You feel something unfamiliar in your breasts. Is it a cyst, a normal change in breast tissue, or something that needs further investigation?
 
Finding a breast lump does not automatically mean you have breast cancer. Most lumps are benign (non-cancerous). Doctors evaluate a breast lump through a comprehensive three-step approach: a clinical breast exam, diagnostic imaging (ultrasound or mammogram), and a tissue biopsy only if necessary.
 
1. Your doctor will ask about the lump
Your appointment typically begins with a detailed medical history. Your doctor will ask targeted questions to understand your symptoms better:

• When did you first notice the lump?
• Has it changed in size or become painful?
• Does it change with your menstrual cycle?
• Have you noticed nipple discharge, skin changes, or nipple changes?
• Is there swelling or a lump under your arm?
• Have you had previous mammograms, breast ultrasounds, or biopsies?
• Is there a personal or family history of breast or ovarian cancer?

If you have previous breast imaging, it may be useful for comparison.
 
2. You will have a clinical breast examination
Your doctor will examine both breasts and nearby lymph-node areas, including the armpits.
The examination may assess the lump’s location, size, shape, texture, tenderness, and mobility. Your doctor will also look for changes involving the breast skin or nipple.
These findings provide useful clues, but it is generally not possible to determine whether a breast lump is benign or cancerous simply by feeling it. Imaging is often the next step.
 
3. You may need ultrasound, mammography or both
The type of imaging recommended depends on factors such as your age, symptoms, medical history, and clinical examination.
 

• Breast ultrasound: Uses sound waves to examine the lump and can help determine whether an area is fluid-filled, such as a cyst, or solid.
• A diagnostic mammogram: Uses specialized breast X-rays to investigate a particular symptom or area of concern. Additional mammographic views may be taken to examine the area more closely.
• Breast MRI: May also be considered in selected situations. In many cases, mammography and ultrasound complement each other.

 
4. What does BI-RADS mean?
After imaging, the radiologist may assign a BI-RADS category, a standardized system used to describe breast imaging findings and guide the next step.
 

BI-RADS category	Assessment	Recommend Action
BI-RADS 0	Incomplete	More information is needed.
BI-RADS 1–2	Negative or benign	Additional imaging or prior exams needed.
BI-RADS 3	Probably benign	Follow-ups are usually recommended.
BI-RADS 4–5	Suspicious / Highly Suspicious	Biopsy is generally recommended.
BI-RADS 6	Proven Malignancy	The biopsy has already confirmed cancer.

BI-RADS is not a breast cancer diagnosis or cancer stage.
 
5. Will I need a breast biopsy?
Not every breast lump needs a biopsy.
If the examination and imaging findings indicate a benign condition, your doctor may recommend routine care or follow-up imaging. If a finding is suspicious or cannot be confidently classified as benign, tissue sampling may be recommended.
 
A core needle biopsy is commonly used to obtain small samples of breast tissue. Imaging such as ultrasound or mammography may be used to guide the needle accurately to the area being investigated. The tissue is then examined by a pathologist to determine whether the finding is benign or malignant.
 
Depending on the type, size, and location of the breast finding, other procedures may also be considered, including vacuum-assisted excision (VAE) or an excisional biopsy. VAE uses a vacuum-assisted device to remove breast tissue through a small incision, while an excisional biopsy involves surgically removing part or all of the abnormal area for examination.
 
Importantly, being referred for a breast biopsy does not mean that breast cancer has already been diagnosed. The purpose of the biopsy is to establish a diagnosis.
 
What if imaging looks normal, but I can still feel the lump?
A persistent breast lump should still be discussed with your doctor even when initial imaging is reassuring.
 
Doctors consider the complete clinical picture, including the physical examination, imaging findings, previous studies, and individual risk factors. If the clinical and imaging findings do not match, further evaluation may be appropriate.
This is why breast lump assessment is not based on one test alone. Clinical examination, appropriate breast imaging, and biopsy, when necessary, work together to establish the diagnosis.
 
Why choose Bumrungrad for breast lump diagnosis and breast care?
At Bumrungrad International Hospital, the Breast Center works with the Diagnostic Radiology and Nuclear Medicine Center and Horizon Regional Cancer Center to support breast screening, diagnosis and treatment.
Multidisciplinary care may involve breast radiologists, breast surgeons, pathologists, medical oncologists, radiation oncologists, and other specialists according to each patient’s needs.
 

• Advanced Diagnostics:

Bumrungrad offers advanced breast imaging and diagnostic services, including 3D digital mammography, breast ultrasound, breast MRI, stereotactic and other image-guided breast biopsies. The hospital also uses Lunit INSIGHT MMG, an AI-assisted mammography system that analyzes mammographic images and highlights suspicious areas for closer evaluation. AI supports the radiologist’s interpretation rather than replacing specialist review.
 

• Internationally Accredited Care:

Bumrungrad’s Breast Cancer Program received Joint Commission International Clinical Care Program Certification (JCI CCPC) in 2025, recognizing its commitment to international standards for quality and patient safety in breast cancer diagnosis and treatment.
 

• Global Recognition:

In Newsweek and Statista’s Best Specialized Hospitals Asia Pacific 2026, Bumrungrad ranked No. 1 in Thailand and 58th in Asia-Pacific for Oncology. Bumrungrad was also ranked No. 96 worldwide in Newsweek’s World’s Best Hospitals 2026, remaining the only hospital from Thailand in the global Top 100.


Frequently Asked Questions
Does breast lumps always mean cancer?
No. Many breast lumps are caused by benign conditions. However, a new, persistent or changing lump should be medically evaluated.
 
Should I see a doctor if the lump does not hurt?
Yes. Whether a lump is painful or painless cannot reliably determine its cause.
 
Will I need a biopsy at my first appointment?
Not necessarily. Your doctor may first perform a clinical examination and recommend breast imaging. A biopsy is usually considered when tissue diagnosis is needed.
 
Can an ultrasound tell whether a breast lump is cancer?
Ultrasound can provide important information about a lump and its imaging characteristics. However, if a finding appears suspicious, a biopsy may be needed to establish a diagnosis.
 
Finding a breast lump can be worrying, but the purpose of the appointment is to replace uncertainty with information. The sooner a new or changing lump is properly evaluated, the sooner you can understand what it is and what, if anything, needs to happen next.
 
 
References

1. American College of Radiology. ACR BI-RADS® v2025 Manual. Reston, VA: American College of Radiology; 2025.
2. Klein KA, Kocher M, Lourenco AP, et al. ACR Appropriateness Criteria® Palpable Breast Masses. Journal of the American College of Radiology. 2023.
3. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Screening and Diagnosis.
4. Moy L, Heller SL, Bailey L, et al. ACR Appropriateness Criteria® Palpable Breast Masses. Journal of the American College of Radiology. 2017;14(5S):S203–S224.
5. Lehman CD, Lee AY, Lee CI. Imaging management of palpable breast abnormalities. American Journal of Roentgenology. 2014;203(5):1142–1153.
6. Giess CS, Smeglin LZ, Meyer JE, Ritner JA, Birdwell RL. Risk of malignancy in palpable solid breast masses considered probably benign or low suspicion: implications for management. Journal of Ultrasound in Medicine. 2012;31(12):1943–1949.

 
Medically reviewed by:
Piyawan Kensakoo, M.D.
Breast Surgery & General Surgery
Last medically reviewed: September 2026