Breast Lumps

Understanding Breast Lumps

Breast lumps are very common and lead to concern when they are discovered. Most breast lumps are benign. A new breast lump could be a breast cancer, therefore your doctor must evaluate it. Breast cancer is a leading cause of death in women, but if found early breast cancer can be curable. The key to early detection is monthly selfbreast exam, yearly examination by your doctor, and periodic mammograms.

Who is at Higher Risk?

It is know that certain women are at greater risk for breast cancer. These risk factors are:

  • Age over 40, and especially over 50.
  • History of cancer in the other breast.
  • Mother, sister, or daughter with breast cancer.
  • Never having given birth or giving birth after the age of 30.
  • Early onset of menstrual cycles.
  • Carrier of certain genetic mutations.

Screening for Breast Cancer

Monthly Breast Self Exam (BSE) can help women distinguish the difference between “normal” lumpy breast tissue and lumpsthat must be evaluate by a surgeon. Particular attention must be paid to any lump that is new, persistent, especially prominent, hard, or enlarging. Breast cancer screening includes the following:

  • Monthly Breast Self Exam (BSE) beginning at age 20.
  • Yearly exam by your physician.
  • Yearly mammogram beginning at age 40.

Understanding Your Breasts

Many women do not examine their breasts because they feel they don’t know what to look for. Normal breast tissue often feels lumpy and varies in consistency from woman to woman, and even from week to week during the menstrual cycle. Understanding the normal anatomy of the breast and practicing regular breast selfexam will help you to gain confidence in being able to distinguish between normal breast tissue and suspicious lumps. If you do not already have our booklet on selfexam, be sure to get a copy.

The Normal Breast

Your breasts are loosely attached to the pectoral (chest) muscles and are suspended and supported by fibrous bands called Cooper’s ligaments. The mammary glands are located throughout the breast. These glands produce milk during breastfeeding. Fatty tissue is present in varying amounts depending on weight and age.

Benign (Non-Cancerous) Lumps

Fibrocystic tissue is the most common cause of breast lumps in women ages 35 to 50. It is caused by the mammary gland’s response to normal hormonal changes. The lump may consist of cysts, or there may be fibrous changes. Tenderness is often a factor. These changes usually improve after menopause. Often, symptoms of fibrocystic changes can be reduced by eliminating caffeine. Vitamin E and evening primrose oil can also be helpful. If you want more information, ask for our booklet on fibrocystic breasts. Simple cysts are single or multiple fluid filled sacs. Theses may be easily treated in the office by needle aspiration.

Fibroadenoma is a solid tumor occurring most commonly in women between ages 18 and 35. It is freely moveable and usually non-tender. It may be treated by removal. Fibrodenoma
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Papillomas are small growths of the lining of the mammary ducts that can produce a clear or bloody discharge from the nipple. Intraductal Papilloma
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Maligant Tumors

Malignant tumors are usually single, hard and painless. They develop from mammary ducts and glands. If not removed, these lumps continue to grow in an uncontrolled manner spreading to the lymph nodes, and eventually into the blood stream and distant organs such as the brain, lungs, liver and bone.

Cancerous Tumor

Your Medical Evaluation

Your surgeon will perfom a complete history and physcial exam with particular attention to examination of the size, location and consistency of any lumps. A mammogram and/or ultrasound may be ordered. In some cases, the lump may be evaluated in the office by performing a fineneedle aspiration or a larger “core needle” biopsy.

Breast Biopsy

There are several methods for performing a biopsy of a breast lump. Click here for information about Breast Biopsy. All or part of the lump may be removed. The surgery may leave a small scar, but should have little effect on the countour of the breast itself. Biopsy is usually done on an outpatient basis.

Abnormalities on Mammogram or Ultrasound

Lumps or other abnormalities such as microcalcifications may be discovered by mammogram or ultrasound. It may not be possible to feel these abnormalities. If they have suspicious characteristics, a biopsy will be recommended.