A breast lump is a thickening or bump that feels different from surrounding breast tissue. A lump may be discovered in a breast incidentally, during a breast self-examination, or during a routine physical examination by a doctor.
Lumps in the breasts are relatively common and usually not cancerous.
Lumps may be painless or painful. They are sometimes accompanied by nipple discharge (see see Nipple Discharge) or changes in the skin, such as irregularities, redness, a dimpled texture (called peau d'orange, or skin of an orange), or tightened skin. Lumps may be fluid-filled sacs (cysts) or solid masses, which are usually fibroadenomas. Fibroadenomas are not cancerous, and cysts usually are not.
The most common causes include
Fibroadenomas (see Fibroadenomas) are typically painless lumps that feel like small, slippery marbles. They usually develop in young women, especially adolescents. These lumps may be mistaken for cancer, but they are not.
Fibrocystic changes (see Fibrocystic Changes) includes pain, cysts, and general lumpiness (including fibroadenomas) in the breast. Women may have one or more of these symptoms. Breasts feel lumpy and dense and are often tender when touched.
In most women, fibrocystic changes are related to the monthly fluctuations in levels of the female hormones estrogen and progesterone. These hormones stimulate breast tissue.
Most fibrocystic changes do not increase the risk of breast cancer. A few of them do, but only slightly.
Lumps sometimes result from
Infections, galactoceles, and scar tissue formation do not increase the risk of breast cancer.
The following information can help people decide whether a doctor's evaluation is needed and help them know what to expect during the evaluation.
Certain symptoms and characteristics are cause for concern:
When to see a doctor:
Because breast lumps may be cancerous (although they seldom are), they should be evaluated by a doctor within about 3 to 7 days.
Delay of a week or so is not harmful unless there are signs of infection such as redness, swelling, and/or a discharge of pus. Women with such symptoms should see a doctor within 1 or 2 days.
What the doctor does:
Doctors ask the woman questions about the lump and other symptoms, including general symptoms such as weight loss, fatigue, and bone pain (which may indicate advanced cancer). Doctors also ask the woman about her medical and family history, including risk factors for breast cancer (see Risk Factors for Breast Cancer).
Doctors then do a physical examination, focusing on the breasts and areas near it (see Screening). Painful, rubbery lumps in younger women are usually fibrocystic changes, particularly if the woman has had similar lumps before. Doctors determine whether the breasts are similar in shape and size and check each breast for abnormalities, particularly warning signs. Cancer is more likely if warning signs are present.
Usually, testing is needed because determining whether breast lumps are cancerous or not during a physical examination is difficult and because failing to identify cancer has serious consequences.
Ultrasonography is typically done first to try to differentiate solid lumps from cysts, which are rarely cancerous.
If the lump appears to be a cyst, a needle with a syringe is often inserted into the cyst, and the fluid is removed (called aspiration) and examined. The fluid is tested for cancer cells if it is bloody, if little fluid is obtained, or if the lump remains after aspiration. Otherwise, the woman is checked again in 4 to 8 weeks. If the cyst cannot be felt, it is considered noncancerous. If it recurs, aspiration is done again, and the fluid is sent for analysis regardless of appearance. If the fluid in the cyst suggests cancer or if the cyst recurs a third time, biopsy is done.
If the lump appears to be solid, mammography is typically done, followed by a biopsy. Most women do not need to be hospitalized for these procedures. Usually, only a local anesthetic is needed.
Treatment depends on the cause. For fibrocystic changes, wearing a soft, supportive bra and taking pain relievers, such as acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID), may help relieve symptoms.
Sometimes cysts are drained. Fibroadenomas can usually be removed. However, they may recur.
Last full review/revision November 2008 by Mary Ann Kosir