COMMON QUESTIONS ABOUT BREAST CANCER: HOW CAN THE DOCTOR TELL IF A LUMP IS CANCER OR JUST A CYST?

It is not always easy for your doctor to distinguish between a cancerous lump and a cyst by means of a physical exam alone. But there are some distinctions. Cysts tend to fluctuate in size with the menstrual cycle, and are usually painful and sore. In contrast, a cancerous lump is apt to be more stable in size and less tender. Typically, cysts are easier to move, more spherical, and softer than breast tumors, which are anchored to surrounding tissues. Ask your doctor his or her impression of the lump. If a needle biopsy is performed, ask if the fluid or material recovered from the lump indicated a fluid-filled cyst. Often the size of a cyst will decrease once the fluid has been aspirated from it, so ask whether such a decrease in size has occurred.

A mammogram is another good tool in helping the doctor to decide if the lump is cystic or cancerous. Unfortunately, it is not foolproof and should be done in conjunction with a biopsy. The mammogram may show small calcifications (which show up as white densities) when cancer is present. In the case of cystic disease, larger calcifications may also be present. The shape and density of the lump tend to be the distinguishing factors: cysts generally have a very uniform density and may have a small surrounding ring of thick, fibrous tissue; tumors are much more irregular in shape and density.

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Cancer