Breast Cancer: Benign Breast Lumps

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Breast Cancer: Benign Breast Lumps

During your routine monthly breast examination, you find a lump. Now what?

Don't panic. Eighty percent of all breast lumps are benign, which means they're not cancerous. Benign breast lumps usually have smooth edges and can be moved slightly when you push against them. They are often found in both breasts.

There are several common causes of benign breast lumps, including normal changes in breast tissue, breast infection or injury, and medicines that may cause lumps or breast pain.

Breast tissue changes during a woman's entire life. It is particularly sensitive to changing estrogen and progesterone hormone levels during the menstrual cycle.

What Are the Types of Benign Breast Conditions?
The types of benign breast conditions include:

Fibrocystic changes. For some women, fluctuations in hormones during normal monthly menstrual cycles can create changes in the breasts that are referred to as fibrocystic breast changes. Women with fibrocystic breasts usually experience lumps in both breasts that increase in size and tenderness just prior to menstrual bleeding. They occasionally have nipple discharge as well.
The lumps are milk ducts and surrounding tissues that have grown and dilated to form cysts. The cysts rapidly enlarge in response to hormones released near menstruation. The lumps may be hard or rubbery and may be felt as a single (large or small) breast lump. Fibrocystic changes can also cause thickening of the breast tissue.
Fibrocystic changes are often most noticeable during your 40s -- in fact, these changes are the most common cause of benign breast lumps in women ages 35 to 50. Postmenopausal women are less likely to have these types of breast changes because hormone stimulation of breast tissue no longer occurs.
Simple Cysts. Simple cysts are fluid-filled sacs that usually occur in both breasts. They can be single or multiple and can vary in size. Tenderness and lump size often change with the woman's menstrual cycle.
Fibroadenomas. Fibroadenomas are the most common benign tumors found in the female breast. They are solid, round, rubbery lumps that move freely in the breast when pushed upon and are usually painless. Fibroadenomas are the result of excess formation of lobules (milk-producing glands) and surrounding breast tissue. They occur most often between the ages of 20 and 30 and are more common in African-American women.
Intraductal papillomas. These are small, wart-like growths in the lining of the mammary duct near the nipple. They usually affect women 45 to 50 years of age and can produce bleeding from the nipple.
Traumatic fat necrosis. This condition occurs when there is trauma (sudden injury) to the breast, although most women don't recall a specific injury. This causes fat to form in lumps, which are generally round, firm, hard, single and painless.

Can Men Have Breast Lumps?
Yes. Men can have tender breast enlargement, often with a lump beneath the nipple. Sometimes this is in one breast, but it often occurs in both. This benign condition is called gynecomastia. Gynecomastia can also occur after certain types of medicines are prescribed.

Can a Breast Lump Indicate An Infection?
Possibly. Sometimes breast infections are first noticed as a painful lump, with or without redness. Mastitis is an infection that often occurs in women who are breastfeeding. Mastitis is an infection caused by bacteria that enter the mammary ducts through the nipple. Localized pockets of infection will appear as tender, warm lumps in the breast.

A Word About Breast Self-Exam
By performing monthly breast self-exams, you can become familiar with the normal monthly changes in your breasts.

Breast self-examination should be performed at the same time each month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month.

What Should I Do If I Find a Lump?
See your doctor if you discover any new breast changes, changes that persist after your menstrual cycle, or other changes that you are concerned about. A physician should examine you if you find:

An area that is distinctly different from any other area on either breast.
A lump or thickening in or near the breast or underarm that persists through the menstrual cycle.
A change in the size, shape or contour of the breast.
A mass or lump, which may feel as small as a pea.
A marble-like area under the skin.
A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly or inflamed).
Bloody or clear fluid discharge from the nipples.
Redness of the skin on the breast or nipple.
What Will Happen at the Appointment?
After taking a detailed health history, your health care provider will perform a thorough breast exam to feel for lumps or other changes in the breast tissue and under the arms.

If there is nipple discharge, a sample will be collected and examined under a microscope to detect the presence of cancer cells.

Breast imaging ( mammogram or ultrasound) will be performed if your previous studies are not current. Breast imaging helps determine if the lump is a solid mass or filled with fluid.

Your doctor may order a biopsy in order to remove a sample of cells or tissue from your breast. That sample is then given to a pathologist, a doctor who specializes in diagnosing abnormal tissue changes.

You may return to the doctor for another evaluation in a few weeks.

How Are Benign Breast Conditions Treated?
Fibrocystic breast changes do not require treatment, but your doctor may recommend therapies to help relieve monthly tenderness.

Simple cysts can be treated through fine needle aspiration, which can often be done during the evaluation. This is a nonsurgical form of breast biopsy in which a small needle is used to withdraw a sample of cells from the breast lump. If the lump is a cyst, removing the fluid will cause the cyst to collapse.

Fibroadenomas and intraductal papillomas can be removed surgically.

Mastitis can be treated with hot compresses or by taking hot showers and letting the warm water flow over the breasts. Sometimes an antibiotic will be prescribed.

What Can I Do for Myself to Continue Good Breast Health?
Perform monthly breast self-examination beginning at age 20.
Have a baseline mammogram at age 35.
Have screening mammograms every year starting at age 40.
Have breast examinations by your health care provider (physician or nurse) every three years starting at age 20 and every year starting at age 40.
Keep track of your family health history. If you are at increased risk, talk with your doctor about the benefits and limitations of starting mammography screening earlier, having other tests performed or scheduling more frequent exams.
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