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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.

Common breast concerns

  • 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. 

Screening for breast cancer

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.

Breast tissue density

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.

For women at high risk of breast cancer

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.

Diagnostic tests and procedures

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:

  • A painless exam, a breast ultrasound uses high-resolution sound waves to create images of the breast, which are viewed on a computer screen. It is often used in conjunction with a diagnostic mammogram. A breast ultrasound can determine whether a mass or lump is fluid-filled or solid. It can guide breast biopsies or cyst aspirations.

  • A breast MRI is a painless exam that uses radio waves and high-powered magnets in conjunction with contrast material to create highly detailed images of the breast. Highly sensitive breast MRIs are helpful in determining whether breast disease has spread or for evaluating patients already undergoing cancer treatment. It may be used to determine how far cancer has spread or to evaluate breast implants for leakage or rupture. In some instances, breast MRI is used as a screening tool for women with an increased calculated risk for developing breast cancer or for those who are genetically predisposed carrying the breast cancer genes BRCA1 and 2.

  • A biopsy is a tissue sample taken for microscopic examination and analysis by a pathologist (disease specialist). If a breast lump or abnormality is detected during a breast exam or imaging exam, we’ll schedule an image-guided breast biopsy so our physicians can remove cell or tissue samples to determine whether they are benign (harmless) or malignant (cancerous). 

Breast cancer treatment

Our dedicated team of medical oncologists and surgeons are experts in treating breast cancer. Patients have access to the latest treatments, including:

  • Chemotherapy
  • Radiation therapy
  • Surgery, including lumpectomy, mastectomy and reconstruction
  • Targeted and hormonal therapy

A cancer navigator is assigned to each patient to help coordinate appointments and treatment plans, since a cancer diagnosis can be scary and health care can be complex. In addition, patients have access to clinical trials, complementary and alternative medicine, classes and support groups, rehabilitation, and more. Learn about our innovative breast cancer treatments.

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Make an appointment

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