A protocol-based systemic approach is needed in the management of breast lumps. A triple assessment based on clinical examination, mammogram and ultrasound scan is usually quite accurate in deciding whether a lump is present and if so, whether it is malignant. If no lump is found the patient can be reassured. If there is still any doubt about the lump, then one should consider a fine needle aspiration, a core needle biopsy or excision. Further treatment depends on the type of lump found.