Breast Health Diagnosis & Treatment

Our experienced team of breast health practitioners can help clarify the nature of your breast health concern and bring you peace of mind.

• Breast lumps in women: Often what is thought of as a "mass" or "lump" is actually normal breast tissue, not cancer. Common causes of lumps can be fibroadenomas, cysts, lipomas, injury to the breast, and mastitis.
  
• Breast masses in men: Gynecomastia means enlargement of the male breast and is the most common cause of a breast mass in a man. It is described as a tender mass underneath the nipple. Any breast mass in a man needs to be evaluated. 
  
• Breast pain: Breast pain (mastalgia) is very common. It can be cyclic (associated with the menstrual cycle), or non-cyclic (not related to your period). Breast pain alone is rarely a sign of breast cancer. Pain can be due to hormonal changes, an enlarging or inflamed cyst, injury, certain medications, and pain in the chest wall or muscles. 
• Nipple discharge: If nipple discharge is spontaneous, persistent, emanates from one duct, and is clear, bloody or a mixture of bloody and clear fluid, further evaluation with exam and breast imaging is recommended. Some causes of nipple discharge include overstimulation of breast tissue, certain medications, and benign growths or clogged ducts in the breast.
• Breast skin changes: Usually there are other reasons for breast skin changes, but we do recommend evaluation, especially if these are new, persistent or worsening. Skin changes that cause worry include skin puckering or dimpling, nipple inversion, thickened skin tissue, with enlarged pores, warmth, pain or redness of the skin, and scaling, thickening or flaking of the nipple or areola. 

Evaluation for common breast concerns can include: 

• Thorough medical history review and clinical breast exam
• Mammogram and/or breast ultrasound  
• Needle biopsy can be suggested, to remove a small piece of tissue to look at under a microscope
• Aspiration (fluid withdrawal) of a cyst if it is symptomatic or abnormal on imaging
• Consultation with a specialist

Follow-up can include:

• Imaging and/or exam, depending on the findings and your particular situation
• Routine screening, or earlier return to keep a close watch

If you have a concern with your breasts, make an appointment with a breast health specialist for an evaluation. 

If detected early, breast cancer can be successfully treated and cured. At Virginia Mason Franciscan Health, our board-certified radiologists and imaging technologists offer the most advanced imaging methods to help guide diagnosis and treatment.

A screening mammogram is a low-dose, digital X-ray that creates images of the breast. Our board-certified radiologists, specializing in mammography, can enhance the images on a computer screen for analysis. We use 3D digital screening mammography to detect tumors, cysts, and other subtle changes in breast tissue that may be too small to detect by touch.

Early detection, including regular screening mammograms, can save your life. Virginia Mason Franciscan Health recommends these breast screening guidelines for women who are not at high risk of developing breast cancer:

• Yearly screening mammogram for women aged 40 and older
• Yearly clinical breast exam
• Monthly breast self-exam (BSE)

The recommendation for BSE is controversial. There is no evidence that it is beneficial in the long run, so if you feel uncomfortable checking your own breasts, don't worry. However, BSE can help you become more aware of how your breasts normally look and feel. Talk to your doctor about a breast cancer screening schedule that’s right for you.

Washington law requires that all patients who get a mammogram be notified of their breast density. Breast density refers to the amount of fibroglandular tissue relative to fatty tissue in a woman’s breast. A woman is considered to have dense breasts if she has a lot of fibroglandular tissue and not much fatty tissue. Women with dense breasts may have an increased risk of breast cancer when compared to women with average or below average breast density. Your mammography screening clinic or center will notify you of your breast density when you receive your mammogram result letter. For more information about breast density, talk with your provider.

Women at high risk for developing breast cancer often need more intensive and earlier screening. This may include a yearly mammogram, a clinical breast exam once or twice a year, and for some women, a yearly breast MRI. Some women may also be candidates for genetic testing due to family background. At Virginia Mason Franciscan Health, we offer hereditary cancer risk assessment and genetic counseling. Talk with your physician about a referral to our genetic counseling services or call 206-223-6193.

If your screening mammogram shows any potential abnormalities, you may need further testing. Alternatively, if you experience any unusual breast pain or symptoms, your provider may order a diagnostic test. At Virginia Mason Franciscan Health, we provide comprehensive diagnostic testing for breast health:

To schedule a screening mammogram, find a location near you and call for an appointment. A referral is not necessary.