Breast lumps

Overview

A breast lump can manifest as either a firm or soft growth within the breast, exhibiting diverse textures and shapes. It primarily consists of tissue and commonly emerges in the breast or beneath the arm. While the majority are benign, it’s crucial to seek medical evaluation. Treatment for breast lumps varies according to their underlying cause, and in certain cases, no intervention may be necessary.

Symptoms

Breast tissue naturally varies in texture, and while some individuals may have more pronounced lumps than others, symmetry is typically considered normal. Nonetheless, any notable changes, such as the emergence of firmer or distinctly different feeling lumps, should be a cause for concern.

Changes may include:

• Firm, easily moving lump beneath the skin
• Orange-like dimpling of the skin
• Firm and smooth breast lump
• Round or irregularly shaped
• Changes in the nipple, like inversion or discharge
• Colored alteration in the skin

During breastfeeding, a lump might indicate engorgement or a blocked duct. Some may experience periodic breast discomfort associated with the menstrual cycle.
Breast lumps can come from various reasons, and often they are not cancerous. If a lump or any change in the breast is observed, consult a healthcare provider to find out why the lump is there and if any treatment is necessary.

Medical consultation is particularly important when the breast lump is new and feels firm or fixed, if it persists for 4 to 6 weeks without going away, if there is changes in texture, and if the lump is getting larger.

Other symptoms to be aware of include:

• A nipple that has recently become inverted.
• Changes in the skin of the breast, such as alterations in color, crusting, dimpling, or puckering
• Sudden discharge from the nipple, especially if it is bloody.

Causes

Breast lumps can be caused by:

• Breast cysts: These cysts usually develop rapidly around menstruation, and they are more common in people who have not gone through menopause. A breast cyst can have a diameter of few millimeters or reach the size of an orange. They are firm, spherical, smooth sacs inside the breast that are filled with fluid.
• Fibroadenomas: These are common in younger women in their 20s and 30s. They might shrink or grow, especially during pregnancy, while using hormone therapy, or during the menstrual cycle. These lumps are not cancerous. They may feel smooth and can move easily under the skin.
• Fibrocystic breast changes: Changes in the fibrocystic breast associated with the menstrual cycle are typical. Usually, the symptoms improve following a period. The breasts might feel fuller and tender, small fluid-filled sacs and rubbery tissue can make it seem like there is a lump, but it is usually not something to worry about.
• Intraductal papilloma: Commonly visible in an ultrasound, this growth is usually pain-free, but may result in a clear or bloody fluid flow from the nipple. This development in a milk duct resembles a skin tag.
• Lipoma: This is often not a cause of concern. This lump is usually soft and consists of fatty tissue in the breast.
• Infections: Infection in the breast can make a part of the tissue hard. Skin edema, redness in the breast region, and breast soreness are frequently associated with the lump. The lump may result from an abscess, a collection of infected fluid in the breast tissue.
• Injury or post-surgery: Also known as fat necrosis, this breast lump may result from a major injury to the breast tissue or from a post-surgical problem.
• Breast cancer: A lump in the breast is caused by a tumor growing in the breast tissue. The skin over the lump might thicken, change color, or become red. Other signs include dimpled or pitted skin, changes in breast size or shape, nipple discharge, inverted nipples, and swollen lymph nodes in the armpit or near the collarbone. A painless, hard lump in the breast with uneven edges could indicate breast cancer.

Risk factors

Breast lumps can indicate breast cancer, though most are non-cancerous. Various factors contribute to the risk of developing a breast lump, and while some may suggest the presence of cancer, others do not.

Non-cancerous risk factors include:

• Age: Breast lumps caused by fibroadenomas, and fibrocystic changes are more likely to develop among women in their 30s and 40s.
• Menstrual cycle: Due to excess fluid in the breast on or before period, a lump may develop.
• Pregnancy: Glands that produce milk multiply and enlarge, which may result in lumps during pregnancy.
• Premenopause: Breasts may feel more sensitive and lumpier due to hormonal changes when approaching menopausal stage.

Breast cancer-related risk factors include:

• Alcohol consumption: Breast cancer is more likely to develop with an increased alcohol consumption.
• Being female: Breast cancer is far more common in women than in men.
• Delayed childbirth or not giving birth: Women who have their first child after the age of 30 or who have not had children may have a slightly higher risk of breast cancer.
• Dense breasts: Having thick breast tissue increases the risk of breast cancer. They usually contain less fatty tissue and more glandular and fibrous tissue.
• Early menstruation or later menopause: A marginally elevated risk of breast cancer is associated with menopause after the age of 55. Women who begin their period before the age of 12, has also an increased risk of breast cancer.
• Genetics: The most frequent cause of inherited breast cancer is a mutation in either the BRCA1 or BRCA2 gene. Genetic alterations are inherited from parents to offspring.
• Growing older: Tests typically detect breast cancer in adults 55 years of age and older. The risk generally increases with age.
• Having family history of breast cancer: If a parent or sibling, or other close family, also had breast cancer, the likelihood of developing the disease is increased.
• Having non-cancerous breast conditions: Breast cancer is more likely to develop from non-cancerous breast conditions, such as lobular carcinoma in situ (LCIS), atypical ductal hyperplasia, and atypical lobular hyperplasia.
• Hormonal birth control: Some forms of hormonal birth control, such as birth control pills, shots, and intrauterine devices (IUDs), may slightly increase the risk of breast cancer.
• Hormone therapy: Breast cancer risk is higher among women who had hormone therapy for a long period, particularly estrogen combined with progesterone.
• Lack of exercise: Breast cancer risk increases with not engaging in regular physical activity.
• Not breastfeeding: Breastfeeding has protective effects against breast cancer. Women who do not breastfeed their babies may have a slightly higher risk of developing breast cancer compared to those who breastfeed.
• Obesity: After menopause, women who are overweight have an increased risk of breast cancer.