really matter, I just need someone who will be nice to me even though I’m clearly an idiot who doesn’t know how to adult).

posted by anonymous to Health & Fitness (12 answers total)

1. You're too young to be eligible for breast screening services ***without a reason***. With a reason, you are eligible. Every GP who feels a plum-sized lump in your breast is going to refer you on.
2. Bring a friend with you. Friend can take notes, and can make sure you ask all the questions you want to ask.
3. If you can think up questions now, make a list of them, print it out, and give a copy to friend while keeping one for yourself. First question: "If this is a fibroadenoma, what is the process for getting rid of it?"
4. If you feel it's going to be too hard for you to say "I've had it for three years" then let friend help you with this. She can prompt you to say it, or she can say it for you.
posted by BlahLaLa at 9:43 PM on August 28, 2015 [1 favorite]

That is terrifying but my ex went through that that a few times and it was some kind of non-malignant growth. She wound up with a half inch scar.
posted by Mr. Yuck at 9:47 PM on August 28, 2015

Yes, you can just make an appointment with a GP. See if friends have one they would recommend. (And/or if a friend or family member can go with you.)

I went to my regular GP. I have a lump that flairs every few months (I'm also 25). She felt my boob and confirmed I have a lump, and asked me questions about it. (When I noticed, when it flared, if it hurt, etc.) She wants to me do an ultrasound with a biopsy/drain it if there's fluid. I haven't done it yet due to other health issues, but she said it was likely nothing to worry about. (The only problem is that it becomes painful and swollen. And obviously any lump should be checked.)

So, they'll likely refer you to at least an ultrasound/biopsy/imaging. My GP told me that they don't usually recommend mammograms at this age because the breast tissue is difficult to see through until you're older. After tests they'll determine what treatment you need, which may mean draining or it may mean a procedure to remove it.

Take a deep breath. You'll get through this.
posted by Crystalinne at 10:15 PM on August 28, 2015

It's hard to advocate for yourself! You aren't alone and I am proud of you for being brave and taking your first steps here so you can be your body's champion when you visit the doctor.

Here's what I said when I first asked about a lump in my boob (which was about a month ago): "So, there's something different about this breast and it's making me anxious. I think it's been different for a few years but I've been too nervous to talk to anyone about it. Can we make a breast exam our priority today please?" And my gyno was like absolutely, let's see what's up. And she did a breast exam (clothes off, laying down, hands and arms behind my head, etc). She also felt what I felt ("a 4cm lump at 10 o'clock") and said that she didn't think it was too big a deal but we ought to get it checked out anyway so off I went to get an ultrasound. Turns out, my right boob is hella dense and what we found was actually just some super thick breast tissue that's kind of knobbly and that's why we both felt something off. In reality all things were a-ok. But I didn't know that for ages and the not knowing was really crummy.

If anybody, be it doctor, nurse, whatever, give you shit for this, look them dead in the eye and say, "Attitudes like that and health care professionals like you are the reason I haven't come in till now. Please show me there's more to you than just bullying someone like me who really needs your support right now." Or send them to me and I will fight them for you. Good luck -- I know this is hella scary and I am thinking of you.
posted by Hermione Granger at 10:53 PM on August 28, 2015 [3 favorites]

I'm in the process of getting a lump removed from my breast. Here's my experience:

My lump was found during an annual exam, so they referred me to another doctor who used an ultrasound machine to capture images of it. Apparently younger women have denser breast tissue, so that's why they use ultrasound rather than do a mammogram. They had me come in every 6 months for a few years so they could monitor its growth. I would imagine that if you went to your doctor and told them you had found a lump, they'd take it from there. They'll probably do a physical breast exam before going for an ultrasound.

Earlier this year, they measured it and found that it had grown big enough that I should have it removed. For removal, I had two options: a lumpectomy, or cryoablation. Cryoablation is where they stick a needle in the fibroadenoma and freeze it, and the freezing kills the tissue. Your body reabsorbs this dead tissue over a period of time.

I chose to have a cryoablation done, since it's far less invasive, and only requires local anesthetic. It didn't end up happening because the doctor couldn't get the lump to stay in place to get the needle in, so now I'm scheduled for a lumpectomy. Other than the fact that it didn't work out, it wasn't a bad experience. It hurt for about 24 hours afterward, and didn't really stop me from doing anything. I'll have to get back to you on the recovery time for the lumpectomy.

Good on you for taking care of yourself. It can be pretty scary to deal with these things, but they can be taken care of relatively easily.

Good luck!
posted by Maeve at 11:34 PM on August 28, 2015 [1 favorite]

No one should judge you. If you get any questions about why you waited, just say, "I was scared." The important thing is that you've stopped waiting. Please be sure to follow up so we know how it all works out. Sending you lots of positive energy.
posted by janey47 at 3:15 AM on August 29, 2015

Anxiety causes me to put off doctor visits too. My response if this is brought up is to simply say "The important thing is that I'm here now. " End of sentence.
posted by bookmammal at 3:37 AM on August 29, 2015 [4 favorites]

I also have doctor issues. In general, I find being upfront with my doctor about this helps -- "I hate going to the doctor. It has nothing to do with you, doctor, specifically. I know it's an issue and I'm working on it." They are generally pretty nice about this! If they are not, then that is the doctor's issue, not yours, so don't go back to that doctor.

Also, not sure if this is an option in your area, but in general I have found nurse practitioners a bit more sympathetic to Doctor Issues than regular MDs. (On average -- obviously there is a wide range of variance over both.) If you can find a practice where routine care things are handled by an NP under an MD's oversight that may help.

And -- I am a bit embarrassed by this, but I actually started giving myself positive rewards after going to the doctor for ANYTHING, like I was three. (For me it is Fancy Starbucks Beverage, something I love and don't normally let myself buy. But for you it could be anything.) This has totally helped and gives me something to focus on during the appointment.

You can totally do this and it will be SO MUCH BETTER to know what's going on than to keep stressing out about it. Good luck!
posted by pie ninja at 6:03 AM on August 29, 2015 [2 favorites]

I have had a lump in my left armpit/breast area since I was a teenager, and was too embarrassed-scared to get it checked out for years. I eventually did ask my doctor about it. She asked how long it had been there, but didn't seem to think it was odd that I had waited years to get it checked out - I'm guessing that it's not uncommon.

Based on how it felt, my doctor said that it was probably just breast tissue that had migrated into my armpit, but she sent me to get an ultrasound to check. The ultrasound confirmed that she was correct, so the lump is still there - there's no medical reason to do anything to it.

I highly recommend getting a friend or family member to suggest a doctor to you - some doctors are MUCH better than others at being kind and nonjudgmental.
posted by insectosaurus at 6:27 PM on August 29, 2015

Just to fill in a gap -- I've had weird breast things twice, once a decided dimple and once some unsettling nipple discharge. Both times, I was sent for a mammogram AND ALSO an ultrasound on the breast in question. I went into the radiology center, got changed, they did the imaging and then had me wait around half an hour to an hour to make sure the radiologist on staff didn't want them to take extra pictures. Then they sent me home and sent the test result on to my ob/gyn, who called me about it a week or so later. (The dimple was just the result of weight loss, it turns out, and the discharge a Thing That Happens To Ladies Of A Certain Age Sometimes, go figure.)

In my experience, people in medical imaging centers are really kind, because they know you don't wind up there unless you're really worried about something-or-other. But they're also not allowed to tell you anything about what they see in the US, at least, so don't hound them for an analysis or diagnosis they may not be qualified to give you.
posted by Andrhia at 6:29 PM on August 29, 2015

I found a lump in my breast when I was 22. It was not a fibroadenoma, but it wasn't a malignancy either (it was a hamartoma). I had an initial exam (I went to an urgent care clinic at the local hospital as I didn't have a GP at the time), which turned into a referral for an ultrasound, which turned into a referral for a fine needle biopsy. About a year later the lump became painful and I elected to have it removed surgically.

The removal was very straightforward for me -- I went to the hospital in the morning, having fasted since the night before, I was sedated for about half an hour and the lump was removed. I had to wear a sports bra 24/7 for about a week afterward to support my breast, but that might not be the case for you, as my lump was in a position such that the weight of the breast could have pulled the incision open. It was closed with glue and covered with a regular bandage.

Nowadays the scar is almost imperceptible, to the point that during breast exams providers sometimes need me to show them where it is because they can't see or feel it.

Everything about this is scary, of course, but you're doing the right thing now. Believe me, many (most?) people wait just as long if not longer to deal with stuff like this. In my experience, once you're referred to the breast specialist facilities for imaging, etc, everyone becomes incredibly nice. There may be bad apples but overall I don't think I've ever had a more positive healthcare experience in terms of courtesy, friendliness, etc.
posted by telegraph at 4:11 AM on August 30, 2015

I can only answer your first question. I also had a lump when I was 25. Sorry for the long post but I tried to be descriptive. The doctor will just ask you when you noticed it. Then you will say something like, “Three years ago but I was too anxious to come in.” As someone that also has anxiety, I would recommend this because then it would be less likely that he or she will react harshly after you just state that you were anxious about it. A lot of woman who have lumps would be anxious about it and doctors are used to dealing with anxious patients.

Then, what will happen is the doctor will say ok lets take a look at it and ask you to change into those weird paper dresses and lay on the doctor’s table thing. They will then check your breast and might even ask you to point it out if they can’t find it. Once they find it they will probably ask you to change back and that he/she will talk about what it could be once he/she comes back. Then, when they come back they will say, “It could be A, B, or C and not necessarily cancerous” (can’t remember what my doctor told me but these are not dangerous and are common). Then they will probably explain that they are not dangerous but add that they would like to make a referral for an echo or biopsy so that he/she can tell you for sure what it is.

First of all, the appointment might not be for a couple of weeks. I know that this made me anxious but what you have to do is just remember, there’s no reason for you to freak-out now. Are you a doctor? No. Can you tell if it’s cancerous? No. Is there anything you can do about it? No. It’s not your job to know if it’s cancerous and freak out, it’s theirs. All you can do is your job witch is to relax and take care of yourself in the meantime.

This is the mentality that I had when I had to wait for the appointment. I used it before when I was applying for graduate school (Is it your job to deny or accept your application? No. Are you the school? No. It’s not your job to accept your application and freak out about it, it’s theirs. All you can do is your job witch is just make the best application possible). I decided to use this for my breast tumor because it really worked

When you go in for your biopsy they make you change into these robs that are nicer than the paper dresses but are basically the same thing. Once you are in they check your breast to find the area and they put on the ultrasound jell and look at it. At this point they can tell a couple of things about the tumor like if it’s even a tumor. Then they well numb the area and do a biopsy witch they perform using a syringe like device. They will take out a little bit of the tumor for analysis and insert a small maker, usually made out of titanium, so they can refer to the same place if they have to go back. Then they do a mammograms and that is it. You have to wait again for the results but your job is done. Now it’s time for them to do their job and analyze the tumor. My tumor turned out to be benign (not cancerous) and then it kind of disappeared on its own.
posted by human_readable at 2:30 PM on August 30, 2015 [1 favorite]