Expert: Claes-Gustaf Nordquist, M.D. - 3/19/2008

Question
I have pasted in my last question. I was only able to find a cantre that would do an ultrasound and mammogram in a timely fashion. My mammogram showed nothing but cancer could not be ruled out on my ultrasound which did show a 1.3 cm mass with "appeared thickening around the mass. My Dr wants to refer me to have an excisional biopsy done. Is that really the best course of action?? Should that be considered when there are less invasive options available. I again am 21 and vainly am concerned with a scar on my breast as well as the appearance that will be left if the lump as well as surrounding tissue is removed. of course I will do what needs to be done but am i over reacting in thinking that the type of biopsy that they are suggesting may not be warranted? Thanks Again

Question:
I am a 21 yr old female who recently found a 1cm hard but movable lump in my right breast. In the last month it has not changed in size at all. It doesnt feel out of place other then the fact that it is so hard and rounder then the rest of my breast tissue. Just yesterday it started hurting, Could I have aggravated the breast tissue by constantly touching it?? I have an appoint in a few weeks for an ultrasound and mammogram.When my dr. examined it she did not seem alarmed. Any opinion on What it most likely is? also in order to get these test done within a month i have to travel nearly 8 hours. Are there any other test you would suggest i could have done to speed up the process or avoid multiple trips. Any info you could give would be greatly appreciated, Thanks so much

Answer:
At your age the risk of breast cancer is VERY small indeed, furthermore your symptoms with pain, tenderness and soreness make a cancer diagnosis even more unlikely. It may be a cyst or a fibroadenoma - in both cases signs of a fibrocystic breast condition which is common among young women and not dangerous. So I'm not alarmed either. On principle Mammography & ultrasound breast scans should be done together with breast MRI scans and as in your case here also with a thin needle aspiration biopsy since your lump can be felt. That way you would get your diagnosis at once! good luck!

Answer
A needle biopsy - if available where you are, wherever that may be - would be MUCH less invasive and quite good enough to reach a sure diagnosis. If not available though and you can not go to where it is your options are limited even though your cancer risk at your age is very small.