More than 5,000 women and men come to our interdisciplinary breast centre every year with suspected breast disease. We have the opportunity to immediately obtain a precise picture of breast changes using ultrasound and mammography, and in over 80 per cent of the patients presented, we can give the all-clear after the diagnostics have been completed, as the findings are benign.
In addition to palpation, breast diagnostics includes state-of-the-art imaging procedures as well as minimally invasive procedures for tissue removal and for the histological confirmation of unclear findings. We work with certified methods to ensure that nothing is left to chance. All examination results, images and data are always assessed by at least two breast cancer specialists, who then present their findings to the interdisciplinary team.
In order to give you as a patient the best possible certainty when clarifying your symptoms, we prioritise two things:
- Personalised care in admission and consultation meetings and
- comprehensive, i.e. thorough and interdisciplinary, quality-assured diagnostics in order to quickly gain clarity about the type and extent of the disease.
Although changes in the breast are a cause for concern for many patients, we can quickly give the all-clear in the majority of cases. Most findings in the breast do not have the character of a disease. In most cases, our specialists at the Breast Centre can quickly provide you with a precise diagnosis.
Typical benign changes in the breast:
Fibroadenomas
These are the most common benign findings in the breast (palpable in most cases). They are lumps that consist of connective tissue and are particularly common in younger women. Once they reach a certain size, patients may perceive them as disturbing, painful or cosmetically altering the shape of the breast. In such cases, we offer you breast-sparing surgical removal on an outpatient basis after prior fine tissue examination.
Mastopathies
Due to the influence of oestrogens (female hormones), more connective tissue is formed in the case of mastopathy, which makes the breast look lumpy and harder. Affected patients usually experience pain before their period (mastodynia). The diagnosis is confirmed by taking a sample. There are various conservative treatment methods, which we will be happy to advise you on during our consultation hours.
Cysts
A cyst is an area in the breast that is filled with fluid. Cysts can vary in size. In most cases, they are an incidental finding and do not cause any symptoms. For diagnostic or therapeutic purposes or in the event of symptoms, the fluid can be easily aspirated and examined.
Lipomas
A lipoma is a benign fatty tissue lump in the breast. It can be removed if it is disturbing or growing.
Nipple secretions
Nipple secretions can occur on one or both sides of the breast. Clarification is advisable. In some cases, benign milk duct growths (papillomas) are found, which can be surgically removed.
Inflammatory breast changes
These can occur at any time. A distinction is made between inflammation during pregnancy or breastfeeding (mastitis puerperalis) and outside of pregnancy (mastitis non puerperalis). Depending on the severity, local treatment is carried out with or without antibiotics in combination with cooling. If an abscess forms (accumulation of pus in the tissue), a puncture or surgical treatment may be advisable to relieve the condition.
Breast cancer (mammary carcinoma) is a malignant tumour of the mammary gland and is diagnosed in around 70,000 women in Germany every year. It is the most common cancer in women.
The symptoms of malignant breast disease can vary greatly from patient to patient, but breast disease can usually be easily recognised through regular screening examinations such as palpation and mammography.
Possible symptoms that should be clarified:
- Palpable breast lump
- Retraction of the nipple
- Leakage of fluid from the nipple
- Changes in the shape or colour of the breast
Patients and those seeking advice with a conspicuous family history, i.e. frequent cases of breast and/or ovarian cancer in the family or a very young age of onset, are advised and cared for at the Centre for Familial Breast and Ovarian Cancer. In addition to testing for specific genetic changes (e.g. risk genes such as BRCA 1 and 2), the centre also coordinates intensified screening. Patients with an increased risk of breast cancer receive further preventive examinations such as breast ultrasound, mammography or breast MRI via the tumour risk consultation.
Further information can be found on the website of the Centre for Familial Breast and Ovarian Cancer.
You or your doctor have felt hardening in your breast or changes can be seen on the X-ray images of the mammogram. We want you to gain clarity as quickly as possible. Make an appointment at our breast centre. If you have already had a mammogram or other examinations outside our clinic, we would ask you to bring these documents with you (e.g. previous images and written findings).
During your first appointment at our Breast Centre, we will discuss your personal situation in detail as well as any X-rays you may have had and carry out further diagnostic steps.
These usually include
- Palpation of the breast
- Ultrasound examination
- Further imaging examinations if necessary
During your first appointment, we can carry out the complete examination in our consultation room and, if necessary, take a tissue sample.
Imaging diagnostics
We have various imaging procedures at our disposal for the early detection and diagnosis of an unclear breast lump. In co-operation with the radiology department, we can offer all diagnostic procedures (MRI, mammography and sonography) including minimally invasive procedures (punch biopsy, vacuum biopsy).
X-ray examination of the breast
Mammography is carried out by the radiology department using radiation-saving digital technology. The findings are analysed thoroughly and based on guidelines to ensure a reliable risk profile. On the X-ray images, we can recognise microcalcifications as well as the size and number of any lumps present and largely distinguish them from benign changes.
In the event of fluid leakage from the nipples, a galactography (examination of the milk duct) can be carried out. Contrast medium is injected into the milk duct to visualise changes.
Further information on mammography and appointments at the Radiologie am Michelsberg can be found on the homepage of the Clinic for Diagnostic and Interventional Radiology.
Ultrasound examination of the breast
Today, breast sonography is an indispensable part of breast diagnostics. With the help of breast sonography, abnormal findings on mammography and palpation can be further assessed. It complements the X-ray examination and is carried out in our breast consultation. Breast ultrasound also makes it possible to detect the smallest changes that were not previously recognisable.
In breast ultrasound, the breast is examined using high-frequency ultrasound. This allows the tissue to be visualised down to the smallest details, such as milk ducts and glandular lobules. It is also the examination method of choice for younger women with dense breast tissue. The team at the Breast Centre has a particularly high level of expertise and excellent, state-of-the-art equipment.
Breast magnetic resonance imaging (MRI)
Magnetic resonance imaging is a supplementary examination and is carried out by our colleagues in Radiology. The imaging procedure is used as required in the following cases:
- Diagnosis of recurrence of breast cancer (relapse)
- Diagnostics after breast reconstruction with implants
- Diagnosis of high-risk patients (e.g. with a family history)
Further information on MRI can be found on the homepage of the Clinic for Diagnostic and Interventional Radiology.
Minimally invasive diagnostics
If the findings in the breast are unclear, we will take a small tissue sample (biopsy). This allows us to clarify whether the lump is benign or malignant and to what extent further treatment is necessary.
We offer the following minimally invasive procedures:
- Ultrasound-guided vacuum or punch biopsy
- Mammography-guided vacuum biopsy in cooperation with the radiology department
- Magnetic resonance imaging-guided vacuum biopsy in co-operation with the radiology department
We choose the examination procedure that best visualises the findings. If required, we can organise biopsies under mammography or MRI control for you via our colleagues in radiology.
In this procedure, we take tissue samples from the lump using a hollow needle. The procedure is performed on an outpatient basis under local anaesthetic. We can perform the punch biopsy under image control in our breast consultation.
Similar to a punch biopsy, the histological examination is carried out under local anaesthetic under ultrasound or X-ray control. The vacuum technique allows larger tissue samples to be taken than with a punch biopsy.
Small benign findings (e.g. fibroadenomas) can be easily removed in our surgery under local anaesthetic using the vacuum technique (mammotome).
If the vacuum or punch biopsy is unsuitable for your findings, we can clarify the abnormal area by means of a minor surgical procedure.
Visualisation of non-palpable focal findings before a planned operation
In the case of planned surgical removal of non-palpable breast findings, these are localised on the day of the procedure under ultrasound or X-ray and marked with a thin wire for the operation.
Examination of the tissue samples
All tissue samples are analysed under the microscope by the pathology department after appropriate technical processing. The histological findings are available after two days at the latest. We will then discuss and plan the next steps with you.