You do a breast self-exam and find a lump. Now what?
If you notice any breast changes, you should call your doctor right away to get checked, but don't panic. Most 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.
Breast tissue changes during a woman's entire life. It is sensitive to changing hormone levels during the menstrual cycle.
What Can Cause Benign Breast Lumps?
- Fibrocystic changes. For some women, changes in hormones during normal monthly menstrual cycles can create breast changes. These are known as fibrocystic breast changes. Women with fibrocystic breasts usually get lumps in both breasts that increase in size and tenderness just before they get their period. They sometimes have nipple discharge as well.
The lumps are milk ducts and tissues around them that have grown and gotten wider to form cysts. The cysts enlarge quickly in response to hormones released near your period. The lumps may be hard or rubbery and may be felt as a single (large or small) breast lump. Fibrocystic changes can also cause breast tissue to thicken.
These changes are often most noticeable during your 40s. They 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. That’s because they don’t have monthly changes in hormones.
- Simple cysts. Simple cysts are fluid-filled sacs that usually happen in both breasts. There can be one or many. They can vary in size. Tenderness and size often change with your menstrual cycle.
- Fibroadenomas. These are the most common benign tumors. If you push on them they are solid, round, rubbery lumps that move freely. They’re usually painless. Fibroadenomas happen when your body forms extra milk-making glands. Women between 20 and 30 get them most often. They’re also 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 who are 45 to 50. They can cause bleeding from the nipple.
- Traumatic fat necrosis. This happens when there is an injury to the breast, thought you may not remember an injury happening. It causes fat to form in lumps that are generally round, firm, hard, and painless. You usually get one at a time.
How Are Benign Breast Conditions Treated?
- Fibrocystic breast changes do not require treatment, but your doctor may recommend things to help relieve monthly tenderness.
- Simple cysts can be treated through fine needle aspiration. You don’t need surgery to do this. A small needle is used to suck out some cells from the breast lump. If the lump is a cyst, they can suck out the fluid and the cyst will collapse. Cysts can also go away on their own, so your doctor may choose to wait before trying to get rid of it.
- Fibroadenomas and intraductal papillomas can be removed surgically.
- It can be hard to tell if a lump from traumatic fat necrosis is that or something else until your doctor does a biopsy. These usually don’t need to be treated. But if the lump bothers you, it can be cut out.
Can Men Get Breast Lumps?
Yes. Men can have tender breast enlargement, often with a lump under the nipple. Sometimes this is in one breast, but it often happens in both. This noncancerous condition is called gynecomastia.
Does a Breast Lump Mean Infection?
Possibly. Sometimes a painful lump, with or without redness, is the first sign of an infection. Mastitis is an infection most common in breastfeeding moms. It’s caused by bacteria that get into the mammary ducts through the nipple. Infection happens in small pockets. You’ll feel tender, warm lumps in the breast.
For relief, try a hot shower and let the warm water flow over your breasts. A warm compress can also help. Sometimes your doctor will prescribe an antibiotic.
What Should I Do If I Find a Breast Lump?
See your doctor if you discover any new breast changes. A doctor should examine you if you find:
- An area that is clearly 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 of the skin on the breast or nipple or how it looks. It could be dimpled, puckered, scaly, or inflamed.
- Clear or bloody fluid coming out of the nipple
- Red skin on the breast or nipple
What Will Happen at My Appointment?
Your doctor will ask you some questions about your health history. He will perform a breast exam to feel for lumps or other changes in the breast tissue and under the arms.
If there is fluid coming out of your nipple, your doctor will collect a sample and check for cancer cells.
He may also do a mammogram or ultrasound to see if the lump is solid or filled with fluid.
Your doctor may order a biopsy. He will take a tiny sample of the lump with a needle or small cut and send it to a lab.
How Do I Keep My Breasts Healthy?
- Once you turn 20, your doctor may give you a breast exam in which he feels your breast tissue for changes. The American Congress of Obstetricians and Gynecologists recommends a clinical breast exam every 1-3 years starting at 20.
- Get a mammogram as you get older. It’s best to talk with your doctor to decide the right time and how often because experts disagree. The American Cancer Society recommends getting one every year once you turn 45. Others say every 2 years when you turn 50 until you’re 74.
If you’re at high risk for breast cancer, you should get a mammogram every year. You may start getting them at a younger age, too. You may also get ultrasound screenings too. Breast MRI screening, in addition to mammogram, is used only if your lifetime risk of breast cancer is greater than 20%. Talk with your doctor to decide what may be best for you.