Diagnosis

Tests to evaluate your condition may include:

• Clinical breast exam. Your doctor feels (palpates) your breasts and the lymph nodes located in your lower neck and underarm area checking for unusual breast tissue. If the breast exam — along with your medical history — suggests you have normal breast changes, you may not need additional tests.

  But if your doctor finds a new lump or suspicious breast tissue, you may need to come back a few weeks later, after your period, for another clinical breast exam. If the changes persist or the breast exam is concerning, you may need additional tests, such as a diagnostic mammogram or ultrasound.

• Mammogram. If your doctor detects a breast lump or prominent thickening in your breast tissue, you need a diagnostic mammogram — an X-ray exam that focuses on a specific area of concern in your breast. The radiologist closely examines the area of concern when interpreting the mammogram.
• Ultrasound. An ultrasound uses sound waves to produce images of your breasts and is often performed along with a mammogram. If you're younger than age 30, you might have an ultrasound instead of a mammogram. Ultrasound is better for evaluating a younger woman's dense breast tissue — tissue tightly packed with lobules, ducts and connective tissue (stroma). Ultrasound can also help your doctor distinguish between fluid-filled cysts and solid masses.
• Fine-needle aspiration. For a breast lump that feels a lot like a cyst, your doctor may try fine-needle aspiration to see if fluid can be withdrawn from the lump. This helpful procedure can be done in the office. A fine-needle aspiration may collapse the cyst and resolve discomfort.

• Breast biopsy. If a diagnostic mammogram and ultrasound are normal, but your doctor still has concerns about a breast lump, you may be referred to a breast surgeon to determine whether you need a surgical breast biopsy.

  A breast biopsy is a procedure to remove a small sample of breast tissue for microscopic analysis. If a suspicious area is detected during an imaging exam, your radiologist may recommend an ultrasound-guided breast biopsy or a sterotactic biopsy, which uses mammography to pinpoint the exact location for the biopsy.

It's important to report any new or persistent breast changes to your doctor, even if you've had a normal mammogram within the last year. You may need a diagnostic mammogram or ultrasound to evaluate the changes.