What Does A Lump Mean?

Physicians find lumps all of the time. Most of them are benign and transient (of course the pregnancy "lump" is transient but may not be so benign).  So how does a doctor know which lump merits concern and investigation?

The basic tools are straight-forward. A simple history, which addresses a variety of issues including some of the following, may lead to the correct clinical impression: Have you ever had cancer or any unusual growth on your skin or elsewhere?  What surgery have you had?  How is your appetite? Have you lost weight recently?  Have you had sweats at night or experienced fevers which have no obvious explanation?  Have you been exposed to toxic environments or  materials in your work or personal activities?

And then, the doctor takes the time to perform a competent examination, examining the lump, skin, lymph node areas, thyroid, abdominal organs, breasts, testicles and other areas which may harbor malignancy and which are accessible to palpation or examination.

Only then, does the doctor consider the differential diagnosis and possible laboratory and radiologic tests which may help to establish a diagnosis and differentiate a benign from a more serious condition.  And then,  after a discussion with the patient, the doctor orders the standard tests - and  specialty focused tests such as fine needle sampling (biopsy) of the tissue in question.

Then the doctor and the patient (and those the patient wants to be involved) discuss the findings, the diagnosis and the treatment options and plan. 

Medicine is not television drama. The physician - who has been carefully trained to understand and require each step that I have outlined - collects all necessary information to form an evidence-based diagnosis.  Scientific evidence trumps intuition and conjecture.