Breast lump
Encyclopedia
Breast lump is a localized swelling that feels different from the surrounding breast tissue. It is a symptom
/sign
for a variety of conditions. As approximately 10% of breast lumps ultimately lead to a diagnosis of breast cancer
, it is important for women with a breast lump to receive appropriate evaluation.
is a non-cancerous, fluid-filled sac in the breast. They generally feel smooth or rubbery under the skin and can be quite painful or cause no pain at all. Cysts are caused by the hormones that control the menstrual cycle and, as such, are rare in women older than 50.
A sebaceous cyst
is a non-cancerous, closed sac or cyst below the skin that is caused by plugged ducts at the site of a hair follicle. Hormone stimulation or injury may cause them to enlarge but if no symptoms are present, medical treatment is not required.
Abscess
es are non-cancerous pockets of infection within the breast. They can be quite painful and cause the skin over the breast to turn red or feel hot or solid. Abscesses of the breast are most common in women who are breast-feeding.
s are non-cancerous abnormal growths of the glandular tissue in the breast. The most common form of these growths, fibroadenoma
s, occur most frequently in women between the ages of 15 and 30 and in women of African descent. They usually feel round and firm and have smooth borders. Adenomas are not related to breast cancer.
Intraductal papilloma
s are wart-like growths in the ducts of the breast. These lumps are usually felt just under the nipple and can cause a bloody discharge from the nipple. Women close to menopause may have only one growth, while younger women are more likely to have multiple growths in one or both breasts.
Breast cancer
usually feels like a hard or firm lump that is generally irregular in shape and may feel like it is attached to skin or tissue deep inside the breast. Breast cancer is rarely painful and can occur anywhere in the breast or nipple.
is a condition in which the normal fat cells of the breast become round lumps. Symptoms can include pain, firmness, redness, and/or bruising. Fat necrosis usually goes away without treatment but can form permanent scar tissue that may show up as an abnormality on a mammogram.
A lipoma
is a non-cancerous lump of fatty tissue that is soft to the touch, usually movable, and is generally painless.
or during a routine check-up. Upon noticing an unusual lump in the breast the best course of action is to schedule an examination with a physician who can best diagnose the type of breast lump and strategy for treatment.
s and abscess
es require drainage for treatment, while sebaceous cyst
s and fatty lumps are best treated by surgical removal.
s: "wait and watch," open surgery and minimally-invasive surgical alternatives.
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
/sign
Medical sign
A medical sign is an objective indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....
for a variety of conditions. As approximately 10% of breast lumps ultimately lead to a diagnosis of breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
, it is important for women with a breast lump to receive appropriate evaluation.
Types of Breast Lumps
| Findings in women seeking evaluation of apparent breast lump | |
| Fibrocystic breast changes Fibrocystic breast changes Fibrocystic breast changes or fibrocystic breast disease is a condition of breast tissue affecting an estimated 30-60% of women. It is characterized by noncancerous breast lumps in the breast which can sometimes cause discomfort, often periodically related to hormonal influences from the menstrual... |
40% |
| No disease | 30% |
| Fibroadenoma Fibroadenoma Fibroadenomas of the breast, are lumps composed of fibrous and glandular tissue. Because breast cancer can also appear as a lump, doctors may recommend a tissue sample to rule out cancer in older patients... |
7% |
| Other benign mammary dysplasias and neoplasms | 13% |
| Breast cancer Breast cancer Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas... |
10% |
Cysts and Abscess Lumps
A breast cystBreast cyst
A breast cyst is a fluid-filled sac within the breast. One can have one or more breast cysts. They're often described as round or oval lumps with distinct edges. In texture, a breast cyst usually feels like a soft grape or a water-filled balloon, but sometimes a breast cyst feels firm.Breast cysts...
is a non-cancerous, fluid-filled sac in the breast. They generally feel smooth or rubbery under the skin and can be quite painful or cause no pain at all. Cysts are caused by the hormones that control the menstrual cycle and, as such, are rare in women older than 50.
A sebaceous cyst
Sebaceous cyst
A sebaceous cyst is a term that loosely refers to either epidermoid cysts or pilar cysts . Because an epidermoid cyst originates in the epidermis and a pilar cyst originates from hair follicles, by definition, neither type of cyst is strictly a sebaceous cyst...
is a non-cancerous, closed sac or cyst below the skin that is caused by plugged ducts at the site of a hair follicle. Hormone stimulation or injury may cause them to enlarge but if no symptoms are present, medical treatment is not required.
Abscess
Abscess
An abscess is a collection of pus that has accumulated in a cavity formed by the tissue in which the pus resides due to an infectious process or other foreign materials...
es are non-cancerous pockets of infection within the breast. They can be quite painful and cause the skin over the breast to turn red or feel hot or solid. Abscesses of the breast are most common in women who are breast-feeding.
Growths
AdenomaAdenoma
An adenoma is a benign tumor of glandular origin. Adenomas can grow from many organs including the colon, adrenal glands, pituitary gland, thyroid, prostate, etc. Although these growths are benign, over time they may progress to become malignant, at which point they are called adenocarcinomas...
s are non-cancerous abnormal growths of the glandular tissue in the breast. The most common form of these growths, fibroadenoma
Fibroadenoma
Fibroadenomas of the breast, are lumps composed of fibrous and glandular tissue. Because breast cancer can also appear as a lump, doctors may recommend a tissue sample to rule out cancer in older patients...
s, occur most frequently in women between the ages of 15 and 30 and in women of African descent. They usually feel round and firm and have smooth borders. Adenomas are not related to breast cancer.
Intraductal papilloma
Intraductal papilloma
Intraductal papillomas of the breast are relatively common lesions with an incidence of approximately 2-3% in humans.They are the most common cause of bloody nipple discharge in women age 20-40 and generally do not show up on mammography due to their small size, so the next step in treatment would...
s are wart-like growths in the ducts of the breast. These lumps are usually felt just under the nipple and can cause a bloody discharge from the nipple. Women close to menopause may have only one growth, while younger women are more likely to have multiple growths in one or both breasts.
Breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
usually feels like a hard or firm lump that is generally irregular in shape and may feel like it is attached to skin or tissue deep inside the breast. Breast cancer is rarely painful and can occur anywhere in the breast or nipple.
Fatty Lumps
Fat necrosisFat necrosis
Fat necrosis is a form of necrosis characterized by the action upon fat by digestive enzymes.In fat necrosis the enzyme lipase releases fatty acids from triglycerides. The fatty acids then complex with calcium to form soaps...
is a condition in which the normal fat cells of the breast become round lumps. Symptoms can include pain, firmness, redness, and/or bruising. Fat necrosis usually goes away without treatment but can form permanent scar tissue that may show up as an abnormality on a mammogram.
A lipoma
Lipoma
A lipoma is a benign tumor composed of adipose tissue. It is the most common form of soft tissue tumor. Lipomas are soft to the touch, usually movable, and are generally painless. Many lipomas are small but can enlarge to sizes greater than six centimeters. Lipomas are commonly found in adults...
is a non-cancerous lump of fatty tissue that is soft to the touch, usually movable, and is generally painless.
Diagnosis
Breast lumps are often discovered during a breast self-examinationBreast self-examination
Breast self-examination is a screening method used in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling....
or during a routine check-up. Upon noticing an unusual lump in the breast the best course of action is to schedule an examination with a physician who can best diagnose the type of breast lump and strategy for treatment.
Treatment
Treatments for breast lumps vary depending on the type of lump. Standard breast cystBreast cyst
A breast cyst is a fluid-filled sac within the breast. One can have one or more breast cysts. They're often described as round or oval lumps with distinct edges. In texture, a breast cyst usually feels like a soft grape or a water-filled balloon, but sometimes a breast cyst feels firm.Breast cysts...
s and abscess
Abscess
An abscess is a collection of pus that has accumulated in a cavity formed by the tissue in which the pus resides due to an infectious process or other foreign materials...
es require drainage for treatment, while sebaceous cyst
Sebaceous cyst
A sebaceous cyst is a term that loosely refers to either epidermoid cysts or pilar cysts . Because an epidermoid cyst originates in the epidermis and a pilar cyst originates from hair follicles, by definition, neither type of cyst is strictly a sebaceous cyst...
s and fatty lumps are best treated by surgical removal.
Fibroadenoma Treatment
Several treatment options currently exist for fibroadenomaFibroadenoma
Fibroadenomas of the breast, are lumps composed of fibrous and glandular tissue. Because breast cancer can also appear as a lump, doctors may recommend a tissue sample to rule out cancer in older patients...
s: "wait and watch," open surgery and minimally-invasive surgical alternatives.
- "Waiting and watching" is common for very small fibroadenomas and involves routine check-ups with a physician every 6–12 months.
- Open surgery has historically been the most common method for removing large fibroadenomas, but has several disadvantages. Surgery often requires general anesthesiaAnesthesiaAnesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...
and a day in the hospital, and can leave significant scarring at the site of the incision. - Minimally-invasive surgical alternatives include biopsy-removal techniques and cryoablationCryoablationCryoablation is a process that uses extreme cold to remove tissue .Cryoablation is used in a variety of clinical applications using hollow needles through which cooled, thermally conductive, fluids are circulated...
. Biopsy-removal involves using a vacuum-assisted biopsy device to remove the fibroadenoma bit by bit. This procedure can be effective but often does not remove all of the fibroadenoma, resulting in a possible re-growth. In cryoablation, an ultrasoundUltrasoundUltrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
-guided probe is inserted into the fibroadenoma through a small incision in the breast. Extremely cold temperatures are then used to freeze the lesion, which eventually dies and is reabsorbed into the body.