Breast tissue changes throughout a woman’s life, and the menstrual cycle is highly susceptible to changes in hormone levels that can lead to changes in the breasts. If you notice abnormal breast changes, you should seek immediate medical attention for examination, but don’t panic. Most breast lumps are benign, which means they are not cancerous. Benign breast lumps usually have smooth edges and move gently when pressed. They are usually found in both breasts.
Some common causes of benign breast lumps include normal changes in breast tissue, breast infection or injury, and medications that may cause lumps or chest pain.
Breast lumps, possibly some benign conditions
- Fibrocystic changes. For some women, hormonal changes in the monthly menstrual cycle can cause breast changes. They are usually fibrocystic changes, with bilateral lumps that increase in size and swelling before menstruation. Sometimes breast changes may also occur. These changes are usually cysts formed by the growth and widening of the breast ducts and surrounding tissue. The cysts increase in size rapidly as a result of increased hormone release around the time of menstruation. The cysts are hard or rubber-like and may feel like individual breast lumps. Fibrocystic changes can also cause thickening of the breast tissue. These changes are usually easily detected at age 40 and are the most common cause of benign breast lumps in women aged 35 to 50. Postmenopausal women are less likely to develop these breast changes because their hormone levels do not change from month to month.
- Simple cysts. Simple cysts are fluid-filled cysts that usually appear in both breasts and may have 1 or more. These cysts vary in size. The swelling and pain and size usually vary with the menstrual cycle.
- Fibroadenoma. This is the most common benign tumor. If pressure is applied, a parenchymal, round, rubbery-feeling mass that can move relatively freely will be palpated. It is usually painless. It is more common in women aged 20 to 30 years.
- Papilloma in the ducts of the breast. This is a small wart-like growth within the protective layer of the milk ducts near the nipple that usually occurs in women 45 to 50 years old and causes bleeding from the nipple.
- Traumatic fat necrosis of the breast. It can occur after a breast injury, but some people may not remember the cause of the injury, and the trauma can cause lumps of fat to form. It is usually round, firm and painless. Usually there is only 1 from 1 trauma.
- Gynecomastia. Men can also have distended, painful breast enlargement, usually with a lump under the nipple. Sometimes it is in one breast, but usually appears in both breasts. This non-cancerous condition is known as gynecomastia.
If it is a benign breast lump, how is it treated?
- Fibrocystic changes do not require treatment, but your doctor will offer advice to help relieve the monthly swelling and pain.
- Simple cysts can be treated with fine needle aspiration and do not require surgery. A fine needle can aspirate some cells from the breast lump. If the lump is a cyst, fluid can be aspirated and the cyst will rupture. The cyst will also go away on its own, so your doctor may choose to wait before trying to remove it.
- If it is a fibroadenoma and a papilloma in the duct, it can be surgically removed.
- It is difficult to determine if the mass is traumatic fat necrosis or otherwise until the doctor performs a biopsy. Treatment is usually not needed. However, if the mass is causing distress, it can be removed.
Breast lumps may also be infections
Sometimes a painful lump is a sign of an infection, with or without redness. Mastitis is the most common infection in breastfeeding women and is caused by bacteria entering the milk ducts through the nipple. The infection can appear in small sacs, causing a swollen, painful, warm lump to be felt in the breast.
For relief, try taking a hot bath and letting the hot water run over your breasts. Hot compresses can also work. Sometimes doctors will prescribe antibiotics.
What can I do if I find a breast lump?
If you notice changes in your breasts, you should seek medical attention. Your doctor will examine you if you find any of the following.
- An area is significantly different from any other area on either breast.
- A lump or thickening within, around, or under the breast that does not go away during the menstrual cycle.
- A change in the size, shape, or contour of the breast.
- A bulge or lump that may feel like it’s the size of a pea.
- A marble-shaped area under the skin.
- Changes in the touch or appearance of the skin of the breast or nipple, which may have become shallow, puckered, scaly, or inflamed.
- The nipple is overflowing with clear or bloody fluid.
- Redness of the skin of the breast or nipple.
What happens at the appointment?
The doctor will ask some questions related to your personal medical history, perform a breast exam, and touch for lumps or other changes within the breast tissue and in the armpit.
If there is fluid coming from the nipple, the doctor will take a sample and check for cancer cells.
A mammogram or ultrasound may also be performed to determine the nature of the lump.
The doctor may recommend a biopsy, where a small sample of the lump is taken through a biopsy needle or small incision and sent to the lab for testing.
How do I keep my breasts healthy?
- After age 20, your doctor may perform a mammogram to determine if there are changes in your breast tissue. The American College of Obstetricians and Gynecologists recommends breast exams every 1 to 3 years, starting at age 20.
- Mammograms are performed as you get older. It is best to consult with your doctor to determine the correct timing and frequency of exams, as experts still do not agree. If you are at high risk for breast cancer, you should have a mammogram every year, or you can start earlier. Ultrasound screening is also available. In addition to mammograms, some women at high risk for breast cancer are also screened with breast magnetic resonance imaging (MRI). Consult your doctor to determine the best option.