Specialist surgical consultation
Discovering a breast lump, nipple discharge or other abnormality
can be a frightening experience. With all the publicity surrounding
breast cancer it is easy to assume the worst. Understandably you
will want to see a breast specialist as soon as possible.
Fortunately, appropriate investigations will prove that most of
these problems are benign.
I will listen to your description of the problem and ask some
relevant questions regarding your general health and life
Both breasts will be examined carefully. The use of ultrasound at
the time of initial consultation significantly improves the speed,
comfort and accuracy of assessment.
Ultrasound is painless and quick to use with no risk of
radiation exposure. It distinguishes fluid filled cysts from
solid lumps, guides needle-biopsy and accurately documents the size
and shape of an abnormality. It allows rational decision
making about the selection and sequence of other tests.
I will then discuss the place of any further investigations such
as mammography or biopsy in your particular situation. This allows
an individualised approach to your problem.
If mammograms are required they are performed at this stage.
If an abnormality is identified on these tests then a needle
biopsy is necessary to get a sample of the tissue for testing in
the laboratory. This is done under local anaesthetic and takes
about ten minutes. Local anaesthetic is injected to numb the skin.
A small needle is passed into the tissue under ultrasound
guidance and a sample of tissue is removed.
By the end of this first consultation I will be able to give you
a provisional diagnosis. Many lumps such as fluid filled cysts will
be completely treated in this one visit. The result of the needle
biopsy is usually available within 1-2 days and will confirm a