Ninety percent of lumps are benign and can be due to a whole host of causes, from menstruation to cysts to remnants of an old injury.
Most lumps are treatable or don’t need to be treated. Usually, they aren’t even associated with an increased risk of breast cancer.
Don’t panic if you feel a lump in your breast, but do take it seriously. “It’s important to tell your doctor and to get it checked, but it's more than likely that it will not be breast cancer,” says Lindsay Petersen, MD, a breast cancer surgeon at Henry Ford Cancer Institute in Detroit.
While you don’t need to do a formal self-exam every month, you should be familiar enough with your breasts to notice any changes. “If you feel something that’s different that feels like a marble or an area that all of a sudden feels kind of firm or thicker and you never noticed it before, you need to go to a physician,” says Cynara Coomer, MD, chief of breast surgery and director of the Florina Rusi-Marke Comprehensive Breast Center at Staten Island University Hospital in New York City.
Other symptoms that should definitely be discussed with your doctor include new or worsening pain in your breasts; breast changes that don’t go away after your period ends; any lumps that grow; or discharge from your nipple.
If you feel a lump in your breast, here’s what you and your doctor might find that’s not cancer.
Many women get lumps and other changes in their breasts before and during their period. These are relatively easy to recognize because they come and go in rhythm with your menstrual cycle. “You’ll find the lump one week and not be able to find it the next,’ says Dr. Petersen. “That’s normal.”
Period-related lumps often come with achiness in both breasts. Try over-the-counter pain meds or creams and make sure your bras fit well to limit the discomfort. Some women also swear that cutting back on caffeine helps, but the evidence is spotty.
Fibroadenomas are a common type of non-cancerous breast lump, especially in younger women. They're made up of breast gland tissue and connective tissue. “They feel kind of rubbery,” says Dr. Petersen, “and they’re mobile and can scoot around in the breast.” They also usually don’t hurt.
Doctors can often tell if a lump is a fibroadenoma from either an ultrasound or a mammogram.
If a fibroadenoma is less than 2 centimeters, it’s called a simple fibroadenoma and doesn’t have to be treated, Dr. Petersen says. A simple fibroadenoma may even shrink on its own and does not raise your risk for breast cancer.
Complex fibroadenomas are bigger than 2 centimeters and have an irregular shape. This type of mass can increase your risk of breast cancer slightly, and your doctor may want to biopsy it, Dr. Petersen says.
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Fibrocystic breast changes
Breast fibrosis means you have extra connective tissue in your breast that can feel lumpy. This is the same kind of tissue that makes up ligaments and scar tissue. Fibrosis affects about half of women sometime in their life and is more common between ages 30 and 60.
Cysts are small fluid-filled sacs, which are usually round and can also move around your breast. They can hurt, and the pain often gets worse before your period. Cysts go hand-in-hand with fibrosis. In fact, you won’t get a cyst unless you have fibrosis first, says Dr. Coomer.
No one knows what causes these fibrocystic breast changes, but they may be linked with monthly hormones. “It’s like a hardening of the breast tissue,” says Dr. Coomer. “We used to call it fibrocystic breast disease, but that sounds like something that needs to be treated. This is denser, more fibrocystic tissue. It’s not something we can treat, nor do we need to treat it.”
However, if an ultrasound reveals that a cyst contains both fluid and solid matter, or only solid matter, you have what’s called a complex cyst. These growths need to be biopsied, as they may up your breast cancer risk slightly.
Necrosis means fat tissue has died, typically due to an injury–like your seatbelt cutting into your breast or being jabbed by an elbow. Surgery and radiation can also result in fat necrosis.
This kind of breast lump isn’t cancer, but it can feel that way. “Sometimes it will feel like a rock-hard mass,” says Therese Bevers, MD, medical director of the Cancer Prevention Center at the University of Texas MD Anderson Cancer Center in Houston. “This can be kind of scary.”
It may be even scarier if the damage doesn’t show up for a year or two after the original injury, by which time you may have forgotten about the incident.
Head to the doctor to check it out–but if it is fat necrosis, you’ll usually leave it alone. “It probably would create more problems if you take it out,” says Dr. Bevers. “Surgery itself is trauma. The concern is you might create another lump.”
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Phyllodes tumors are a rare type of lump representing only 1% of all breast tumors. They grow in leaf-shaped patterns, hence their name from the Greek for “leaflike.”
“A phyllodes mass may be a little bit more lumpy and have multiple nodules,” says Dr. Bevers. Most common among women in their 40s, phyllodes tumors don’t typically hurt.
While most of these growths are benign and don’t increase the risk of cancer, they do need to come out. “Phyllodes tumors will grow uncontrollably,” says Dr. Bevers. About 10% of phyllodes tumors are cancerous, but they don’t usually respond to radiation, chemotherapy, or hormonal breast cancer treatments.
Surgeons usually take out some of the tissue around a benign phyllodes tumor to reduce the chance of it coming back. If the tumor is cancerous, treatment is either a lumpectomy or a mastectomy.
Intraductal papillomas of the breast are tumors made of gland and fibrous tissue as well as blood vessels that grow in the milk ducts and can cause lumps near the nipple. “They’re well defined so we can feel them, almost like a smooth marble in the breast,” says Dr. Coomer.
Papillomas may also cause a clear or bloody discharge from the nipple, and they are most common among women ages 35 to 55. Your doctor will surgically remove the papilloma, along with the part of the duct it grew in.
Having just one papilloma usually doesn’t carry a higher risk of breast cancer. Your cancer risk may be raised, though, if you have more than one, if you develop them at an early age, if there are abnormal cells in the papilloma, and if you have a family history of cancer.