Breast lumps are swellings or areas of thicker tissue in your breasts. Or, a lump might be found if you have a mammogram as part of routine breast screening. In fact, about nine out of 10 lumps that women can feel themselves in their breasts turn out not to be cancer. A 'tail' of breast tissue and muscle goes up into your armpit. In your armpits there are lymph nodes — these are glands found throughout your body which are part of your immune system.
Your testing plan will depend on your symptoms and what type of benign breast condition is suspected. Your Benigb may recommend regular screenings of your breasts. The lumps are usually round, firm, hard, single, painless and in the area of a surgical scar. Small spots of Benign breast nodules salts can show up anywhere in breast tissue. How are fibroadenomas diagnosed and treated? A thorough breast exam will be performed.
Vitamins for fatty liver. 2. Breast pain
Lancet ;1 The normal histologic appearance represents a spectrum ranging from a predominance nodues ducts, Benign breast nodules, and intra- and inter-lobular stroma to patterns with a predominance of fibrous change and cyst formation, a process formerly called fibrocystic disease Figure 2. Ultrasound-guided core biopsy: This is a tissue sampling technique that does not Promotional models toronto surgery. However, of interest was the fact that tamoxifen prevented more non-invasive breast cancers than did raloxifene Recent studies examined the histologic composition of dense and non-dense breast tissue. For classification as definitely effective, two or more randomized trials are required. Benefits and risks of Benign breast nodules hormone therapy when it is initiated soon after menopause. Critical assessment of new risk factors for breast cancer: considerations for development of an improved risk prediction model. Benign Nodulrs tumors. Resolution may occur but residual periductal fibrosis and nodule formation often persist. For the category, insufficiently studied, only one randomized trial, either negative or positive is available. Show More. If the lump is a cyst fluid-filled sacremoval of the fluid will cause the cyst to collapse.
Breast lumps 2.
- Benign breast nodules: Benign breast nodules are breast lumps that are not cancerous.
- Benign breast conditions also called benign breast diseases are noncancerous disorders of the breast.
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Breast lumps are swellings or areas of thicker tissue in your breasts. Or, a lump might be found if you have a mammogram as part of routine breast screening. In fact, about nine out of 10 lumps that women can feel themselves in their breasts turn out not to be cancer. A 'tail' of breast tissue and muscle goes up into your armpit.
In your armpits there are lymph nodes — these are glands found throughout your body which are part of your immune system. In women, breasts are affected by hormones. This means breasts can feel tender, heavy, and lumpy. This usually happens just before your period and goes back to normal once it starts. Benign breast lumps can appear anywhere in your breast.
They may or may not be painful, and can be large or small. Sometimes a lump can develop alongside other symptoms too. See your GP if you develop any of the following symptoms. Although most breast lumps are found to be benign non-cancerous , these symptoms can sometimes be a sign of breast cancer. Get a picture of your current health and potential future health risks with one of our health assessments.
Find out more today. Your GP will ask you about your symptoms and examine you. They may also ask you about your family history and whether a close relative has had breast cancer. Your GP may ask you to come back for another appointment at a different time in your menstrual cycle, if they think the changes may be related to the hormone cycle.
This is because lumps can come and go at certain times in your cycle. If you have a breast lump, you will usually need to have further tests to check whether your lump is caused by cancer or something else. Your GP will refer you to a doctor at a hospital or specialist breast clinic to have these tests.
What tests you need will depend on what symptoms you have and your age. You may be asked to have a:. The treatment for benign breast lumps depends on what the lumps are. Fat necrosis lumps tend to disappear on their own without treatment.
If you're pregnant, your breasts will change while your baby is developing to get ready for breastfeeding. Your breasts may get bigger and feel sore and tender.
Sometimes, benign breast lumps can develop or get bigger during pregnancy:. But, if a breast lump is cancer, it can grow very quickly. Sometimes, men develop lumps in their breasts as part of a condition called gynaecomastia.
Gynaecomastia develops when the balance of hormones changes and your body starts to produce too much oestrogen and not enough testosterone. If you have gynaecomastia, a breast lump can form underneath your nipple and the breast sometimes gets bigger.
Lumps can develop in one or both breasts and can sometimes be tender and sore. If you notice a change in the look or feel of your breast, make an appointment with your GP.
Your breasts do change as you get older. When you reach the menopause , the amount of glandular tissue in your breasts reduces because of hormone changes. The amount of fatty tissue goes up. Some women develop a condition called duct ectasia around the time of the menopause. This is when a duct underneath your nipple becomes swollen and blocked.
It can be painful and you might feel a lump behind your nipple. Some women have a bloody discharge from their nipple too. Duct ectasia is non-cancerous and can be treated with an operation to remove the blocked ducts. Calcium lumps breast calcifications are small spots of calcium salts.
Calcium lumps are usually benign and harmless. However, they can sometimes be an early sign of breast cancer, particularly if there are a few in the same area of your breast. If you have calcium lumps, your doctor may ask you to have more tests.
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The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them.
Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page. For more details on how we produce our content and its sources, visit the 'About our health information' section. Back to top Menu. Men can get breast lumps too. See our FAQ on breast lumps in men for more information. Types of benign breast lumps There are many different types of benign breast lump. These include the following.
These are solid growths of tissue. These are sacs of fluid that build up in your breast tissue. You can have one or more cysts and they vary in size. Phyllodes tumour.
This is a type of breast lump that can be either benign or malignant cancerous. Because of the risk that they may be cancerous, your doctor will usually recommend that these lumps are removed. Atypical hyperplasia. This is an over-production of cells in the ducts or the lobes of your breasts. Fat necrosis. These are firm lumps that can form on your breast. They usually develop when scar tissue forms after an injury to your breast.
Sclerosing adenosis. This is usually a small, painful and firm lump. This type of lump is sometimes found on a mammogram during breast screening. Breast infection mastitis or an abscess. Duct ectasia can develop around the time of the menopause. This is when the ducts under your nipples get blocked. This can cause your nipple to turn inwards and a lump to develop under it.
Some women have a blood-stained discharge from their nipple too. Symptoms of benign breast lumps Benign breast lumps can appear anywhere in your breast. A lump or thickening in your breast or armpit. A change in the size, shape or feel of your breasts. Dimpling, puckering or redness of the skin on your breast. A change in the shape or position of your nipple — for instance, if it starts turning inwards towards your breast becomes inverted.
A rash around your nipple area. Discharge from one or both nipples. Worried about breast lumps? Diagnosis of benign breast lumps Your GP will ask you about your symptoms and examine you. Treatment of benign breast lumps The treatment for benign breast lumps depends on what the lumps are.
If the lump is bigger than 4cm across, your doctor may suggest you have it removed. You may need to take painkillers or other medicines to treat your symptoms. If you have a cyst, it can be drained aspirated with a needle.
You probably won't need further treatment. This is because they can develop into cancer.
Detection of focal tenderness is helpful diagnostically and suggests a tender cyst, rupture through the wall of an ectatic duct, or a particularly tender area of breast nodularity. Imaging has become an integral part of the management of benign breast disorders. What does your doctor do in a physical examination? NCBI Bookshelf. By performing monthly breast self-exams , you can become familiar with the normal monthly changes in your breasts.
Benign breast nodules. Can benign breast conditions increase the risk of breast cancer?
Mammography is useful for evaluation of palpable lesions, particularly in those over Digital mammography is preferred because of its ability to penetrate through dense breast tissue which is commonly found in younger women. Ultrasound is often used as initial evaluation of a palpable mass in women under age If a simple cyst is present, no further evaluation is necessary Figure If not, mammography may also be necessary to fully evaluate the lump.
If the mass has findings suggestive of a fibroadenoma by ultrasound and mammography, short term follow-up and re-imaging can be considered usually performed in 6 months. Experts are divided as to the necessity to biopsy all fibroadenomas. MRI is more sensitive than digital mammography but false positives are more common Upper panel illustrates by ultrasound a non-dense black area representing cyst fluid.
The lower panel is the corresponding area on mammogram showing a dense area. With the combination of mammogram and ultrasound, the lesion can be shown to be a cyst. Fibrocystic change typically presents on mammogram as round or oval, well defined masses that can be subsequently shown to represent cysts on ultrasound Figure Diffusely scattered dystrophic calcifications may also be found on the mammogram.
Consequently, the goal of mammographic evaluation is to provide reassurance to the patient and physician that the risk of neoplasm is low.
Aspiration of cysts is usually necessary only in a those cases where the mass does not fulfill all criteria for a simple cyst or if the cyst is painful. Biopsy may be necessary to confirm the benign nature of calcifications, particularly if clustered, linear or variously shaped. If the risk is believed to be greater, core biopsy is recommended.
Stereotactically directed core biopsy is ideal for evaluation of calcifications and provides highly discriminative information regarding the presence or absence of malignancy. If this technique is not available, insertion of a wire into the lesion radiographically followed by surgical excision or mere removal of a palpable lesion is warranted. Careful examination distinguishes solitary, discrete, dominant, persistent masses from vague nodularity and thickening. Practice Guidelines of the Society of Surgical Oncology 51 recommend the following evaluation: In women less than age 35, all dominant discrete palpable lesions require referral to a surgeon.
If vague nodularity, thickening or asymmetrical nodularity is present, the examination is repeated at midcycle after one or two menstrual cycles. If the abnormality resolves, the patient is reassured and if not, referred to a surgeon. Breast imaging may be appropriate. With vague nodularity or thickening, one obtains a mammogram with repeat physical exam at mid-cyle 1 to 2 months later and refers to surgeon if the abnormality persists.
Post-menopausal women are referred for surgical consultation after a mammogram. For gross cysts i. If the aspirated fluid does not contain blood, the fluid is discarded without further histologic analysis unless the cyst contains solid components i. If the fluid contains blood or if the cyst is complex, the, fluid is sent for cytology and consultation from a surgeon requested.
With persistent refilling of the same cyst after aspiration, surgical consultation is warranted. When mammography is negative but a dominant mass is present, biopsy is required to rule out malignancy since lobular carcinoma may not be seen on mammograms.
In those younger, mammography may be omitted if ultrasound and biopsy yield definitive information. Many experts omit biopsy in younger women with lesions characteristic of fibroadenoma on ultrasound and elect to follow carefully with serial ultrasounds at six monthly intervals for two years and yearly thereafter.
However, other experienced surgeons disagree and believe that all fibroadenomas require diagnostic core biopsy or FNA and especially in BRCA mutation carriers in whom medullary cancer may be found. Biopsy confirmation of a fibroadenoma eliminates the need for serial ultrasounds. Breast discharge is evaluated according to the algorithm illustrated below on Figure Careful attention to several factors are necessary including determination whether the discharge arises from one duct or multiple ducts, is bloody, or is milky.
The initial step in evaluating pain is to distinguish true breast pain from chest wall pain Figure Several well designed, randomized, controlled, double blind, cross over trials have validated the efficacy of medical therapy for cyclic mastalgia. Based upon these studies, we categorize therapies as definitely effective, definitely ineffective , possibly effective , and insufficiently studied.
For classification as definitely effective, two or more randomized trials are required. For the category, possibly effective, one randomized trial must be positive in some respect but others may be negative.
For the category definitely ineffective, prospective trials must be uniformly negative. For the category, insufficiently studied, only one randomized trial, either negative or positive is available. Danazol, bromocriptine, and tamoxifen have been proven to be effective Figure Linoleic acid in the form of evening primrose oil has been shown effective in two randomized trials but not in the third, the largest trial.
Its role in treatment therefore remains uncertain Vitamin E is considered definitely ineffective and iodine and vaginal progesterone possibly effective. Medroxyprogesterone acetate, caffeine avoidance, and progesterone have not been sufficiently studied. Several other therapies have not been examined in randomized controlled trials but are likely to be beneficial since they are based upon physiologic principles.
For example, precise fitting of a bra to provide support for pendulous breasts has been reported to relieve pain in observational studies. Onset of menopause is known to reduce the frequency of breast pain. This therapy is reserved for patients in whom all other measures fail and the pain is considered severe. Reduction of the dosage of estrogens in post-menopausal women or addition of an androgen to estrogen replacement therapy e.
Relative efficacy of agents to treat breast pain. These data are from the Breast Clinic in Cardiff, Wales and represent observational studies and not randomized, controlled efficacy trails. No large randomized, controlled studies have compared the relative efficacy of danazol, bromocriptine, evening primrose oil and tamoxifen. Figure 15 rank orders them according to efficacy based upon data from individual reports from the same clinic.
Minimal data are available from clinical trials which involve direct head to head comparisons. It should be noted that overall responses to danazol, bromocriptine and evening primrose oil are lower in those with non-cyclic pain than those with cyclic pain.
However, not all studies have carefully excluded patients with non-breast pain and therefore conclusions regarding non-cyclic pain should be considered tentative. The approach to non-breast pain is outlined in Figure A major consideration for women who present with breast problems is whether they have a higher than normal risk of developing breast cancer. Certain breast lesions such as fibrocystic changes are associated with no increased risk of subsequent breast cancer Table I.
A recent report also suggested that radial scars increase relative risk by 1. It should be noted that the Gail model for assessing breast cancer risk, which is based predominantly on reproductive factors, underestimates the long term risk of breast cancer in women with benign breast disease. On the other hand, the five year prediction is more accurate The presence of dense breast tissue on mammography has also been reported to be a predictor of increased incidence of breast cancer Figure Two components of this finding must be considered : one , the presence of high breast density makes it more difficult to read mammograms and masks the sensitivity of finding a breast cancer initially but identifies it later and two , there is an increased risk of breast cancer associated with increased breast density.
With long tem follow-up studies, masking is not the explanation for the increased breast cancer risk Breast cancer risk is also increased in association with high plasma estradiol and testosterone levels in postmenopausal women 62;65 and 20 kg or more weight gain 66 in the pre-menopausal years.
Another risk factor is use of hormone replacement therapy. This risk is probably increased further in women starting this therapy shortly after the menopause i. Starting this therapy a long time after experiencing menopause long gap is associated with a lesser relative risk The use of estrogen alone in the WHI was associated with a trend toward reduction of risk of breast cancer at five years and a statistically significant reduction in those adhering to therapy Available data suggest that the effects of menopausal hormone therapy in the WHI is a class effect and not related to the specific type of estrogen or progestin.
One study, however, suggests that use of crystalline progesterone as the progestogen is associated with a lesser risk than use of medroxyprogesterone acetate To aid in assessing breast cancer risk, a questionnaire developed by Gail, utilizes answers to 7 questions to calculate the 5 year and lifetime risk of developing breast cancer This model has recognized deficiencies in that it does not consider second degree relatives with breast cancer, proliferative lesions of breast other than ADH, alcohol intake, obesity, or birth control pill and menopausal hormone therapy MHT use.
Nonetheless, the Gail model has been prospectively validated in over women followed for an average of 4. Patients with benign breast lesions imparting an increased risk of breast cancer can be offered tamoxifen or raloxifene as a prevention strategy. The risk of breast cancer is determined using the Gail or Tyrer-Cuzick model and the benefits versus risks of tamoxifen evaluated.
Risk factors not included in the Gail or Claus models include degree of breast density, plasma free estradiol levels, bone density, weight gain after menopause, and waist-hip ratio 25;65;66; Current recommendations suggest that women with a five year risk of breast cancer of over 1.
A recent overview has shown a 38 percent reduction of the relative risk of breast cancer with tamoxifen but benefits may be offset by increased risks of thromboembolic phenomena, endometrial cancer, and maturation of cataracts The Star trial addressed whether raloxifene might be preferable to tamoxifen and 79 demonstrated relative equivalence.
However, of interest was the fact that tamoxifen prevented more non-invasive breast cancers than did raloxifene More intensive and frequent screening with multi-modality imaging i.
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Eighty percent of all breast lumps are benign non-cancerous. Appointments There are several common causes of benign breast lumps: Benign breast changes Breast infection or injury Medications that may cause lumps or breast pain, especially birth control pills , hormone replacement therapy, soy products, and caffeine Breast tissue changes during a woman's entire life.
What are the types of benign breast conditions? Fibrocystic changes - Changes in hormone balances during normal, monthly menstrual cycles can create, for some women, symptomatic breast changes that are referred to as fibrocystic changes. Cysts often are described as benign, tiny, fluid-filled sacs that may feel like lumps.
Tenderness and lump size commonly increase the week before the menstrual period and lessen a week after. The lumps may be hard or rubbery and can appear as a single breast lump that may be large or small.
Fibrocystic changes also can appear as thickening of the breast tissue. Fibrocystic changes can occur in one or both breasts and are the most common cause of benign breast lumps in women age 35 to It is relatively uncommon for postmenopausal women to have symptomatic breast changes because of a lack of hormone stimulation of breast tissue.
Simple cysts - Simple cysts are benign 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. Cysts may also be affected by caffeine coffee, tea, chocolate, energy drinks. Fibroadenomas - Fibroadenomas are the most common benign solid tumors found in the female breast. They are round, rubbery, slippery lumps that move freely in the breast when pushed. They form as the result of excess formation of lobules milk-producing glands and stroma connective tissue in the breast.
Fibroadenomas are usually painless. They occur most often between the ages of 20 and 40 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 40 to 50 years of age and can produce bleeding from the nipple or nipple discharge. Traumatic fat necrosis - This condition occurs when there is trauma sudden injury or surgery to the breast.
This causes fat to form in lumps. The lumps are usually round, firm, hard, single, painless and in the area of a surgical scar. Can men have breast lumps? Can a breast lump indicate an infection? Breast self-exam By performing monthly breast self-exams , you can become familiar with the normal monthly changes in your breasts.
What should I do if I find a lump in my breast? Conditions that should be checked by a health care provider include: An area that is distinctly different from any other area on either breast A lump or thickening in or near the breast, or in the underarm that persists through the menstrual cycle A change in the size, shape, or contour of the breast A mass or lump that may feel as small as a pea A marble-like area under the skin A change in the feel or appearance of the skin dimpled, puckered, scaly or reddened area, thickened with orange peel appearance on the breast A change in the appearance of the nipple [inverted, creased, scaly, or reddened Spontaneous bloody or clear fluid discharge from the nipples What will happen at the appointment?
A detailed health history will be taken. A thorough breast exam will be performed. Your health care provider will feel for lumps or other changes in the breast tissue. If there is a nipple discharge, a sample will be collected and examined under a microscope to detect the presence of cancer cells.
Ultrasound can help determine if the lump is a solid mass or filled with fluid. Other diagnostic tests may be needed, such as: Fine needle aspiration FNA : This is a non-surgical 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 fluid-filled sac , removal of the fluid will cause the cyst to collapse.
If the lump is solid, cells can be smeared onto slides for examination in the laboratory. Core biopsy: This is similar to FNA, but a larger needle is used because actual breast tissue is removed, rather than a sampling of cells. A sample of the lump is removed, but the whole lump is not removed. The types of core biopsies include ultrasound-guided core biopsy and stereotactic core biopsy. Ultrasound-guided core biopsy: This is a tissue sampling technique that does not require surgery.
A biopsy needle is placed into the breast tissue.
Benign Breast Conditions
There are different types of breast lumps. The following descriptions and illustraitons provides some details. If you have any questions, follow-up with your doctor. Not all tumors are malignant cancerous. Following are examples of the most common benign breast conditions which produce lumps. Fibrocystic changes are the most common non-cancerous breast condition.
The size and tenderness of Fibrocystic lumps usually increase before menstruation, decreasing after the period ends. This condition, also known as cystic mastitis, generally disappears after menopause. Medical opinion is still divided over whether Fibrocystic disease increases the risk of breast cancer. Recent research has reported that the chemical called methylxanthines, found in coffee, tea, cola, chocolate and some diet and cold medication, seems to promote the growth of Fibrocystic lumps.
In one study, more than half the women who gave up the above items from their diets found that their cysts gradually disappeared. They occur most frequently in women between 18 and 35 and account for nearly all breast tumors in women under The often result in a discharge, either clear or bloody, from the nipple. As we have seen, most breast lumps are benign, non-cancerous cysts or tumors.
Although they may require surgical removal to prevent their interfering with normal breast function, they will not invade surrounding tissue; they are not life threatening. Malignant breast tumors, however, if not detected and treated early, will continue to grow, invading and destroying adjacent normal tissue. If unchecked, they will spread to surrounding lymph nodes; then, by a process called metastasis, cancer cells will break away from the tumor and spread, through the lymph system and bloodstream, to other areas of the body.
At this stage, breast cancer is deadly, and chances of cure are far lower one-half or less than in the early, localized stage. Commonly developing from the mammary glands or ducts, such malignant lumps generally about 50 percent appear in the upper, outer quadrant of the breast, extending into the armpit, where tissue is thicker than elsewhere.
Eighteen percent of breast cancers occur in the nipple area, 11 percent in the lower out quadrant, and 6 percent in the lower inner quadrant. ANY change in size, shape, texture or nipple that occurs in one breast only is more dangerous than if such changes happen simultaneously in both breasts in the same position. Report such a change at once. An estimated 46, women and men died of breast cancer in , in spite of treatment including surgical removal of the cancerous breast, lymph nodes, and in extreme cases ovaries.
Many of these deaths could be averted if more women would examine their own breasts and consult their doctors promptly in case of suspicious findings. When treatment does not begin until cancer has disseminated, the five-year survival rate is exceedingly low.
Remember that, although you can discover your own breast lumps, only your doctor can determine accurately whether a lump is benign or malignant. The important thing is to be diligent and thorough in your monthly BSE — and to report any abnormality. Carol M. Baldwin Breast Care Center.