Breast Lump

Having a lump in your breast may be alarming. On the other hand, a breast lump is a growth, a mass, or swelling in or around your breast or armpit. A breast lump can be due to common benign breast cancer; however, the presence of a lump does not always point to cancer. Common causes of benign lumps include changes in breast tissue, cysts, adenomas, injuries, and infections, which seldom occur. Whereas benign lumps have smooth edges and when pressed, can be moved a little.

Characteristics of a Breast Lump

Tender or soft
Smooth or dimpled
Moveable or fixed
Circular or irregular shape
Large or small
Tender or painful
Even changes in your nipple, inversion, or fluid discharge can be experienced.

Always notify your doctor if you find any new breast change.

Common Causes of Breast Lumps

1. Fibroadenomas: These are the most common type of benign lump. They are generally round and solid and feel rubbery. They are generally painless and movable. More common in women between 20 and 30 years, and more often in African-American females, they may need to be removed by surgery.

2. Fibrocystic Changes: The hormonal changes that occur with menstrual cycles can lead to the formation of cysts within the breasts. This can cause them to feel lumpy and tender, especially just before menstruation. Fibrocystic changes are extremely common in women aged 35-50.

3. Simple Cysts: These fluid-filled sacs come in different sizes and are tender; they may undergo changes in the course of the menstrual cycle. They may be aspirated using fine needle aspiration or otherwise resolve spontaneously.

4. Intraductal Papillomas: Small, wart-like growths, these occur in the milk ducts and might result in nipple discharge. Generally, they affect women between the ages of 30 and 50. Surgical removal is often prescribed.

5. Traumatic Fat Necrosis: After a blow to the breast, fat cells can come together into firm lumps. These will often need a biopsy to confirm but otherwise will not require treatment.

How Many Breast Lumps are Malignant?

While breast lumps can be malignant, only one in five actually are. The remainder have other causes to include:

Fluid-filled sacs, most common before menopause. Fibrocystic changes may lead to the development of rubbery tissue and cysts. Fibroadenomas are usually benign lumps, which are common in younger women. Calcifications are formed from calcium deposited following surgeries or even procedures. Lipomas are usually made of slow-growing fat lumps beneath the skin. Infections of the breast can present as painful lumps, including painful abscesses. Menstrual changes may cause lumps associated with hormonal fluctuations that usually get resolved over time. Some breastfeeding issues, with clogged milk ducts, may be related to painful lumps.
Whatever the cause, it is important that you see your doctor about any lump or change in your breast.

Breast Cancer Lump Symptoms

Breast cancer lumps can differ, but these lumps often feel:

Hard: Sometimes these lumps have clear margins and can become less movable over time.
Irregular: Cancerous lumps sometimes cause skin indentation or puckering.
Tender: Some lumps produce localized pain.
P flattering Nipple: An inverted nipple or any discharge from the nipple may point to some problem.

Types of Breast Cancer Lump:

Ductal Carinoma In Situ: This is a kind of cancer that affects only the milk ducts.
Invasive Ductal Carcinoma: Most common type of breast cancer; it originates from the milk ducts and spreads out.
Invasive Lobular Carcinoma: A rare form of cancer originating in the lobes and spreading to other places.
Inflammatory Breast Cancer: A very aggressive cancer that may cause redness and swelling.

Can Men Get Breast Lumps?

Yes, men can get lumps of the breast. Though rare, men can get breast cancer, especially lumps close to the nipple. Transgender men and transgender women may be at higher risk for breast cancers due to varying hormone therapies and surgeries. Gynecomastia is a condition of rubbery lumps under the nipples of men that is not cancerous.

Can a Breast Lump Mean Infection?

Infections of the breast can cause painful lumps. While most infections occur in women who are breastfeeding, anyone can develop an infection. If the infection is not treated, an abscess may form.

Mastitis: This is an infection of the breast which makes it become inflamed, often painful and swollen, and symptoms similar to flu. Treatment usually comprises antibiotics, killers, and advice on breastfeeding.

What Should I Do if I Find a Lump?

If you find anything new – a lump, for example, or some thickening, or redness, or discharge – see your doctor. Your doctor will check your breast and may send you for a mammogram, an ultrasound, or a biopsy to find the cause.

Monitoring Breast Health

The first two important ways to know your breasts are through regular self-examinations and professional screenings. The sooner a change in your breast is detected the more likely it is that a life can be saved. Here’s how you can monitor your breast health:

1. Breast Self-Examination (BSE):

A breast self-examination is the first step in knowing what your normal breasts feel and look like and being able to tell if something has changed.

When to Start: Begin monthly self-exams at age 18.
When to Perform: Do it right after your period stops, or if you are not menstruating, select a date each month that is easy to remember. Where to Note: Record anything in a journal or an app that will allow you to track changes over time. Steps for Breast Self-Examination:
In Front of a Mirror (Visual Check): Stand undressed with your arms at your sides. Check for any visual changes in the size, shape or texture of your breasts. Repeat with your arms raised and hands on your hips.
While Standing (Tactile Check): Use your finger pads to apply pressure in a circular manner over your entire breast, including underneath your armpit and around the nipple. First, use light pressure, working gradually to deeper pressure. Feel for any lumps, thickened areas, or unusual textures. Squeeze your nipple to check for discharge.
Lying Down (Tactile Check): Lie on your back and place a pillow under your shoulder. Feel each breast with the opposite hand. Use the same pattern described for the standing check.

2. Mammograms:

Mammograms are low-dose X-rays of the breast and are the most effective tool as far as early detection of breast cancer is concerned because they can find cancers before they are big enough to be felt.

When to Start: The American Cancer Society suggests that cis-women of average risk of breast cancer start having annual mammograms beginning between ages 40 to 44 years old.
After Age 55: You may switch to getting mammograms every other year.
High-Risk Individuals: If you come from a family affected by breast cancer, or you carry specific gene mutations, like BRCA1 or BRCA2, then begin the annual mammogram and breast MRI at age 30.

Breast Health for Transgender and Nonbinary

Transgender Women: Those who have received hormone therapy are at a heightened risk for breast cancer and should follow the mammogram recommendations for cisgender women, based on age and risk profile.
Transgender Men: Individuals who have undergone top surgery still retain breast tissue and should be discussing a tailored approach to the screening of breast cancer with their physician.
Nonbinary People: Guidelines for testing should be personalized, based on past use of hormones or surgery.

Talk with Your Doctor

Personal Risk Assessment: Work with your healthcare provider to assess your personal risk factors for breast cancer and develop a screening plan that works for you.

Any Changes?: If you find a lump or any other changes during a self-exam, such as skin texture changes, swelling, or nipple discharge, consult your doctor promptly.

Key Takeaways:

Most lumps found in the breast are not cancerous; however, it is crucial that you see your doctor as soon as possible to determine whether you have developed a new lump or change. Early detection can save lives.

Sources

American Cancer Society: “American Cancer Society Recommendations for the Early Detection of Breast Cancer,” “Tips for Getting a Mammogram.”.”
Breastcancer.org: “The Confusing World of Breast Cancer Screening for Transgender People.”Dana-Farber Cancer Institute: “What Does a Breast Cancer Lump Feel Like?”
U.S. Preventive Services Task Force: “Breast Cancer Screening.”
National Breast Cancer Foundation, Inc.: “Breast Lumps.”
Susan G. Komen: “Types of Breast Tumors.”
StatPearls: “Intraductal Papilloma.”
Cleveland Clinic: “Breast Lumps,” “Breast Self-Exam.”
Mayo Clinic: “Breast Cancer Prevention: How to Reduce Your Risk,” Mastitis.”